Transcript Document 7149222

Ergonomics Guidelines
for Nursing Homes
Recommendations
for
preventing and reducing
Work Related Musculoskeletal Disorders
(WMSDs)
Module 2
What this presentation covers
• Identifying some problem tasks in nursing homes
– Resident care
(other than manual lifting and repositioning)
– Housekeeping, stocking supplies
– Dietary operations
– Laundry operations
• Recognizing practical solutions to address problem
tasks
See Module 1 for problems addressing manual lifting and
repositioning of residents.
What this presentation covers
Note: The recommended solutions presented
in these slides are not intended to be an
exhaustive list, nor are they all expected to be
used in any given facility. The information
represents a range of available options that a
facility can consider using.
Introduction
There are significant numbers of work-related
musculoskeletal disorders (WMSDs) that occur in
activities other than manual lifting and repositioning of
residents in the nursing home:
• Resident care
(other than manual lifting and repositioning)
• Housekeeping, stocking supplies
• Dietary operations
• Laundry operations
Identifying Problem Jobs/Tasks
Job Assessment:
• Observe employees perform task
• Discuss with employees about activities and
conditions that they associate with difficulties
• Check injury records
• Identify problems
• Implement solutions/improvements
Resident Care Other Than Lifting and
Repositioning
Problems: Reaching, Leaning, Bending, Kneeling,
Squatting, etc.)
Caregivers may find themselves
working in awkward postures when
assisting residents in activities of
daily living and related activities,
such as
Bending and reaching to make bed
Bending to help with shoes
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showering and bathing
toileting
dressing or undressing
performing personal hygiene
feeding a resident
making a bed
Resident Care Other Than Lifting and
Repositioning
Solution: Height-adjustable beds, bathtubs, lift bath
carts, shower gurneys
Adjusting equipment/ devices to
waist height eliminates bending
and reaching for caregivers and
for those who clean tubs and
make beds.
Resident Care Other Than Lifting and
Repositioning
Solution: Work Practices
• Use upright, neutral working postures and
proper body mechanics. Bend your legs,
not your back.
Good posture - straight
back, bent knees
• Use long-handled extension tools on handheld shower heads, wash or scrub brushes,
and other items to eliminate bending,
twisting, and long reaching when washing
residents’ legs, feet, and trunk.
• Lower rails on beds/gurneys when feeding
residents or providing other care to
eliminate extended reaching.
• Work with enough space to avoid awkward
postures.
Bad posture - Extended
reach over rail
Laundry Operations
Problems: Lifting, Bending, Reaching, Twisting
Excessive reaching, bending,
and/or lifting laundry
(especially heavy when wet)
can cause work-related MSDs
such as strains and sprains to
the back or shoulder area.
• collecting and sorting soiled
linens
• placing in washers
• transferring wet linen to dryers
• folding and storing on shelves
or placing in carts for transport
Laundry Operations
Solution: Side-access hampers, tilted hampers
Tilted laundry bins bring
items closer and reduce
awkward reaching.
Hamper with platform
under the laundry bag
allows easy side access
to the bag without having
to lift the bag up to clear
the hamper.
Laundry Operations
Solution: Spring-loaded carts
Spring-loaded carts automatically bring linen within easy
reach and help reduce the amount of bending over and
pulling on linen that the worker has to do.
Carts should have wheel
locks. Heavy carts
should have brakes.
Cart floor rises as weight of linens decreases
Laundry Operations
Solution: Front-Loading Washers and Dryers
Front-loading
washers and dryers
with bottom of door
opening between hip
and elbow height
For deep tubs, use a rake with a long or extendable handle
to pull linen closer to the door opening.
Laundry Operations
Solution: Work Practices
• Load and unload washers and dryers in small amounts.
• Avoid lifting and twisting when handling loads. Face the load
and keep the items as close to the body as possible.
• If you must use top loading washers: handle small loads of
laundry, handle only a few items at a time, and brace your
body against the front of the machine when lifting.
• Use easy-to-move carts on wheels rather
than picking up baskets of soiled linen or
wet laundry.
• Avoid lifting/reaching or working above
shoulder height.
Dietary Operations
Problems: Lifting, Reaching, Bending
• Frequent elevated and
extended reaches for supplies
or heavy containers
• Bending and unpacking cases
from the floor
• Lifting heavy food supplies to
and from storage areas
• Lifting and dispensing large
containers of soup, food
• Lifting food trays above
shoulder level or below knee
level
Dietary Operations
Solution: Redesign or reposition
Redesigning or repositioning tasks eliminates extended
and elevated reaching, and allows elbows to remain
close to the body (e.g., turn boxes over on side to allow
for easier access).
Kitchen worker using
elevated reach
Box placed on side allows
for less reaching.
Dietary Operations
Solution: Height-adjustable countertops,
work stands
Work at a height appropriate for the task being performed
to keep elbows close to the body and thus reduce
reaching.
• Height-adjustable
countertops
• Step stool or
work stand to
avoid reaching
above shoulders
Work station with adjustable
feet that raise/lower work
surface to fit worker.
Working at appropriate height
Dietary Operations
Solution: Kettle, pot, and skillet tilts
Kettle, pot, and skillet
tilts allow for easy
dispensing of foods,
as well as for cleaning.
This eliminates the
need for lifting.
Anti-fatigue mats or insoles or
shock-absorbing floors to
minimize back and leg strain
Housekeeping
Problems: Lifting, Reaching, Pushing/Pulling, Bending,
Kneeling
The housekeeping staff
performs many tasks that
may result in forceful
exertion, repetition, and
awkward postures:
• Mopping floors
• Dusting, sweeping
• Cleaning whirlpools, tubs
• Collecting trash
• Changing light bulbs, other building
maintenance work
Housekeeping
Solution: Work Practices
• When mopping, alternate mopping styles
frequently (e.g., push/pull, figure 8, and
rocking side-to-side). Wear rubber-soled
shoes in wet areas to prevent slipping.
• Use powered devices over manual
equipment (e.g., vacuum instead of
broom) for moderate-to-long duration
use.
• Use chemical cleaners and abrasive
sponges to minimize scrubbing force
(may need to ventilate rooms when
chemicals are used).
• Use kneepads when kneeling.
Housekeeping
(Continued)
Solution: Work Practices
• Use extension handles, step stools,
or ladders for overhead jobs. When
dusting overhead, use an extender.
• Avoid lifting heavy buckets, e.g., lifting
a large, full bucket from a sink. Use a
hose or similar device to fill wheeled
buckets with water.
Instead of lifting
a large full
bucket (left), fill
a wheeled
bucket (below).
• Use carts to transport supplies, or carry only
small quantities and weights of supplies.
• For cleaning small objects in a deep
sink, place a plastic basin or other
object in bottom of deep sink to raise
the work surface.
Carts, Other Mobile Equipment:
Design and Maintenance Issues
Carts:
• moving
– food trays
– cleaning supplies
– equipment, tools
– laundry, linens
• dispensing medications
Cart to transport cleaning
supplies, tools, etc.
Food tray cart
Other equipment, such as:
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Medication dispenser
Mobile medical
equipment
beds, gurneys
wheel chairs
mobile medical equipment
large wheeled containers
for cleaning
Carts, Other Mobile Equipment:
Design and Maintenance Issues
Problems: Holding, pushing, or handling equipment can
cause forceful exertions or awkward body postures. Some
of the ways equipment can cause problems include:
• Jammed or worn wheels, which
make it harder to move and steer
• Faulty brakes, which cause
equipment to shift
• Handles on beds, carts, or other
equipment, which are either the
wrong size or placed at an
inappropriate height
Hard to push: heavy cart, handles
too high, hard to see over
• High or heavy medical, food, or
linen carts, which require
bending, reaching, or twisting to
load or unload
Carts, Other Mobile Equipment:
Design and Maintenance Issues
Solution:
• Use well maintained carts and equipment with large, low
rolling, low resistance wheels for easier maneuvering, and
that can roll easily over mixed flooring as well as gaps
between elevators and hallways. This can decrease the force.
• Carts should have full-bearing wheels of a material designed
for the floor surface.
• Make sure that cart or equipment is not too high or wide to
see over or around.
• Make sure handles are at waist height and positioned to allow
neutral posture. Adjust if needed.
Carts, Other Mobile Equipment:
Design and Maintenance Issues
(Continued)
Solution:
• Make sure that storage or retrieval of items does not
require bending too low or reaching too high or far.
• Organize cleaning carts to avoid lifting and reaching over
the cart. Place commonly used supplies in front.
• Have scheduled systematic preventative maintenance:
– Check brakes for their ability
to lock and hold
– Oil and adjust mechanisms
to work easily
– Clean or replace casters or wheels
so they roll easily and smoothly
Jammed wheel,
faulty brake
Summary
In this module, you learned about the following:
• Identifying some problem tasks in nursing homes
– Resident care
(other than manual lifting and repositioning)
– Housekeeping, stocking supplies
– Dietary operations
– Laundry operations
• Recognizing practical solutions to address problem
tasks
Resources
Guidelines for
Nursing Homes
– developed by the
Occupational
Safety and Health
Administration
(OSHA)
Resources
• WISHA
http://www.lni.wa.gov/Safety/Topics/Ergonomi
cs/default.asp
• OSHA
http://www.osha.gov/ergonomics/guidelines/nu
rsinghome/index.html
• NIOSH
http://www.cdc.gov/niosh/topics/ergonomics/
Thank you for taking the time
to learn about safety and health
and how to prevent future
injuries and illnesses.
