Safe Client Handling

Objectives

Ergonomics

Risk factors

High risk client care activities

Conditions that result in high risk environments

Best solutions for moving and handling clients

The Basic Problem

Fundamental ergonomics

The National Institute of Occupational Safety and Health (NIOSH) research:

– Under IDEAL CONDITIONS, 90% of males, and 75% of females can safely lift 23 kilograms (~51 pounds), MAXIMUM.

– Some settings do not provide ideal conditions (straight back, no bending, no twisting, positive grasp, infrequent lifts, etc.)

Conclusion

– One worker cannot safely lift an adult client alone, and positioning tasks that require greater than 23Kg of exertion are also hazardous.

What Makes Clients Risky?

They are bulky—adults are > 51 pounds

No handles! (Technical term is “coupling” = good grasp)

The unpredictable occurrence

Possible lack of help from client

Possible consideration of wounds

Risks of Job Tasks

What factors contribute to a worker being hurt during client positioning?

– Awkward postures

– Lifting heavy loads

– Length of lifting (supporting the client over a period of time)

– Reaching

– Frequency of positioning tasks

OSHA “Regulations” Regarding client Positioning

OSHA recommends

minimizing manual

lifting of clients in all

cases and eliminating

lifting when possible.

Basic Safe Client-Positioning Process

Identify

– Characteristics of the client to be positioned

– Type of positioning to be accomplished

– If movement, where the client is being moved to.

– Task-related Hazards

– Environment/facility-related hazards

– What personnel/equipment will be needed

– How to move or lift the client.

Possible Risks In Job Environment

Slip, trip, and fall hazards

Uneven work surfaces (bed to stretcher, chairs, toilets)

Space limitations—(i.e. client fallen in the bathroom)

Equipment hazards (respirators, IV pumps etc.)

Other Risks

Help unavailable when needed (understaffed facility)

Client handling equipment in poor working order

Combative clients

Others?

Assessing the Client Before Moving

Always review the client care plan before attempting to move the client.

A client care plan describes a specific client’s needs, degree of assistance required, special treatments, etc.

Assessing a Client

Next ask the following questions before moving or transferring the client.

Can they provide assistance?

Can they bear weight?

Can they cooperate and follow instructions?

How big and heavy is the client?

Note client’s wounds, dressings, and any machinery.

Types of Client Moves and Lifts

Lateral transfers: Moving a client sideways

Repositioning: Moving a client up and down or side to side in a bed or chair

Transfers involving sitting position: bed to chair, bed to bed, chair to toilet, car to chair

Floor: Recovering a client that has fallen on the floor

Why Use client Equipment?

When a client weighs too much for safe manual positioning

Frequent unassisted lifting and movement of clients causes muscle and joint pain/damage.

client handling/moving equipment

Sling – for clients that are totally dependent

Lean Stand Assist – for clients that have some lifting ability

Ceiling Mounted Lift Device – for clients that are totally dependent

Client Assist Devices

Sliding boards (also called back boards)

Slip sheet, roller sheet, or draw sheet

Trapeze lift attached to bed (mostly used on orthopedic clients)

Walking or gait belt

Shower chairs

Toilet seat risers

And many more…

Lifting and Moving Algorithms

What are lifting and moving algorithms?

– They were developed by a group of nursing experts and tested in different client populations

How do algorithms help you?

– They give you a safe process to accomplish the task you are trying to perform

– Ensure that you and the client will not get hurt during the move

Now lets look at one example of a lifting and moving algorithm…

Reposition in Bed: Side-to-Side, Up

Basic Lifting Techniques

Always remember basic safe lifting techniques while performing duties

– Stand as close to the client as possible

– Keep back straight

– Get a good grip on the client

– Lift with legs when possible

SUMMARY

Back injuries are among the most costly and disabling of all injuries.

A back injury now could cause pain for a lifetime – it is important to treat the back well.

Always use the proper lifting techniques and systems, doing so will allow a healthy back for tomorrow and years to come.