Patient Care Ergonomics Remember… Through Ergonomics • Job can be redesigned • Jobs can be improved to be within reasonable limits of human capabilities However, ergonomics is not a magical solution… • To be effective, a well thought out system of implementation must be developed
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Patient Care Ergonomics
Remember… Through Ergonomics
• Job can be redesigned• Jobs can be improved to be within
reasonable limits of human capabilities However, ergonomics is not a magical
solution…• To be effective, a well thought out system
of implementation must be developed
Here’s A Successful Solution using Patient
Care Ergonomics…
Successful Solutions
Overview of a Safe Patient Handling & Movement Program
Safe Patient Handling & Movement Program
•Management Support
•Champion•SPHM Team •Program
Elements
•Equipment•Knowledge
Transfer Mechanisms
•Technical Support
For success, required infrastructure MUST be in place prior to implementing SPHM Program
Based on Specific Patient Characteristics (from Assessment)
Assists nurses in selecting• Safest Equipment • Safest Patient Handling
Technique Advises # of staff needed
How were these Algorithms Developed?
Developed by a group of nursing experts
Tested with different patient populations in a variety of settings
When Should The Algorithms be Used?
Use the Algorithms for every patient/resident who needs help moving
Remember….• The Algorithms provide general
direction• Caregiver must use their
professional judgment in applying Algorithms
How Do We Lift This Resident?
Let’s assess NH resident: Fred Veteran
80 year old resident of a VA Nursing Home.
Weight: 156 lbs. Height: 5’ 9” Has dementia and a history of falls. Some days he is cooperative. Other days
he is combative and fearful. When he is cooperative, he can bear
weight. Otherwise, he resists standing. He is to be out of bed every day in a chair.
Assessing Fred V.
Take a few minutes and complete a Patient
Handling Care Plan for Fred Veteran.
(Use Handout A-3, Patient Assessment & Care Plan)
Assessing Fred V.
Level of AssistanceDependent
Can the resident bear weight?
No, because the resident is not cooperative
Does resident have upper extremity strength needed to support weight during transfers?
No, because resident is unreliable for using his upper extremity strength
Assessing Fred V.
Resident’s level of cooperation and comprehension
Unpredictable
Weight: 156 lbs. Height: 5’ 9”
Special circumstances?
History of Falls
Finishing Fred V.’s Care Plan
Although the resident can sometimes bear weight, he can be uncooperative.
The “No” answer to “Is the Resident cooperative?” leads you to: “Use full body sling lift and 2 caregivers”
Answer: Use full body sling lift and 2 caregivers
Patient Assessment, Care Plan, & Algorithms for Safe Patient Handling
& Movement
The Assessment, Algorithms , & Care Plan go hand in hand...1. Assess the Patient2. Determine what handling
activities you must perform3. Follow the algorithms to
determine what equipment and # of staff are needed
4. Complete the Care Plan5. File for future use
Step 3. Obtain Pre-Site Visit Data
Remember…Involve as many staff as possible and as much as
possible…
Step 3. Obtain Pre-Site Visit Data
Now… think of one of your high-risk units from your facility and complete a cursory “Unit Data Collection Tool” for that unit.
* Complete Unit Data Collection Tool Profile (Handout A-5)
Step 5. Conduct Site Visit
Site Visit Walk-through• Patient room sizes/configurations• Ceiling Characteristics/AC vents/TVs• Showering/bathing facilities• Toileting process
Step 5. Conduct Site Visit
Site Visit Walk-through• Equipment
•Availability Accessibility•Use Condition•Storage
• Staff attitudes
Step 5. Conduct Site Visit
After Site Visit… Organize data by entering into
Site Visit Summary Data Sheet (p. 34 and Handout A-6)
Use during Risk Analysis in order to make Recommendations
9 Step Ergonomic Workplace Assessment of Nursing
Environments
Step 6. Perform Risk Analysis
Step 6. Perform Risk Analysis
Risk Identification/Breakdown High Risk DEPARTMENT/AREA High Risk JOBS (RN, CNA, LPN, etc.)
• Specific TASKS of High Risk Jobs (p. 30)
• Specific ‘ELEMENTS’ of High Risk Job TASKS
Step 6. Perform Risk Analysis
What do we need to look at to identify Specific
RISKS of ‘ELEMENTS’ of High Risk Job TASKS?
Step 6. Perform Risk Analysis
Element/Task Risk Identification
Task Intensity Task Duration Work Posture General Design of Equipment Space Characteristics Where do you think problem
exists?
Step 6. Perform Risk Analysis
Methods to Gather Risk Data General Observation Staff Discussions Staff Questionnaires Review of Medical Data Symptoms Surveys Quantitative Evaluations
Previous Studies Job Consistency
& Fatigue Brainstorming &
Group Activities Job Safety
Analyses
Step 6. Perform Risk Analysis
Job Safety Analysis (JSA) Break down job into steps Identify hazards associated
with each step Determine actions necessary to
eliminate or minimize hazards
Step 6. Perform Risk Analysis
Job Safety Analysis (JSA)
Let’s try it!!!
See Job Safety Analysis Worksheet (Handout A-7)
Step 6. Perform Risk Analysis
Risk Analysis is used to find Risk Factors that may cause injury.
There are three categories of Risk Factors in a Patient Care
Environment...
What do you think they are??
Step 6. Perform Risk Analysis
Risk can come from: Patient Handling Tasks Health Care Environment Patient
Once risks are identified, steps can be taken to protect Staff
and Patients!
Step 6. Perform Risk Analysis
What Risk Factors are related to the Health Care Environment?
Step 6. Perform Risk Analysis
Health Care Environment Risk Factors
Slip, trip, and fall hazards Uneven work surfaces (stretchers, beds,
chairs, toilets at different heights) Uneven Floor Surfaces (thresholds) Narrow Doorways Poor bathing area design
Step 6. Perform Risk Analysis
Health Care Environment Risk Factors
Space limitations • Small rooms• Lots of equipment• Clutter• Cramped working space