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Patient Care Ergonomics Training for Healthcare Workers. OSHA Nursing Home Guidelines. OSHA Nursing Home Guidelines. OSHA also saw the need to address this serious problem in the Healthcare Industry…. OSHA Targeted Several Industries – Nursing Home Industry – 1 st Targeted March 13, 2003.

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OSHA Nursing Home Guidelines

OSHA also saw the need to address this serious problem in the Healthcare Industry….

OSHA Targeted Several Industries –

Nursing Home Industry – 1st Targeted

March 13, 2003


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Why has OSHA targeted Nursing Homes?

OSHA recognized that direct care staff in nursing homes experience high numbers of back and other musculoskeletal injuries every year.


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Why has OSHA targeted Nursing Homes?

OSHA targets Patient handling as the greatest risk factor contributing to the majority of injuries, lost & restricted workdays, and worker’s comp costs in Nursing Homes


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Why has OSHA targeted Nursing Homes?

According to OSHA…

  • The nursing home industry injury incident rate is 13.9 injuries and illnesses per 100 full-time workers.

  • This is more than double the incident rate of 6.1 of industry as a whole.

    (US Department of Labor, Occupational Safety & Health Administration. Hospital eTool-HealthCare wide hazards module: Ergonomics. Retrieved 6/12/02 from http://www.osha.gov/SLTC/hospital_etool/hazards/ergo/ergo.html)


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Why has OSHA targeted Nursing Homes?

OSHA summarized these findings:

  • Nursing Home workers suffer most injuries (51.2 %) when handling Patients.

  • 58% of their injuries are strains and sprains.

  • While back injuries account for 27% of all injuries in the private sector, in nursing homes they account for 42% of all injuries.

    (OSHA. (n.d.) Worker safety and health in the nursing home industry. Retrieved 6/10/02 from http://www.osha.gov/NewInit/NurseHome/factsht.html)


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OSHA Guidelines for Nursing Homes: Ergonomics for the Prevention of Musculoskeletal Disorders

Reducing Staff Injury and Improving Patient Safety


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Strategies to Reduce Ergonomic Injuries in ALL Prevention of Musculoskeletal DisordersIndustries

OSHA Outreach & Assistance

  • Consultation Services

  • Compliance Assistance Specialists

  • Regional Office (Atlanta)

  • OSHA Training Institute (OTI)

  • Educational Resource Centers

  • www.osha.gov


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Strategies to Reduce Ergonomic Injuries in Prevention of Musculoskeletal DisordersIndustries

Enforcement

  • General Duty Clause

    Ergonomic Guidelines

  • Act as ‘Guidelines’

  • Offer Best Practices & Sources of Information


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OSHA Guidelines for Nursing Homes Prevention of Musculoskeletal Disorders

Primary Goal…

“Providing an alternative to manual Patient lifting is the primary goal of the ergonomic process in the nursing home setting and of these Guidelines.”


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OSHA Guidelines for Nursing Homes Prevention of Musculoskeletal Disorders

“OSHA recommends that manual lifting of Patients be minimized in ALL cases and eliminated when feasible.”


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Recommendations Prevention of Musculoskeletal Disordersfor Employers

  • Develop Process for Protecting Workers *

  • Identify Problems/Implement solutions for Patient lifting and repositioning *

  • Identify Problems/Implement solutions for activities other than Patient lifting and repositioning *

  • Training * (* included in this Training)


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1. Develop Prevention of Musculoskeletal DisordersProcess for Protecting Workers that…

  • Provides Management Support

  • Involves Employees

  • Identifies Problems

  • Implements Solutions

  • Addresses Reports of Injuries

  • Provides Training

  • Evaluates Ergonomic Efforts


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2 Prevention of Musculoskeletal Disorders. Identify Problems/Implement Solutions for Patient Lifting and Repositioning

  • Analyze needs and abilities of Patients *

  • Use established protocols to determine appropriate handling & movement methods specific for each Patient *

  • Integrate Patient handling solutions & equipment into Nursing Home *


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Making beds Prevention of Musculoskeletal Disorders

Feeding Patients

Lifting food trays

Collecting wastes

Pushing heavy carts

Bending to remove items from a deep cart

Lifting & carrying when receiving & stocking supplies

Bending & manually cranking bed

Removing laundry from washer/dryer

More…

3. Identify Problems & Implement Solutions for ‘Other’ Activities


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Consider employee Prevention of Musculoskeletal Disordersexposure to:

Forceful exertions

Repetitive activities

Awkward postures

Consider these aspects of the 3 types of Exposures:

Duration

Frequency

Magnitude of exposure

3. Identify Problems & Implement Solutions for ‘Other’ Activities

To determine if problems exist with these ‘Other’ activities…


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4. Training Prevention of Musculoskeletal Disorders

Train

  • Nursing Assistants and Other Workers at Risk of Injury

  • Charge Nurses & Supervisors

  • Designated Program Managers


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OSHA Ergonomic Guidelines for Nursing Homes Prevention of Musculoskeletal Disorders

Training Recommendations

for

Nursing Assistants and Other Workers at Risk of Injury


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OSHA Ergonomic Guidelines for Nursing Homes Prevention of Musculoskeletal Disorders

Training for Nursing Assistants and Other Workers at Risk of Injury

  • NH Policies & Procedures to follow to avoid injury, including proper work practices & use of equipment

  • NH Procedures for reporting work-related injuries & illnesses as required by OSHA


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OSHA Ergonomic Guidelines for Nursing Homes Prevention of Musculoskeletal Disorders

Training for Nursing Assistants and Other Workers at Risk of Injury

  • How to recognize Musculoskeletal Disorders (MSDs) and their early detection

  • Advantages of addressing early indications of MSDs before serious injury develops


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Injuries and illnesses affecting muscles, nerves, tendons, ligaments, joints or spine

Some common MSD’s are:

De Quervain’s disease

Epicondylitis

Rotator Cuff Syndrome

Sciatica

Carpal Tunnel Syndrome

What are MSD’s?


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Causes of Workplace MDS’s ligaments, joints or spine

  • Exposure to:

    • Repetition

    • Forceful Exertions

    • Awkward Postures

    • Contact Stress

    • Vibration


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Musculoskeletal Disorders ligaments, joints or spine

  • Lifting and moving Patients can also lead to MSDs

  •  MSDs can happen two ways:

    • Develop gradually and get worse over time (cumulative trauma)

    • Result from a single event (lifting a very heavy Patient)


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Musculoskeletal Disorders ligaments, joints or spine

  • How do you know if you’re developing a MSD?

    • Pain that won’t go away

    • Joints won’t move easily

    • Swelling  


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Signs & Symptoms of MSDs ligaments, joints or spine

  • Decreased gripping strength

  • Decreased range of motion

  • Loss of muscle function

  • Inability to complete daily tasks

  • Pain in wrists, shoulders, forearms, knees

  • Fingers/toes turning white


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Back or neck pain ligaments, joints or spine

Stiffness

Painful joints

Pain, tingling or numbness in hands or legs

Shooting or stabbing pain in arms or legs

Swelling or inflammation

Burning sensation

Signs & Symptoms of MSDs


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Musculoskeletal Disorders ligaments, joints or spine

  • To prevent serious injury…

    • If you think you may be developing a MSD, take care of it NOW!

    • Use lifting equipment to reduce or eliminate the need for lifting Patients and possibly hurting yourself!


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Consequences of not reporting promptly ligaments, joints or spine

  • If you have signs & symptoms that are not reported early, permanent disability may result.

  • Employers are required to respond promptly to those reports.


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OSHA Ergonomic Guidelines for Nursing Homes ligaments, joints or spine

Training Recommendations

for

Charge Nurses & Supervisors


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Training for Charge Nurses & Supervisors ligaments, joints or spine

  • Reinforce safety program at facility

  • Oversee reporting guidelines & implement ergonomic recommendations

  • Ensure proper staff work practices

  • Responses to injury reports


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OSHA Ergonomic Guidelines for Nursing Homes ligaments, joints or spine

Training Recommendations

for

Designated Program Managers


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Training for Designated Program Managers ligaments, joints or spine

  • Problem identification via checklists, injury data analysis

  • Selection of proper equipment & work practices

  • Assist workers implement solutions

  • Evaluate effectiveness of ergonomics


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You Have Help! ligaments, joints or spine

  • This Training Program

  • VA Patient Care Resource Guide: Safe Patient Handling & Movement

  • VA Technology Resource Guide

  • www.patientsafetycenter.com


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You Have Help! ligaments, joints or spine

  • OSHA Ergonomic Guidelines for Nursing Homes www.osha.gov/ergonomics/guidelines/nursinghome/index.html

  • OSHA website www.osha.gov

  • OSHA Compliance Assistance Specialists in OSHA area offices


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You Have Help! ligaments, joints or spine

  • OSHA Regional Office in Atlanta, GA

  • OSHA Training Institute (OTI) Educational Resource Center

  • Cal/OSHA “A Back Injury Prevention Guide for Health Care Providers”(www.dir.ca.gov/dosh/dosh_publications/ backinj.pdf)