Thank you to those who attended this week’s webinar, “Ergonomics in Healthcare”. As promised, below are the answers to questions you posed during the live event.
Q: In terms of patient handling, what is happening to address patient care ergonomics for care delivered in the home environment (nurses, nurses’ aides)?
A: Safe patient handling in home care settings continues to lag behind Acute and Long Term Care. Many people in healthcare talk about this being a problem, but actions are lagging behind the concern. Some portable equipment does exist, but it tends to be too bulky, heavy and awkward to transport from home to home. For ongoing home-based care with a dependent client, the emphasis should be on getting in-home mobility aids (and even lifts) to allow the home care nurse and family members to help the person. Even simple devices, like trapeze arms for the bed, can be a considerable help. For shorter term care, particularly with patients of size, the employing organization should consider providing temporary lifting devices in the patient’s home for selected cases. By having a specific criteria for when the temporary equipment is most needed, the organization can begin managing the risk to home health workers.
Q: Many institutions, to save money, try to get as much use out of what they have. Do you agree?
A: Certainly, companies are trying to do more with less these days. Sometimes, that means trying to retrofit equipment or coming up with creative solutions. What’s important to remember, though, is that if you’re trying to “get by with what you have”, you may end up spending more if a person gets hurt, than if you were to have purchased the proper equipment in the first place.
Q: Most people need education on the proper way to lift. Do you agree?
A: Training on proper lifting technique has some serious limitations. Some lifts are unsafe regardless of the technique. For example, adult patients are too heavy to lift safely by any manual technique. Proper lifting technique also requires that the person lifting have unobstructed access to the object being lifted. Many times, that is not the case. Teaching appropriate lifting techniques may certainly be helpful as part of an overall process, but should not be the primary method of prevention. Rather than asking if employees are lifting correctly, ask why they’re even having to lift in the first place! Perhaps a mechanical device would be more appropriate.
Q: How often do you recommend wheel checks, and who should do it?
A: Really, the answer to this depends on the environment and what the wheels are exposed to. For example, if wheels or casters are constantly being cleaned and decontaminated, they are likely going to wear out more quickly. A preventive maintenance program should be implemented, and whether it requires checking wheels every six months or annually, for example, it is really up to what works best at your facility. In terms of who does it, several of our existing clients use their maintenance department. It is also important for there to be an open communication path between employees and who is performing maintenance, so that the appropriate people can be notified in the event of a wheel needing replacement sooner.
Q: Where do you start consulting from in a case where the hospital doesn’t even have any form of lifting mechanism?
A: I recommend that you begin by documenting the need in that facility. I would start with OSHA logs and workers compensation insurance loss run reports. This provides a scope of the problem in the current state. Once the scope has been established within the organization, I would begin to assess the risk in different areas to determine what equipment is needed. If there is hesitancy on the part of administration and/or staff on the feasibility or effectiveness of SPH equipment and processes, I would suggest selecting one of the highest risk units as a trial unit to demonstrate the effectiveness. Try to avoid putting a little bit of equipment in every unit, this approach is destined to failure. The staff need a sufficient number of lifts within easy access distance in order for the equipment to be usable.
Q: Our research suggests monitors should be set with eyes in middle of screen. You suggest top of screen. Please explain why.
A: Our natural field of vision is straight out, and then down 15 degrees. (Essentially, we’re designed to be watching where we’re walking!) This means that if we have the center of the monitor aligned with our eyes, we may need to extend our necks in order to view information at the top of our screen. You can download our e-Book, “Five Steps to Improve Ergonomics in the Office” to get some great tips and tricks on setting up computer workstations.
Q: Do you have an opinion or research data regarding the Rollermouse?
A: Roller mice can be a great option for employees with shoulder injuries or discomfort, because employees only need to move their fingers to operate them. That benefit can also become a concern, however, if the employee has any hand or wrist issues that may decrease the dexterity of their fingers. Roller mice can be a great alternative, but understanding the pros and cons is important!
Q: Do you all have any good programs for maintenance staff?
A: Maintenance staff generally have such a wide variety of tasks that the most effective approach is to provide training on general information about ergonomics risks and prevention strategies. The training should have easy to remember descriptions of the risks and a clear way to link workplace changes to those risks. Humantech has developed the Ergonomics Hit List® to accomplish these goals during training.
Q: How do you recommend that we get each lift team member (including nurse) to pull equal amount of weight during patient boost?
A: I recommend focusing on equipment changes that reduce the forces needed to reposition the patient. Slick sheets, air-powered devices, and ceiling lifts are the most commonly used means of reducing the force required to reposition a patient in bed.