CNA Training Advisor

CNA Training Advisor Volume 12 Issue No. 6 JUNE 2014 REDUCING THE RISK OF WORK-RELATED INJURIES Without taking the necessary precautions and adhering to the proper body mechanics, CNAs could be harmed in the process of providing care to a resident to the extent that their work future is jeopardized. Additionally, a resident could suffer an injury that seriously complicates or outright compromises his or her health. This issue of CNA Training Advisor will address how CNAs can reduce the risk of worker-related injuries. This issue will walk you through the proper methods of lifting and transferring a resident under numerous scenarios. In addition, CNAs must know how to assist their unsteady residents who prefer to ambulate. Ergonomics and exercise play a useful role in keeping CNAs healthy. Lastly, as far-fetched as violence on the part of a resident, family member, or caregiver seems, CNAs must be aware of the risk factors for violence and the proper means of avoiding unintended provocation. Have a good day of training, and stay tuned for next month s issue of CNA Training Advisor, which will cover amputation care. Key Terms to Aid Your Understanding Ambulate To walk about or move from place to place Body mechanics Proper use of the body for support, strength, posture, and coordination in order to safely complete a physical task Ergonomics The science of fitting workplace conditions and job demands to the capabilities of employees Quiz answer key 1. d 2. c 3. a 4. a 5. a 6. b 7. d 8. d 9. c 10. b Program Prep Program time Approximately 30 minutes Learning objectives Participants in this activity will be able to: Identify the techniques for lifting and transferring residents Implement exercises that will improve ergonomics for CNAs Recall specific strategies for handling workplace violence while providing quality care Preparation Review the material on pp. 2 4 Duplicate the CNA Professor insert for participants Gather equipment for participants (e.g., an attendance sheet, pencils, etc.) Method 1. Place a copy of CNA Professor and a pencil at each participant s seat 2. Conduct the questionnaire as a pretest or, if participants reading skills are limited, as an oral posttest 3. Present the program material 4. Review the questionnaire 5. Discuss the answers SEE ALSO hcpro.com/long-term-care

CNA Training Advisor June 2014 This document contains privileged, copyrighted information. If you have not purchased it or are not otherwise entitled to it by agreement with HCPro, a division of BLR, any use, disclosure, forwarding, copying, or other communication of the contents is prohibited without permission. EDITORIAL ADVISORY BOARD Senior Director,Product Erin Callahan ecallahan@hcpro.com STAY CONNECTED Product Manager Adrienne Trivers atrivers@hcpro.com Interact with us and the rest of the HCPro community at HCPro.com Become a fan at facebook.com/hcproinc Follow us at twitter.com/hcpro_inc Email us at customerservice@hcpro.com Questions? Comments? Ideas? Contact Product Manager Adrienne Triversat atrivers@hcpro.com or 781-639-1872, Ext. 3207. Don t miss your next issue If it s been more than six months since you purchased or renewed your subscription to CNA Training Advisor, be sure to check your envelope for your renewal notice or call customer service at 800-650-6787. Renew your subscription early to lock in the current price. Relocating? Taking a new job? If you re relocating or taking a new job and would like to continue receiving CNA Training Advisor, you are eligible for a free trial subscription. Contact customer serv ice with your moving information at 800-650-6787. At the time of your call, please share with us the name of your replacement. CNA Training Advisor (ISSN: 1545-7028 [print]; 1937-7487 [online]) is published monthly by HCPro, a division of BLR, 75 Sylvan Street, Suite A-101, Danvers, MA 01923. Subscription rate: $159/year; back issues are available at $15 each. Copyright 2014 HCPro, a division of BLR. All rights reserved. Printed in the USA. Except where specifically encouraged, no part of this publication may be reproduced, in any form or by any means, without prior written consent of HCPro, a division or BLR, or the Copyright Clearance Center at 978-750-8400. Please notify us immediately if you have received an unauthorized copy. For editorial comments or questions, call 781-639-1872 or fax 781-639- 7857. For renewal or subscription information, call customer service at 800-650-6787, fax 800-639-8511, or email customerservice@hcpro. com. Visit our website at www.hcpro.com. Occasionally, we make our subscriber list available to selected companies/vendors. If you do not wish to be included on this mailing list, please write to the marketing department at the address above. Opinions expressed are not necessarily those of CTA. Mention of products and serv ices does not constitute en dorse ment. Advice given is general, and readers should consult professional counsel for specific legal, ethical, or clinical questions. CNAs play a tremendous role in limiting workplace injuries for themselves, as well as for their residents, their residents caregivers, and their clinical colleagues. Most injuries to residents and clinicians are related to resident transfer and ambulation. Back injuries to staff members are most commonly the result of lifting and twisting when transferring residents. Whenever lifting is required, the use of good body mechanics reduces injuries to staff members and residents. Workplace violence is another area where CNAs need to anticipate trouble by assessing risk factors and observing any changes in residents behaviors. Lifting and transferring techniques Caring for residents who are not fully mobile tends to involve a great deal of lifting. You may need to assist residents from the bed to the chair or wheelchair, and then back to bed. At times, CNAs may also need to help a resident who has fallen to the floor. Serious back, shoulder, and neck injuries occur as a result of poor lifting and transferring habits. Therefore, CNAs need to know the correct techniques for lifting and transferring residents. These techniques might keep CNAs from injuring themselves or their residents. General tips for lifting and transferring include the following: When lifting and transferring, the most important consideration is safety for yourself and the resident. Ask for help and use teamwork if possible. Talk to your helpers about what you plan to do and talk to each other about what you are doing as you do it. Maintain the correct posture. Keep your back straight and knees bent. If you must bend from the waist, tighten your stomach muscles while bending and lifting. Bending your knees slightly will put the stress on your legs, not your back. Never twist when lifting, transferring, or reaching. Pick up your feet and pivot your whole body in the direction of the move. Move your torso as one unit. Twisting is one of the leading causes of injuries. Maintain a wide base of support. Keep your feet at least shoulder width apart or wider when lifting or moving. Hold the person or object close to you, not at arm s length. Holding things close to your body can minimize the effects of the weight. Pushing is easier than pulling, because your own weight adds to the force. Use repeated small movements of large objects or people. For example, move a person in sections by moving the upper trunk 2 HCPRO.COM 2014 HCPro, a division of BLR. For permission to reproduce part or all of this newsletter for external distribution or use in educational packets, contact the Copyright Clearance Center at copyright.com or 978-750-8400.

June 2014 CNA Training Advisor first and then the legs. Repeated small movements are easier than lifting things all at once. Always face the resident or object you are lifting or moving. If in the process of transfer the resident begins to fall, do not try to stop the fall, as this is nearly impossible to do. Instead, try to guide the resident to the floor. Once the resident is on the floor, verify that he or she is not injured and can remain on the floor comfortably while you seek help to lift him or her. Do the following when pulling a resident up in a wheelchair: Lock the wheels of the wheelchair Have the resident fold his or her arms across his or her chest Stand behind the resident, bend your knees, and wrap your arms around him or her, hugging the torso securely by folding your arms just under his or hers in front Straighten your legs, lifting the resident s torso up and back in the chair When turning a resident from side to side in his or her bed, do the following: Stand at one side of the bed and use a lift sheet if available. Place your arms under the resident s shoulders and hips, or grasp the lift sheet. Pull the resident to the edge of the bed, trunk first and then legs. Cross the resident s leg closest to you over the other leg. Place your hands on the resident s shoulder and hip closest to you. Lean in toward the resident and push the torso away from you. Place the top leg in front of the bottom leg. Support the resident s shoulders, back, and hips with pillows. Place a pillow between the resident s legs to support the top leg. Adjust for comfort. Attention to ambulation Residents and CNAs can be injured during resident ambulation. Unsteady residents who use walkers may need assistance depending on their condition and current state. Consider the following safety measures: Assess the resident s size, weight, and physical condition, and always ask for assistance if available Make sure the resident is wearing nonskid footwear Check that the resident s clothing will not trip him or her Use a gait belt to steady the resident, if you desire Follow the resident with a wheelchair if necessary If the resident is using a walker: Ensure that the tips of the walker legs have the proper coverings Verify that the resident is using the walker correctly The key E s: Ergonomics and exercise You may have heard the word ergonomics and wondered what it means. Ergonomics is the science of fitting workplace conditions and job demands to the capabilities of employees. When the physical requirements of the job and the physical capacity of the employee do not match, workrelated injuries can result. Stress on the musculoskeletal system causes the majority of job injuries. Some of these muscular injuries have been linked to work habits that result in temporary or permanent disability. Ergonomics for CNAs include the following: Using equipment that will take the strain out of lifting and transferring Organizing work in new ways (e.g., storing items that employees use daily on easy-to-reach shelves rather than near the floor or above the shoulders) Changing the way that tasks are done Ergonomics can prevent injuries by helping us to understand which tasks and body movements can hurt us and by finding new ways to carry out these tasks. Keeping your back strong, stretched, and healthy is important. Stretching and strengthening exercises 2014 HCPro, a division of BLR. For permission to reproduce part or all of this newsletter for external distribution or use in educational packets, contact the Copyright Clearance Center at copyright.com or 978-750-8400. HCPRO.COM 3

CNA Training Advisor June 2014 combine to balance the strength and tone of the muscles and ligaments. The muscles and ligaments are the supporting structure of the spine, so fitness benefits spinal health. Workplace violence Violence most often occurs in a psychiatric setting. However, residents might attack staff members in any healthcare setting. Risk factors for resident violence include: Mental illness Physical diseases, such as Alzheimer s and Parkinson s Pain Confusion Medication delays or side effects Actions of staff members Environmental factors, such as noise, crowding, and boredom CNAs need to anticipate trouble by assessing risk factors and observing any changes in residents behaviors. Report when residents exhibit acute, unexplained behavioral changes so staff members can identify possible underlying causes and respond quickly. In addition, feelings of anxiety, stress, guilt, and frustration may result in a family member or caregiver becoming violent. The use of alcohol or drugs can also play a part in some cases. You must be mindful of a number of considerations when caring for your residents in order to avoid injury to yourself or to the resident. CNAs should take the following measures when trying to prevent violent behavior in residents: Do not surprise residents. Alert them to your presence. Speak as you enter the room so they know you are there. Explain what you intend to do. No one, especially a confused resident, wants to be touched without knowing what is happening to him or her. Try to preserve residents personal power. Whenever possible, allow residents to make choices for themselves. Do not invade residents space or touch their personal belongings without their permission. Residents often have very little personal space, and they may become violent when trying to defend the space they do have. Do not work alone with potentially violent residents. Always have at least one other staff member in the room. The aide s role CNAs play a tremendous role in limiting workplace injuries for themselves, as well as for their residents, their residents caregivers, and their clinical colleagues. Essentially, CNAs are on double-duty: They are responsible for making sure that they take the necessary steps and precautions to protect themselves from injury while also taking care to try to prevent injury to their residents. The aide s role in avoiding workplace injuries starts with employing the proper body mechanics while caring for residents, specifically in lifting and transferring residents, or assisting with ambulation. Before any of those objectives are undertaken, Each situation will present CNAs with the mental challenge of envisioning how a lift or transfer should go, and what elements or issues could complicate or undermine the plan, before the resident is ever actually moved. Keep in mind that while your health and safety are paramount, your residents are also relying on your skills to keep them safe and free from injury. And your residents deserve your best effort. Outcomes Experience will certainly help facilities in meeting the challenge of evaluating each and every lift, transfer, and ambulation scenario, as well as the benefits of ergonomics and exercise and the importance of recognizing the risk factors attributed to violence. But so will strict adherence to the correct techniques and protocols. It remains important to remember and maintain use of the fundamentals. If you do, you will help to ensure your own safety and the safety of your residents and the avoidance of workplace injuries. H 4 HCPRO.COM 2014 HCPro, a division of BLR. For permission to reproduce part or all of this newsletter for external distribution or use in educational packets, contact the Copyright Clearance Center at copyright.com or 978-750-8400.

JUNE 2014 Volume 12 Issue No. 6 CNA Professor REDUCING THE RISK OF WORK-RELATED INJURIES QUIZ Mark the correct response. Name: Date: 1. Most injuries to residents and CNAs are related to. a. medications b. falls c. violence d. resident transfer and ambulation 2. Which of the following is not a correct component of a CNA s posture when lifting a resident? a. Keep your back straight. If you must bend from the waist, tighten your stomach muscles while bending and lifting. b. Keep your knees bent. c. If lateral shifting is necessary, twist at the waist. d. If bending from the waist is necessary, tighten your stomach muscles while bending and lifting. 3. is easier than because your own weight adds to the force a. Pushing; pulling b. Pulling; reaching c. Pulling; pushing d. Reaching; pushing 4. When pulling a resident up in a wheelchair, you should not. a. unlock the wheels of the wheelchairm b. have the resident fold his or her arms across his or her chest c. straighten your legs, lifting the resident s torso up and back in the chair d. keep the resident close to your body 5. If in the process of transfer the resident begins to fall, do not try to stop the fall; instead, try to guide the resident to the floor. a. True b. False 6. If the resident is using a walker, you should not need to verify that they are using the walker correctly. a. True b. False 7. When assisting an unsteady, ambulating resident, you should. a. assess the resident s size, weight, and physical condition b. make sure the resident is wearing nonskid footwear c. check that the resident s clothing will not trip them d. All of the above 8. Ergonomics is the science of fitting to the capabilities of employees. a. residents conditions b. residents back health c. workplace settings d. workplace conditions and job demands 9. Which of the following is not a risk factor for resident violence? a. Mental illness b. Pain c. Sadness d. Medication delays or side effects 10. To prevent violent behavior on the part of residents, you should. a. surprise residents b. explain what you intend to do before touching residents c. invade residents space or touch their personal belongings without their permission d. work alone with potentially violent residents A supplement to CNA Training Advisor