Manual Handling Policy

Transcription

1 Manual Handling Policy Document Reference Document Status Version: POL028 Approved V6 DOCUMENT CHANGE HISTORY Initiated by Date Author (s) Health and Safety 22 nd September 2008 Danny Daniel Health, Safety and Security Manager Committee Version Date Comments (i.e. viewed, or reviewed, amended approved by person or committee) V5.01 October 2015 Reviewed by Health and Safety Team V5.02 October 2015 Reviewed by the health and safety committee V5.03 December 2015 Updated by H&S Officer V5.01 October 2015 Reviewed by Health and Safety Team

2 Document Reference NHSLA Standards; 1.2.9, Relevant Trust objective; Health and Safety Directorate: Human Resources Recommended at Date Approved at Date Approved Review date of approved document: Equality Impact Assessment Linked procedural documents Dissemination Requirements Document Control Health and Safety Committee October 2015 Integrated Governance Committee October 2015 Executive Leadership Board 3 March 2016 March 2018 unless prompted earlier by statutory regulations Completed Health and Safety Policy Health and Safety Strategy Risk Management Strategy Vehicle Daily Inspection form Learning and Development Policy Occupational Health and Wellbeing Policy All staff via , intranet and through Line Managers for staff who do not have access to IT. This policy will be held on a central database and controlled and archived through the Governance Compliance Unit The East of England Ambulance Service NHS Trust has made every effort to ensure this policy does not have the effect of unlawful discrimination on the grounds of the protected characteristics of: age, disability, gender reassignment, race, religion/belief, gender, sexual orientation, marriage/civil partnership, pregnancy/maternity. The Trust will not tolerate unfair discrimination on the basis of spent criminal convictions, Trade Union membership or non-membership. In addition, the Trust will have due regard to advancing equality of opportunity between people from different groups and foster good relations between people from different groups. This policy applies to all individuals working at all levels and grades for the Trust, including senior managers, officers, directors, non-executive directors, employees (whether permanent, fixed-term or temporary), consultants, governors, contractors, trainees, seconded staff, homeworkers, casual workers and agency staff, volunteers, interns, agents, sponsors, or any other person associated with the Trust. All Trust policies can be provided in alternative formats Contents

3 Paragraph 1. Introduction 4 Page 2. Purpose 4 3. Definitions x 4 Duties x 4.1 Duties General x 4.2 Employees x 4.3 Risk Assessment x Items of Equipment Training Monitoring Review References x Appendices Appendix A Generic Risk Assessment Guidelines x Appendix B Monitoring x Appendix C Equality Impact Assessment Summary x 1. Introduction 1.1 Evidence shows that Manual Handling is one of the biggest causes of injury to Employees in the United Kingdom.

4 1.2 It is the responsibility of the Trust to ensure so far as is reasonably practicable that all manual handling is kept to a minimum, thereby reducing incidents to our staff and reducing sickness absence. 1.3 Complete avoidance of moving and handling is not possible to achieve, when our main function as an organisation is the care and transportation of patients and other tasks that require moving or handling. Clearly the Trust needs to balance its responsibilities under the Health and Safety at Work etc., Act 1974, with the need to provide the public with an appropriate level of emergency service. 1.4 The Manual Handling Operations Regulations 1992 (MHOR) lay down duties on employers to avoid hazardous manual handling activity, as far as is reasonably practicable, to make a suitable and sufficient risk assessment of any hazardous manual handling operation that cannot be avoided and, to reduce the risk of injury from such an operation to the lowest level reasonably practicable. 1.5 A manual handling operation is defined as the transporting or supporting of any load (including persons) that involves the use of hand, body force or equipment. This includes lifting, pushing, pulling, carrying or moving the load. 2. Purpose 2.1 The purpose of this policy is to set out how the East of England Ambulance Service NHS Trust will minimise manual handling operations and ensure a structured approach to moving and handling, in line with the Trust s Risk Management Strategy, the Health & Safety Policy and the relevant statutory provisions. The definition of staff and employees used within this document includes both contractors and volunteers working on behalf of the Trust. The Trust recognises that manual handling could be a contributory cause of musculoskeletal injuries to staff. 3. Definitions The Trust The Policy Staff East of England Ambulance Service NHS Trust The Trust s Manual Handling Policy Includes both contractors and volunteers working on behalf of the Trust as well as full and part time staff. 4. Duties 4.1 General The Trust has a designated Director who is responsible for keeping the provisions within this policy in line with employment legislation, best practice people management principles and NHS guidelines. This is the responsibility of the Director of Nursing and Clinical Quality The Clinical Quality Directorate, People, Development and Education Team (PDE), Health, Safety & Security Officer, Safety and Risk Lead and the Health, Safety and Security Advisors can advise on matters relating to moving and handling. All of which can be contacted via the Trusts switchboards or for OH via the internet on Managers, HR staff and Trade Union representatives are responsible for providing advice and

5 guidance to employees on the application of this policy and procedure The Consultant Paramedic is responsible for the provision of training for moving and handling to all staff via; The Training department - responsible for ensuring that all staff are trained in appropriate techniques for moving handling patients and objects including the use of appropriate equipment, appropriate to their role and the process for undertaking dynamic risk assessments prior to any manual handling activity. The PDE Team - responsible for identifying training needs for all staff within a Training Needs Analysis, and for producing appropriate written information and instructions Line Managers are responsible for ensuring staff receive appropriate information, instruction and training and where practicable monitoring staff in their application of this policy. Staff are responsible for maintaining best practice The Medical Devices and Vehicle Working Group will investigate and recommend appropriate equipment for moving and handling pertaining to their area of expertise All incidents, reported as a consequence of manual handling activities where staff have been absent from work as a result of the reported incident for more than 3 working days, will be investigated by an appropriately trained, identified manager. 4.2 Employees The Management of Health and Safety at Work Regulations 1999 and the Health and Safety at Work etc., Act 1974, require employees to make use of appropriate equipment provided for them, in accordance with their training and the instructions their employer has given them The MHOR requires employees to follow appropriate systems of work laid down by their employer to promote safety during moving and handling activity. These provisions do not preclude well-intentioned improvisation in an emergency, for example during efforts to rescue a casualty Staff are responsible for maintaining sufficient fitness for their individual duties. They must report any condition or injury they have, which may increase the risk of incurring further injury during moving or handling to their Line Manager, who will seek the appropriate advice from Occupational Health and/or Occupational Health Nursing Advisors (OHNA) prior to action being taken In accordance with the MHOR and the Trust s Maternity Leave Policy, anyone whose job involves moving or handling must inform their line manager as soon as they are aware of their pregnancy, so that a specific risk assessment can be undertaken All staff are encouraged to offer suggestions to improve moving and handling practice Staff are responsible for ensuring that all manual handling equipment is checked on a daily basis using the appropriate daily vehicle inspection form Staff will be made aware of how to defect manual handling equipment and the forms that need to be completed.

6 4.2.8 Staff are responsible for reporting any moving and handling incidents or injuries on the appropriate incident form so that it can be investigated by their line manager Within the Learning & Development Policy it is documented that all staff must complete mandatory training. If staff fail to attend training then measures will be put in place to ensure all staff are updated. 4.3 Risk Assessments A number of generic risk assessments have been carried out and are well documented. However, these cannot cover all situations encountered in the working environment. It is imperative therefore that staff undertake specific manual handling individual dynamic risk assessments prior to any moving or handling as described within Appendix A The generic assessments will be reviewed every five years and/or if the nature of the work changes and/or if developments suggest that the assessment is no longer valid (for example, following an incident investigation) The Trust has a duty of care to ensure appropriate alternative arrangements are made, where possible, where extraordinary manual handling is required Operational staff will need to assess the patients clinical condition before deciding the correct course of action to take, to remove the patient from scene to transport utilising the appropriate equipment. Where the risk assessment identifies that additional resources are required for the safe movement of the patient, staff should contact their Emergency Operations Centre for assistance Where risk assessments identify aspects of best practice or techniques to reduce risks, these will be communicated to staff through the appropriate channels Where additional risks are identified, an action plan will be formulated by the locality management. This will then be monitored by the Health and Safety Committee and the Health and Safety Working Group Specific assessments will be arranged by Occupational Health for staff who inform the Trust that they are pregnant. 4.4 Items of Equipment There are a number of pieces of equipment to reduce the risks associated with manual handling for use within the Trust e.g. longboard, Mangar Elk, carry chair, manual handling kits, orthopaedic stretcher, mail trolleys, roll cages, sack barrows etc. This is not an exhaustive list The VWG and Medical Devices Groups will evaluate a variety of patient moving and transfer aids for their suitability in a pre-hospital environment New items of equipment will only be introduced after the following have been carried out: Risk assessment produced (PUWER. LOLER and operational) Safe working procedure written

7 Staff have received appropriate training An appropriate trial has been undertaken with full evaluation reports being made available. 5. Training 5.1 Staff will be provided with up to date training in moving and handling, which includes the agreed techniques for the use of moving and handling equipment, posture, body mechanics, risk assessments, causes and prevention of musculoskeletal injury. Such training is mandatory on commencement of employment. This training is stipulated within the Training Needs Analysis from the Learning Development Policy. This looks at both initial training and professional update training for all staff, contractors and volunteers. 5.2 Moving and handling training has been designed to ensure that staff are able to assess risk for themselves, and adopt the most appropriate moving and handling strategy, use the correct type of equipment and adopt the safest system of work that reduces the risk of injury. This should take account of assessment of task, load, environment and individual capability (Appendix A.) The Trust uses a published manual of moving & handling for the training of all staff. 6. Monitoring 6.1 All manual handling incidents need to be investigated by an appropriately trained line manager to ascertain the root cause of the incident (see also 4.1.7). Where additional controls are identified, action plans will be devised, implemented and monitored at a local level and by the Health and Safety Committee. 6.2 All incidents relating to Moving and Handling will be reported on the DATIX risk management system and reports will be generated. 6.3 All reportable incidents, including manual handling will be discussed and monitored quarterly by the Health and Safety Committee and Health and Safety Working Group, notes of which will be submitted to the Clinical Quality Committee to enable independent monitoring and to provide Board assurance. 6.4 Proactive monitoring will also be undertaken by managers during staff assessments. These completed assessments will be monitored by an appropriately nominate manager. 7. Review This Policy will be reviewed every two years by the Health and Safety Committee or earlier if prompted by changes in legislation. 8. References Health and Safety at Work etc., Act 1974 Manual Handling Operations Regulations 1992 (as amended) Management of Health and Safety at Work Regulations 1999 Health and Safety (Consultation with Employees) Regulations 1996.

8 Safety Representatives and Safety Committees Regulations (SRSCR) National Health Service. (2005). Manual Handling Training Guidelines Policy. Appendix 1 Generic Risk Assessment Guidelines Generic risk assessments will not cover all eventualities and staff should undertake an on the spot dynamic risk assessment prior to carrying out any moving and handling task following the TILE principle. The Trust s moving and handling techniques can be found in the relevant Mandatory Training Workbook, however specific techniques on the moving of objects and the use of equipment are delivered through the mandatory training programme. Should further specialist advice be sought, staff should contact the Health, Safety Officer for guidance. The TILE Principle

9 T I L E is for Task. It is worth stopping to think through exactly what you are going to have to do to complete the manual handling task (from House to Hospital) before you start. There may be an easier way. is for Individual. That s you! Always ask yourself am I physically capable of doing the task we are about to undertake? If the answer is no, then do not try. is for Load. How heavy is the patient? What is their physical and mental condition? What can they do to help? is for Environment. What hazards are there that will make your job difficult? Can you ask for things to be moved? Are there problems on your route from house or scene of the incident to the ambulance? Is there a better route? The following tables identify particular issues that have the potential to increase the risk of injury during moving and handling operations and how the risks may be reduced. Does the Task involve: Holding or manipulating the patient at a distance from the trunk? Can you clear the working area to get closer to the patient/load or manoeuvre the patient/load into a more suitable position before handling? Twisting the trunk? Could changing your body position to face the intended direction of movement or side-stepping prevent twisting the trunk? 95% of all MH injuries are as a result of twisting. Stop twisting stop injuries. Stooping? Try to keep your back straight when dealing with any patient/ loads,, even when not actually moving them. Reaching upwards? Can you lower the load to a more suitable height or stand on a stable, elevated base? Excessive vertical movement? Can you alter the working area to allow a mid-point resting point? Excessive carrying distance? Can you alter the working area to reduce carrying distance and allow a mid-point resting place? Try to incorporate self-paced rest pauses. Excessive pushing and pulling? Try to incorporate self-paced rest pauses or job rotation to allow one set of muscles to rest whilst another is used.

10 Prolonged physical effort? Try to incorporate self-paced rest pauses. Risk of sudden movement of load? Can the patient/load be secured during manoeuvre? Be aware of the risk of sudden collapse or spasm of the patient. Team lifting? Appoint one person to co-ordinate the movement and ensure all team members are clear about the word of command. Remember some team members will be moving backwards and will not be able to see where they are going. A team can be two people. INDIVIDUAL CAPABILITY Does the operation: Require unusual strength? Try to estimate the weight of the patient/load and consider this against your own moving and handling capability at that moment in time. Bear in mind that your moving and handling capacity may have reduced due to fatigue. Request assistance if necessary. Create a hazard to those with health problems? Remember your moving and handling capacity can be reduced if you are ill or have a history of back injury. Require special information or training? Always utilise the moving and handling techniques and specialised equipment or moving and handling aids provided in accordance with your training. Remember it is your responsibility to use the equipment that the Trust has provided. IS THE LOAD: Example Heavy? All patients (except the lightest of children), filing cabinets, desks, beds, laundry bags to name but a few items, should be regarded as exceeding the HSE guideline weights. Try to estimate the weight of any load and consider this against your own individual moving and handling capability at that moment in time. Where possible always use mechanical means to reduce the weight on the body such as the Mangar Elk, a sack barrow, cylinder trolley etc. Request assistance if necessary and refer to the Bariatric pathway in your clinical manual for larger patients.

11 Bulky or unwieldy? All human bodies, large packages, cabinets, ladders etc are unwieldy, even more so if equipment is attached to the item. Try to check the route for any problems that might arise during the manoeuvre. Move any furniture which is going to mean twisting around it. Difficult to grasp? Not all items being moved have suitable handles or hand holds. Where possible use handling equipment and aids provided by the Trust. Likely to move in an unpredictable manner, uncooperative or potentially violent? Patients, boxes with several items in them etc. are likely to move in some way causing the centre of gravity of the patient/load to move. This shift will cause you to move your body to compensate. Where at all possible repack the load to ensure minimal movement and be aware of the potential for patients moving. Trust incident data has identified that patients are more likely to make this movement when they are being carried down stairs on a carry chair as they feel nervous and tend to grab hold of the stair handrail. Apply appropriate harnesses or restraints. Unable to move independently or unable to offer assistance during the operation? Consider if the patient s medical needs and physical capabilities require you to lift and carry the patient or whether the patient can walk with your assistance. The working ENVIRONMENT Are there: Space constraints preventing good posture? Can you reposition the load into a more suitable position? Check your route for obstacles. Try to clear any furniture or obstacles to create adequate floor space, headroom and elbowroom to conduct the operation. Uneven, slippery or unstable floors? Try to check the route that you will take for any tripping hazards e.g. spillages, loose or ripped carpet, polished surfaces, potholes, broken flagstones etc Variation to floor level? Can you use a ramp or elevator? If not, rest pauses at suitable locations.

12 Poor lighting? Switch on any available light sources and request supplementary lighting if necessary. Following this assessment, you should make a judgement as to whether you can reduce the level of risk enough for the operation to be within your own capability. If you are working as part of a team the decision should be a joint one. No one should be pressurised into moving and handling beyond their capability by somebody else. With excessively heavy loads it will be easy to make a no-lift decision and request assistance due to the physical impossibility of lifting the load unaided. It will be much harder to make that decision when a patient is marginally beyond your capability and it is probable that the urgency of need of specialist medical attention will sway your decision in these circumstances. All employees are required to follow appropriate safe systems of work to promote safety during the moving and handling operation. However the Trust recognises that Regulation 5 of the Manual Handling Regulations does not preclude well-intentioned improvisation in an emergency, for example during the rescue of a critically ill or injured patient. These are the situations that are most likely to result in injury because you know you could move the patient, albeit with some difficulty, and you do not want to delay getting the patient to hospital by waiting for help to arrive.

13 What Who How Frequency Evidence Reporting arrangements Acting on recommendations APPENDIX 2 Change in practice and lessons to be shared This Policy The Policy is the responsibility of the Health and Safety Committee which is chaired by the Director Nursing and Clinical Quality who is the nominated Director for Health and Safety in the Trust This Policy will be reviewed every two years or when circumstances indicate that it is no longer valid Every two years Health & Safety Committee Minutes ELB Minutes Minutes of Meetings The Director of Nursing and Clinical Quality, Safety and Risk Lead and the Health, Safety & Security Officer will monitor this policy. The policy will be communicated to all staff via the internal intranet. Those staff who do not have access to this format will be informed by their manager and a copy of the policy will be placed on the premises notice board. Duties of staff Each department and individuals within the Trust have their duties identified within the policy Managers at all levels of the organisation are responsible to ensure compliance with the policy. All incident reports are investigated and learnings and outcomes are identified as necessary. Each manager within the trust has the responsibility to audit their staff on a regular basis. Inspection reports Audit reports. The Health & Safety Committee receive quarterly reports of all key issues identified during these inspections and action is taken where local agreement has not been reached. Managers act on recommendations. Where this does not happen it is escalated to the next level. Where changes are required they will be communicated to all staff using the Trust system, the intranet or via managers for those staff who do not have access to PCs.

14 What Who How Frequency Evidence Reporting arrangements Acting on recommendations Change in practice and lessons to be shared Techniques to be used for manual handling The training department is responsible for ensuring that the staff are trained on how to move a patient or object in a safe manner and where appropriate to use the trust provided manual handling aids Initial training for all A&E and PTS staff Induction training for support staff Professional update (PU) Clinical Manual Trust Handle with Care Book Manual handling is covered on PU every year Sign off sheets Attendance sheets Any issues identified are brought to the attention of the local manager to investigate and if necessary this is also brought to the attention of the Health and Safety Committee. Managers act on recommendations. Where this does not happen it is escalated to the next level. Where changes are required they will be communicated to all staff using the Trust system, the intranet or via managers for those staff who do not have access to PCs. Specialist Advice The trust has a cadre of BTec trained Manual Handling advisors who can advise on manual handling and also currently use an external agency for advice who belong to the Back Care Association Following an incident or sickness absence As required Incident reports OH referrals Any issues identified are brought to the attention of the local manager to investigate and if necessary this is also brought to the attention of the Health and Safety Committee. Managers act on recommendations. Where this does not happen it is escalated to the next level. Where changes are required they will be communicated to all staff using the Trust system, the intranet or via managers for those staff who do not have access to PCs. The Trust OH advisors can also be contacted in the event that specialist advice is needed

15 What Who How Frequency Evidence Reporting arrangements Acting on recommendations Change in practice and lessons to be shared Risk Assessments and Action Plans Generic risk assessments are undertaken of all equipment used by the trust. Staff have the responsibility to dynamic risk assess all moving and handling operations prior to any manual handling activity Specific risk assessments are carried out for certain activities identified following an incident The Trust has an agreed risk Performa which is used. The Trust reviews risk assessments every 5 years or where a situation deems the risk assessment invalid. These assessments are also reviewed following a serious incident to a member of staff, patients or others. Risk assessments. Local managers have the responsibility for populating their local risk register and advising staff and others of the findings of the risk assessment. All staff are required to report incidents to themselves, patients or others on the Trust DATIX incident reporting system. Any issues are reported to the Health & Safety Committee as necessary. The Health, Safety & Security Officer will work with managers to ensure that an action plan is developed and agreed. Where changes are required they will be communicated to all staff using the Trust system, the intranet or via managers for those staff who do not have access to PCs.

16 Equality Impact Assessment Summary Appendix 3 Executive Summary Page for Equality Impact Assessment: Document Reference: Assessment Date: 2 nd June 2011 Responsible Director: Lesley Bradley Conclusion of Equality Impact Assessment: No impact identified Document Title: Manual Handling Policy Document Type: Policy Lead Manager: Danny Daniel Recommendations for Action Plan: None Risks Identified: None Approved by a member of the executive team: YES Name: Lesley Bradley Signature: NO Position: Director of Business Transformation Date: