WELCOME SAFER MOVING HANDLING TRAINING DAY Safety First

WELCOME SAFER MOVING & HANDLING TRAINING DAY Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 1

WHAT IS MANUAL HANDLING ? Manual Handling is the transporting or supporting of a load by one or more people and includes And which by means of its characteristics or of unfavourable ergonomic conditions, involves risk, particularly of back injury Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 2

COURSE CONTENT Ø Legislation Ø Structure of the Spine Ø Injury to the Spine Ø Fitness Ø Ergonomics Ø Principles of Safer Moving & Handling Ø Practical – Inanimate & Animate Loads Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 3

WHY ATTEND THIS TRAINING DAY ? To prevent back injury & its consequences Pain & decreased mobility Affects hobbies, family & social life Financial consequences if unable to work Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 4

STATISTICS Ø Ø Ø 80 -90% of population will suffer with back pain 1/3 of all injuries reported to HSA are caused by manual handling 12. 3 million working days lost each year in U. K. due to musculoskeletal injuries Many injuries build up over a period of time rather than as the result of one incident Early return to work key to recovery Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 5

LEGISLATION Safety Health & Welfare Work Act (2005) Ø Safety Health & Welfare at Work (General Application) Regulations 2007 Ø Manual Handling of loads (Part 2 Chapter 4 Reg. 68 -69) Protection of Pregnant, Post Natal & Breast feeding Employees (Part 6 Chapter 2 Reg. 147 -152) Human Rights Act (2003) Ø Disability Rights Act (2005) Ø Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 6

DUTIES OF THE EMPLOYER (S. H. W. W. Act 2005) Section 8 Manage Health & Safety Provide safe place & systems of work Prepare a safety statement (brought to the attention of the employee at induction & the relevant part to be onsite if task is high risk) Provide training & information (In a form, manner & language likely to be understood) Allow for the election of a safety representative Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 7

DUTIES OF EMPLOYEE (S. H. W. W. ACT 2005) Section 13 Take care of own health & safety & that of others Ø Co-operate with employer Ø Attend training & undergo assessment Ø Use P. P. E. provided Ø Report safety defects (Systems/equipment) Ø Not be under the influence of an intoxicant that may endanger them or others Ø Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 8

2007 MANUAL HANDLING REGULATIONS The employer must ………. Avoid hazardous manual handling (Pt. does it, profiling bed) Assess tasks that cannot be avoided (T. I. L. E. ) Schedule 3 Take account of sensitive risk groups (Pregnant & breast feeding women, children & young workers, night & shift workers) Reduce the risk (Equipment, extra staff, change work practices) Provide information (Weight & C. O. G. of load) Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 9

SCHEDULE 3 CHARACTERISTICS OF THE LOAD Too heavy/large Un weildy/difficult to grasp Unstable/contents likely to shift Stooping/twisting Contours/consistency esp. in collision PHYSICAL EFFORT REQUIRED Too strenuous Twisting movement of trunk Sudden movement of the load Made with body in unstable posture WORKING ENVIRONMENT Not enough Room (vertically) Unable to handle loads at safe height Floor uneven/variations in levels Floor or footrest unstable Temperature, Humidity, Ventilation REQUIREMENTS OF THE ACTIVITY Over frequent/prolonged Physical effort of the spine Insufficient rest/recovery of the body Excessive lifting, lowering, carrying Distances INDIVIDUAL RISK FACTORS Employee Physically unsuited to carry out task Wearing unsuitable clothing, footwear Does not have adequate/appropriate Knowledge or training Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 10

In Practice This Means That…. Full body lifts must be avoided in almost all situations unless § § § Event unforeseeable Accident like RTA Human rights Safety First X © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 11

CONDEMNED LIFTS X Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 12

PROTECTION OF PREGNANT, POST NATAL & BREAST FEEDING EMPLOYEES 2007 Applies to women WHO ………. Are Pregnant Have recently given birth (14 weeks) Are breastfeeding (26 weeks) Safety First The employer MUST…… Carry out a risk assessment (Schedule 8) & If necessary ↓ risk by…… Changing work conditions / working hours Alternative work H & S leave © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 13

SUMMARY Safety Health & Welfare Work Act (2005) Ø Safety Health & Welfare at Work (General Application) Regulations 2007 Ø Manual Handling of loads (Part 2 Chapter 4 Reg. 68 -69) Protection of Pregnant, Post Natal & Breast feeding Employees (Part 6 Chapter 2 Reg. 147 -152) Human Rights Act (2003) Ø Disability Rights Act (2005) Ø Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 14

STRUCTURE OF THE SPINE Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 15

OBJECTIVES Skeletal system (Bones & joints of spinal column) Discs Soft tissue (muscles & ligaments) Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 16

SKELETAL SYSTEM Ø Central Region: ( Skull, ribs, spine, pelvis ) Provides support & protection Ø Outer region: - ( Arms & legs) Allows movement Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 17

SPINAL COLUMN Ø 33 irregular shaped bones (vertebrae) Ø S-shaped Ø Lumber region most often injured when handling loads Ø Sacro-iliac Safety First joint (Pregnancy) © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 18

POSTURE Ø Keep spine in natural s-shape position Ø So that trunk is in alignment Ø With minimal pressure on joints & soft tissue Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 19

POSTURES TO BE AVOIDED STOOPING X X HOLDING LOADS AWAY FROM THE BODY Safety First TWISTING X OVERREACHING X © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 20

LUMBAR SPINE Ø 5 Vertebrae Ø Joined by discs & facet joints Ø Considerable movement Ø Takes most of the force acting on the spine DISC g Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH FACET JOINT 21

DISC STRUCTURE Spongy centre Tough outer layer 80% water Normal Disc No blood supply Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 22

DISC FUNCTION Ø Absorbs shock Gives flexibility to the spine Ø Allows space for nerves to emerge Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 23

EFFECT OF MOVEMENT ON THE DISC Pressure increased towards the back when bending forwards & to the front when bending backwards Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 24

AVOID STOOPING X Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 25

FACET JOINTS A joint is where 2 bones meet Ø A ‘facet joint’ is formed when the vertebrae interlock with the one above & below Ø Take approx. 20% of the force on the spine Ø Ø These joints are prone to wear & tear (Arthritis) Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 26

SOFT TISSUE: LIGAMENTS Ø Taut bands of fibrous tissue Ø Flexible but not elastic (Avoid over-stretching) Ø Poor blood supply (Heal very slowly) Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 27

Muscle Structure Muscles composed of bundles of fibres Ø Ability to shorten & lengthen produces movement Ø Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 28

SOFT TISSUE: MUSCLES WORK DYNAMICLY & STATICALLY X Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 29

SUMMARY Skeletal system (Bones & joints of spinal column) Discs Soft tissue (muscles & ligaments) Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 30

HOW THE SPINE IS INJURED Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 31

OBJECTIVES Injury to: Facet Joint Soft tissue Disc Bone Safety First Disc► © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 32

DISC DEGENERATION Ø Natural Ageing Process Ø Begins @ age 30 Ø Disc Looses its Water Content Ø Accelerated by poor posture & lifting techniques Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 33

EFFECTS OF DISC DEGENERATION SLACK LIGAMENTS Safety First SLIPPED DISC & ARTHRITIS © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 34

SOFT TISSUE INJURIES Overstretched ý Muscles X are torn when cold ý Ligaments are torn because they are not elastic & slack if disc degenerated Overloaded ý Muscles are torn if load is too heavy X AND IF ý Muscles do not have enough time to recover (repetitive work) Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 35

SLIPPED DISC Ø Ø Usually result of CUMMULATIVE damage Initially unaware of damage as no nerves in inner part of disc Wall of disc may fail & jelly may bulge against a nerve Stooping/twisting must be avoided Safety First (Prolapsed Disc) Bulging Disc Prolapsed Disc © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 36

STOOPING Vs STRAIGHT LIFT X Safety First P © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 37

AVOID STOOPING & TWISTING X STOOPING TWISTING P Safety First X P © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 38

WHAT IS TO BE LEARNT? As we do not always initially feel pain when we cause damage to our spine we may think all is o. k. But Be warned!!! Injuries can build up over time. Bad postures and bad handling techniques may cause problems later on in life. Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 39

BONE INJURY Ø Arthritis (Wear & tear) Incorrect movements done repetitively Ø Sacro-iliac joint (Ligaments slacken) (Pregnant women be careful as ligaments slacken) Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 40

SUMMARY Injury to: Facet Joint Soft tissue Disc Bone Safety First Disc► © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 41

FITNESS FOR WORK Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 42

OBJECTIVES Ø What is fitness Ø Muscles relevant to manual handling Ø Safety when exercising Ø Benefits of fitness Ø Stretch break & How to use large leg muscles when moving & handling (weight transference/ankle, knee & hip movements) Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 43

WHAT IS FITNESS “Ability to do ones daily work with enough energy left over” Ø Strength Aerobic (Heart & lungs) Ø Flexibility Ø Endurance Ø Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 44

RELEVANT MUSCLE GROUPS FLEXIBILITY Ø Ø Calves Hamstrings STRENGTH: Ø Ø Quadriceps (Thighs) Abdominals (Stomach) Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 45

ELEMENTS OF SAFE STRETCH Ø Warm up/cool down Ø Avoid sudden jerky movements Ø Stretch to point of slight discomfort Ø Hold stretch for 30 seconds x 3 times Ø Stretch for minimum of 6 weeks to restore flexibility Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 46

BENIFITS OF FITNESS Ø More stamina and energy Ø Decreased risk of injury Ø Improved mental alertness Ø Improved sense of well-being Ø May live longer!!! If not, you’ll definitely…. ‘Get more out of life !!!!!’. Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 47

SUMMARY Ø What is fitness Ø Muscles relevant to manual handling Ø Safety when exercising Ø Benefits of fitness Ø Stretch break & How to use large leg muscles when moving & handling (weight transference/ankle, knee & hip movements) Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 48

ERGONOMICS AT WORK Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 49

OBJECTIVES Ø Definition of Ergonomics Ø Manual Handling Assessment Ø Benefit Safety First of Ergonomics © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 50

Definition Ergonomics aims to “fit the job, environment and equipment to the person” instead of making the person fit the above (e. g. car, sports equipment, kitchen design. This will ensure that work is done in a way that minimises physical and mental effort while maximising efficiency. Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 51

POSTURES TO BE AVOIDED STOOPING X X HOLDING LOADS AWAY FROM THE BODY Safety First TWISTING X OVERREACHING X © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 52

YOU MUST ASSESS YOUR JOB TO SEE IF YOU ARE CAPABLE OF DOING IT SAFELY T task I individual L load E environment Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 53

CASE STUDY Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 54

T. I. L. E. TASK Loads away from the body Twisting/stooping Reaching upwards Long carrying distances Strenuous effort Large vertical movements LOAD INDIVIDUAL Require unusual capabilities Hazard to those with health problems Hazard to those who are pregnant Require special information/training Require PPE Safety First Heavy Bulky/unweildy Difficult to grasp Unsteady/unpredictable Harmful – Co-operative Attachments Walking aids ENVIRONMENT Poor floors Variations in levels Constraints on postures Lighting conditions Strong air movements Hot, cold humid conditions © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 55

SOLUTIONS SHORT TERM SOLUTIONS LONG TERM SOLUTIONS Training for staff Use wheelchair to bring Mr Scot to the toilet & walk back Walking Frame Raised toilet seat Grab rails in bathroom Safety First Relocate Mr Scot to room with ensuite Move Mr Scot into high low bed © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 56

BENEFITS OF ERGONOMICS If you assess your job, you will be… Ø Better able to recognise potentially harmful tasks Ø Safer – decreased risk of injury Ø More comfortable – more energy, less stress Ø More efficient & productive Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 57

SUMMARY Ø Definition of Ergonomics Ø Manual Handling Assessment Ø Benefit Safety First of Ergonomics © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 58

PRINCPLES OF SAFER MOVING & HANDLING Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 59

OBJECTIVES Ø The thought process involved before loads are moved Ø Principles Ø Team Safety First of moving and handling © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 60

BEFORE ANY HANDLING TASK “Think before you begin” AVOID Must you do the task at all? Can the patient do it themselves/is there a profiling bed available ? If you must do the task, Assess – T. I. L. E Can the task be made more manageable by: Encouraging the patient to help Getting help from other staff member Using equipment Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 61

SAFER HANDLING PRINCIPLES (Set of tools) Assess (TILE) Know your own capabilities Broad Base Bend Knees/ use weight transference Good Back Posture (Neutral position & avoid combined bending & twisting) Good Grip (Palmer/elbows tucked in) Get Close To The Load Move smoothly & keep head up when lifting & handling Move with feet (don’t twist) Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 62

SPINAL BIOMECHANICS P Safety First X X © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 63

TEAM HANDLING Be aware of limitations of team handling Work with people of similar height Appoint a leader Plan the manoeuvre Agree a command, to ensure a smooth coordinated movement ‘Ready Steady Action Word’ (Action word can be Slide, Sit, Stand etc) Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 64

SUMMARY Ø The thought process involved before loads are moved Ø Principles Ø Team Safety First of moving and handling © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 65

CHECKLIST FOR USING HOISTS Assess – What are the patients needs? Does the hoist meet those needs? Is the hoist appropriate for the environment? Check the patients weight Vs capacity of hoist Follow manufacturer’s instructions. Has visual inspection been carried out? Remember pushing & pulling techniques Safety First Have as many carers as situation requires Be confident in use of the hoist Ensure hoist is serviced 6 monthly Remove and Report if faulty Remember brakes off except when parked & hoisting from the floor Check emergency lowering button © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 66

USE OF SLINGS Assess and establish patients needs Be familiar with slings available (amputee, toileting) Select correct sling for task Use correct size of sling Check sling for signs of wear/tears Safety First © Andria O’ Donovan Bsc (Physio), Dip SHWW (Physio), M. I. S. C. P. MIOSH 67