Maunal Handling Training Course
Manual Handling Training Course.
Module 1: The law as it relates to patient handling
Part VI of the Safety, Health and Welfare at Work (General Application) Regulations 1993 transposes EU Council Directive 90/269/EEC on the minimum health and safety requirements for the manual handling of loads into Irish Legislation. The regulation is titled the Manual Handling of Loads Regulation. The main requirements of the 1993 Manual Handling of Loads Regulation are that employers must:
?Make efforts to avoid manual handling activities that present a risk of injury, if possible.
? Where it is not possible to avoid the manual handling activity, an
assessment of the manual handling activity must be carried out with
reference to the factors identified in the Eight and Ninth Schedule to the regulations.
Efforts must then be made to reduce the risk of injury, particularly back injury, by applying appropriate control measures.
where possible the weight of the load being handled and the centre of gravity of the load should be available for employees handling the loads.
The Regulations set no specific requirements such as weight limits. However numerical guidelines are available in guidance documents that take into account the weight of a load, the repetition of the task and the location of the load during the lift, as a means of identifying handling activities that involve risk (HSA 2005).
Module 2: Basic information on the anatomy and biomechanics of the spine and muscles. How injuries can occur?
The Lumbar Spine
The lumbar spine is made up of the last five vertebra of the spine. The vertebrae are the bones of the spine; their function is to provide support and protection to the spinal cord. Each vertebra is composed of a large piece of bone called the body, which is attached to a bony ring.
When the vertebrae are stacked one on top of the other, they form a column on the front and a bony tube in the back. The tube formed by the rings in the back is where the spinal cord and nerves run.
The facet joints allow them to be linked like a chain, they provide mobile connections between each vertebra and shift and slide as we bend and twist our backs.
Purpose of the Vertebrae
The vertebrae are composed of many elements that are critical to the overall function of the spine, which include the ...
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When the vertebrae are stacked one on top of the other, they form a column on the front and a bony tube in the back. The tube formed by the rings in the back is where the spinal cord and nerves run.
The facet joints allow them to be linked like a chain, they provide mobile connections between each vertebra and shift and slide as we bend and twist our backs.
Purpose of the Vertebrae
The vertebrae are composed of many elements that are critical to the overall function of the spine, which include the intervertebral discs and facet joints.
Invertebral Disc
An Intervertebral disk sits between each individual vertebra; the disc is a large round ligament that connects the vertebrae together.
The disc is made up of two parts, the annulus is the outer ring; it is the strongest part and is responsible for connecting the vertebrae.
The nucleus pulposus is the soft, inner portion. This has the consistency of crabmeat and is responsible for the shock absorption properties of the spine. The nerve roots of the spine carry information between the lower extremities and the brain.
Problems
Many of the problems that cause back pain are the result of injury and degeneration of the intervertebral disc. Degeneration is a process where wear and tear causes deterioration. The disc is subjected to different stresses and acts as a shock absorber.
Bending over results in compression of the disc, and may also cause the disc to bulge backwards towards the spinal canal and nerves. Twisting and bending together is perhaps the greatest stress on the spine, especially the disc. The earliest changes that occur in the disc are tears in the annulus portion of the disc, which is a large round ligament. These tears will heal by scar formation.
Scar tissue is not as strong as normal tissue; the repeated cycle of many annular tears leads to damaged scar tissue, which means that the disc finally begins to degenerate. As the degeneration progresses the nucleus loses some of its water content, it becomes stiff and loses the ability to act as a shock absorber.
Examples of risk factors that can contribute to back injury include:
Gradual wear and tear caused by frequent or prolonged periods of manual handling activity
Increased wear and tear or sudden damage caused by intense or strenuous manual handling or awkward lifts.
Bending or reaching forward puts strain on the back
Movement which may result in injury to the lumbar spine during handling include repetitive back bending, pulling and lifting from overhead, forward bending and twisting.
Module 3: Personal Fitness for Patient Handling
Practical exercises for fitness, flexibility and muscle tone. Exercises to increase strength and fitness have been part of low back pain treatment programs for many years, but only recently have strength and fitness programs been advocated in industry to reduce or prevent the onset of back pain. Several studies have indicated a positive role for strength and fitness training in reducing the onset of back pain. The list below includes practical exercises for personal fitness, toning and strength, which require no equipment. Stetching should always be done before exercise. Some helpful starches are: Head tilt, Arm crunches, Reach back, Biecep stretch, Side stretch, Front lunge.
o Chin- Ups, bieceps, teres major, trapezius, latissimus dorsi.
o Push- Ups, pertoralis major, anterior deltoid, triceps.
o Crunches, abdominals.
o Leg lifts, lower back.
Module 4: Practical Handling Policy
o Designate and train patient handling trainers.
o Ensure regular training of staff and reassessment of handling polices.
o Where necessary call on outside expertise for training and assessments.
o Minimization to highest extent possible of manual handling.
o Reduce to as low as possible the risk to employees from patient handling through the designation of appropriate finances, time and staff for patient handling.
o Creating and implementing a risk assessment process to avoid or reduce manual handling activity.
Module 5: Risk Assessments
Each attendee of this training course should be able to complete a risk assessment on a particular patients handling problem as they meet them. With difficult cases co-workers help should be sought. An in-depth look at how to create an effective risk assessment is in part a of this question which I would include as an example in any training course.
Module 6: Practical Application of the Minimal Handling Policy
o Employers should have in place a minimal handling policy that requires that full body lifting should be avoided except in life threatening situations
o Where appropriate, patients should be encouraged to move themselves and work systems should be geared towards this.
o Rolling and sliding devices should minimize supporting, pushing and pulling.
Module 7: Demonstration of the use of all types of Lifting Aids and instruction on the frequency of maintaince as required by the Safety Statements.
Gait Belt- Fits snugly around patients waste and has hand straps for caregiver to grasp while assisting during transfers or walking.
Rails- Wooden or metal rails are fixed to walls or equipment to allow patient to help support themselves during transfer.
Hoyer Lift- Hydraulic lift that consists of metal frame and heavy canvas swing. This is used for lifting and suspending during transfer.
Sliding Boards- Smooth board with tapered ends made of wood or plastic. This is used for patient transfer from one surface to another.
Draw/ Sliding Sheet- Flat sheet, which is placed under person in bed, which can later be used for moving patient.
Standing Hoist- This is used for lifting a sitting patient and transferring them to another seat E.G Wheelchair- toilet- wheelchair- bed.
Turntables- this is 2 discs rotating against each other. The person can stand on one and be rotated near another area.
Effective use of this handling equipment minimizes patient handling while maintaining patient dignity.
Module 8: The wearing of Suitable Footwear and Clothing.
Clothing should be loose and comfortable with trouser uniforms. Footwear should be flat and non-slip with no open toes or open laces and good grip.
Module 9: Ensuring passageways, lights and floors allow safe patient handling.
Conditions of floors, pathways etc should be suitable for patient handling. Lighting should be adequate. Beds and trolleys should be at a safe height and adjustable.
References:
www.hse.ie
class notes
Rachel Mulligan- Care Assistant
Darren O'Dowd- Nurse
www.bueaty-uniform.co.uk
Theis from library- Effectiveness of the Manual Handling Training Course in the health care environment. Aine McAndrew 2004
Inroduction to Ergonomics- Mcgraw Hil '95
Safty Health and Welfare at Work Law- A Gudeces
www.tutorum.ie
www.spine-universe.com
www.osha.bc.cal
www.merseycare.nhs.co.uk