Moving and Handling Study guide
Moving and handling care Regulations CQC Outcome 16 Aims and objectives of the session To provide knowledge in safe systems of work, basic principles and legislation and skills in moving objects safely. Terminology Manual handling The Manual Handling Operations Regulations (1992) defines manual handling as any transporting or supporting of a load including the lifting, putting down, pushing, pulling, carrying or moving thereof by hand or by bodily force. What do the Manual Handling Operations Regulations require? The Regulations require employers to: avoid the need for hazardous manual handling, so far as is reasonably practicable ; assess the risk of injury from any hazardous manual handling that can t be avoided; reduce the risk of injury from hazardous manual handling, so far as is reasonably practicable. Hazard Something that has the potential to cause harm. Risk Likelihood that harm will occur and its impact. Risk Assessment Hazards identified, risks evaluated and control measures put in place. Ergonomics Ergonomics is the study of people in their working environment. It adapts the system to the individual to achieve the best possible fit in order to enhance the effectiveness and efficiency with which work and other activities are carried out and to enhance certain desirable human values, including improved safety, reduced fatigue and stress, increased comfort, increased job satisfaction and improved quality of life. The prevention and management of simple low back pain The facts Back pain is extremely common; most adults will experience an episode. In the NHS manual handling accidents account for 40 percent of all sick leave Health care workers have twice the number of back injuries of most other occupations (2008) 80,000 nurses are injured every year, 3,600 have to end their career. The highest compensation to date is 803,000. Responsibility Employer Provision of a safe system of work. Employee Follow appropriate systems provided by employer Everyone assess; avoid; reduce, monitor. In accordance with legislation including the Health and Safety at Work Act 1974 (HSAW). For full details on the Trust s Safe Moving and Handling policy, please visit the Intranet. Trust s policy and procedure Safe Moving and Handling policy. Moving and Handling Risk Assessment. Guidelines for mothers. Risk assessment for expectant mothers, every trimester a risk assessment should take place. Risk assessment on return to work. Control the identified risk. 1
T. I. L. E. O. Task Individual Load Environment Other Factors Lifting and lowering These are guidelines. We cannot impose weight limits on people. Women Men 5kg Shoulder height Elbow height Knuckle height 3kg 13kg 16kg 20kg 25kg 15kg Shoulder height Elbow height Knuckle height 13kg 20kg Mid lower leg height 3kg 5kg Mid lower leg height 2
MOVING AND HANDLING Basic principles Keep the load close to your waist where possible. Stable base. Bend knees. Spine in line. Secure handhold with inanimate objects. Smooth controlled movement. Vary positions. Move with the load. Command Ready, steady, action when lifting with another person. If you move patients you must attend a practical clinical course. Policies / Further reading Safe Moving and Handling policy Contact The Moving and Handling Team for further information: St. Bartholomews, The Royal London and Mile End Hospital: Tel: 020 3594 6815 Mob: 07500 122 403 Newham: Tel: 020 7363 8498 Whipps Cross: Tel: 020 8539 5522 Ext: 6194/5368 MUST DO s Successfully complete the Moving and Handling quiz Book your face to face training session On successful completion of your face to face session your records will be automatically updated. Load Handling Staff Staff involved as part of their duties in the moving and handling of inanimate loads, will require principle-based practical instruction on strategies and approaches for safely moving and handling inanimate loads, relevant to their role in the organisation. 3
Moving and handling (low risk staff) (Low risk staff include: medical laboratory assistant, junior medical technical officer, housekeeper, healthcare scientists, patient experience team, occupational health, simulation centre staff, sexual health technician, nuclear medicine technologist.) If you need further clarification, please contact the moving and handling teams. If you or members of your staff are involved in the direct moving and handling of patients then it is your responsibility to book yourself or your staff on a clinical moving and handling course. This training is not only aimed at protecting you from an injury, it is also about how to move patients in a safe and dignified manner. Evidence clearly illustrates that departments which are trained in moving and handling will have fewer episodes of staff sickness. Pressure sores are also reduced within these clinical areas. The moving and handling team accepts that there are some clinical staff who will never be expected to move and handle patients, but will have some contact with patients. Examples of low risk staff could be sexual health or audiology. If you are required to hoist or move patients on a bed or couch, or assist people with impaired mobility to transfer and walk, then you must book on a course immediately if you are non-compliant. The moving and handling service can consider training that is bespoke to the needs of specific areas where these may differ from standard needs, and where this would be more effective to deliver. The falling patient This could happen in any work area or department and could be for a number of reasons. This could be due to a faint or even a slip or trip. Instinctively in these types of situations, people often try to help, and can cause more harm to themselves or the patient. Therefore the Moving and Handling Team would like to provide some guidance on what to do in these circumstances. Prevention of falls is the best way forward. For further information on reducing harm associated with falls, see the four harms and nutrition section. Consider picture 1 above Picture 1 In this situation, there is nothing that can be done safely. If the member of staff rushed to hold the patient then they would probably end up hurting themselves or even the patient. In this situation the best thing that can happen is that the member of staff calls for help so the patient can be checked for any signs of injury following the fall. Patients must not be lifted manually from the floor and should always be checked by a member of the team for spinal injuries. A flat scoop type hoist stretcher instead of a soft sling may be needed where there is suspected spinal, hip, femur, or shoulder injury. Do not ask other staff to manually lift the patient, as the correct mechanical aid must be found to retrieve the patient to a safe area. Picture 2 shows a member of staff next to the patient and it is in these circumstances you may be able to help facilitate the fall to reduce harm to the patient if you consider it safe to attempt this. If the patient is much taller or larger than you or you have increased vulnerability it may not be safe. If the patient is feeling faint or unsteady call for help someone could bring a chair to sit the patient down. Reassure them. 4
MOVING AND HANDLING Picture 2 Walking with patient Consider picture 3 below the patient is now falling and you are right next to them. Observe how the member of staff has adopted a wider stance and has stepped slightly behind the patient, enough to get away if required. Once behind the patient, place one foot in front of the other and form a stable base with the front knee bent more than the back knee. With both hands open, grasp the person by holding onto their trunk, near their hips. Allow the patient to slide down the front leg until they land safely to the floor. It is important that you do not hold underneath the patient arms (axilla). This could dislocate the patient s shoulder. You are not at this point trying to hold the patient up. Your aim is to try and minimise the impact of the fall. Handlers should avoid flexing their spine, and allow the patient to slide, to minimise any risk of you becoming trapped. Picture 3 Position to steady patient or allow to slide down to floor Picture 4 below shows the patient fallen to the floor. The member of staff has bent her knees as far as she can go and is supporting the shoulder area at this point. Be careful to not hold onto the patient s head as they are falling since this could cause a significant neck injury. 5
A video of how to mange a fall can be seen at the moving and handling page on the Intranet: http:// bartshealthintranet/about-us/corporate- Directorates/Academic-Health-Sciences/ Education-academy/Nursing-midwifery-and- AHPs/Moving-and-Handling/Index.aspx then follow the link to videos. Key Organisations The Health and Safety Executive http://www.hse.gov.uk/ National Back Exchange http://www.nationalbackexchange.org/ References Picture 4 Patient fallen to the floor Picture 5 below shows the staff member s position following the fall. The member of staff is staying with the patient while she calls for help. The staff should kneel behind the patient. Her intervention reduced the velocity of the fall and in doing so reduced the severity of the injury the patient may have suffered during the fall. However, remember why the patient fell in the first place and that this will need to be resolved. Health and Safety Statistics 2014/15, HSE www.hse.gov.uk Source: Labour Force Survey. The Guide to handling of people (HOP 6 Edition). Backcare: London Further reading (available via the Barts Health Trust Intranet click on link below) Safe Moving and handling Policy Back care for office workers Guidance for safer handling during cardiopulmonary resuscitation http://bartshealthintranet/education-and-training/ Education-Academy-Services/Nursing-midwifery- AHPs/Moving-and-Handling/Resources.aspx Low Back pain in adults: early management clinical guideline [ CG887] Published date: May 2009 https://www.nice.org.uk/guidance/cg88 Picture 5 Following the fall 6