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People handling

People handling



Handling Circle Health Oct 2012

Handling Circle Health Oct 2012



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    People handling People handling Document Transcript

    • Object Handling & Patient Minimal Mobility Assistance Module A: Introduction Module B: Inanimate load handling and postural awareness Module C: Mobility assistance and use of equipment East Midlands SS Sinfin Lane Barrow Upon Trent Derby DE73 7HH Tel: 01332 703650 www.compactlearning.co.ukB Brought to you by Trust Interventions Ltd
    • T.I.L.E.O Manual Handling Operations Regulations 1992 The task The individuals capacity The load The environment The other factors, such as attire, systems of work and equipment The acronym TILEO may be used as a reminder of these key factors. Whilst it may not be relevant to consider all factors in every situation, a conscious recognition of the range of influence is needed. The reason for using an ergonomic approach is to try and match the job to the worker and not vice versa as tradition has often dictated. An effective match between a worker and their job provides improved levels of: Work efficiency (performance, productivity etc.) Health and safety Job satisfaction The human body The human mind Fitting the job to the person Design of workExamples of ergonomic solutions include: The provision of equipment to eliminate or reduce handling e.g. a profiling bed, hoist Changing the layout of the workplace to eliminate/reduce postural stress e.g. rearranging a bedroom to allow access to both sides of a bed, creating space between chairs in an older person’s home Reorganisation of work e.g. rotation of staff to vary activities and balance workloads 2
    • Risk AssessmentRisk assessments are simply a formal method for weighing up a situation to ensure safety.We all make risk assessments regularly e.g. to cross the road. If you think about it you willprobably be surprised how many risks that you assess in your everyday life. It is a legalrequirement for employers to identify hazards and assess the risk of injury that employeesface and eliminate them if possible or minimise them as far as reasonably practicable. (Ahazard is something that might cause harm, a risk is the chance, great or small, of a personbeing harmed by the hazard). Where risks are associated with manual handling theassessment must be done in a particular way. Your manager/ supervisor is responsible forensuring that this happens. The information and instructions you are given about how to workwill be based upon these and it is important that you comply with them. As an employee you have a legal duty to assist in the identification of hazards and control ofrisks. Frequently you will recognise hazards that you can make safe e.g. a spillage. If thehazard cannot be removed, avoid the activity if possible. If this is not possible, report thehazard to your manager as soon as you can so that they can ensure a proper risk assessmentis carried out. In an emergency situation, the emergency procedure must be followed. Evenwhen a proper risk assessment has been carried out it is important that you always do an ‘onthe spot risk assessment’ to check for new hazards before every activity, this only takes a fewseconds. Try to remember the acronym TILEO 3
    • S.E.C.SSince all activities that involve assisting people to move carry some degree ofrisk, steps should be taken to avoid them wherever possible through theencouragement of self help or the provision of equipment. This does not meanthat an inferior service should be delivered but that assistance must beprovided in a safe manner. To help ensure that this happens the following keyareas to consider are included in each guideline.Self help Gives suggestions on how a person may be encouraged to move independently. It reminds carers of the importance of verbal encouragement and of the positions to advise people to adopt that may facilitate movement.Ergonomics Gives ideas on steps to take to ensure that the environment is suitable for the manoeuvre. It also lists equipment that may be used to give the person independence or that make the activity safer plus other relevant factors relating to planning a safe manoeuvre.Communication Reminds carers of the importance of checking handling plans and communicating with the person and anyone else involved so that all are properly consulted and understand what is going to happen. Sometimes appropriate verbal prompts are useful to encourage independence or ensure that actions will be coordinated.Safety Highlights factors associated with the activity known to affect safety e.g. inappropriate attire, tripping hazards, lack of space etc 4
    • Potentially Harmful Postures Aggravated by: Sustaining Repeating Twisting Loading Jerky/sudden movement.Hoist Checklist (Pre Use Check) SWL and inspection date General wear and tear Spreader is firmly attached Sling clips Wheels move freely Brakes work Emergency stop and lower No hydraulic leak Battery charged plus spare Legs open and close Handlers are trainer Instructions are availableSling Checklist (Pre Use Check) Suitable for the person size, SWL handler is trained instructions are available general wear and tear label is legible date of last inspection 5
    • Touch, holds and working positionsBefore providing mobility assistance it is necessary to: check the assistance needed e.g. talk to the person, check their handling plan agree with the person and any other relevant people how assistance will be given explain what you are going to doTouchFor most human beings, touch is of vital importance and yet its influence is often ignored oroverlooked when providing mobility assistance. Touch can reassure, give confidence orcomfort but can also convey any negative feelings. Appropriate touch ensures respect for aperson’s feelings, and encourages trust and cooperation. Touch is a method ofcommunication that we use instinctively and subconsciously which others can usually readwith great accuracy. Just as we all speak in a slightly different way, so each of us uses andresponds to touch differently. This is influenced by many factors including: Gender and age Culture & religion Beliefs and values Previous experiences Expectations Understanding levels of pain and certain medical conditionsCarers should always seek permission before touching a person. They should also usetouch in a professional, sensitive and appropriate manner that respects the person’sfeelings and is also safe for the particular manoeuvre.There are two basic ways of using the hands when touching or moving anyone or anything:gripping with the fingers and thumbs; or using an open palm hold.Gripping with fingers and thumbsGripping or holding with the fingers and thumbs is often associated with stooping forwarde.g. lifting a person’s arm from the bed when washing. A gripping action quickly createsmuscle tension in the carer’s hands, arms, shoulders and back, a fact that can easily beobserved by changes in colour in the hand as blood flow is reduced, and by the tirednessexperienced after a few seconds. When a gripping hold is used on a human being thebody’s neuromuscular system perceives it as an imposing hold, or “threat” and there is anatural reflex to withdraw from the touch. This withdrawal indicates that the hold isperceived by most people as less than pleasant but for those with certain conditions e.g.learning disability, dementia etc. the reactions may be far more obvious and result inexcessive resistance. 6
    • Open Palm holdsWhen a lifting action is performed with the flat palm of the hand with the fingers relativelyrelaxed there is more efficient use of muscles than when gripping with just the fingers andthumbs. A carer using this type of hold will not fatigue so quickly and there will be a greaterarea of contact with the person, which avoids pressure points. People usually perceive thistype of hold or touch as enabling and generally respond to it in a more positive manner thanwhen gripping type holds are used. Open palm holds may be used to support any part of aperson’s body provided that it is safe to assist the person to move and the person’s feelings,gender and medical condition are respected.WarningIn some situations there may be no alternative to using a direct grip e.g. when a child isabout to run into danger or by trained staff who need to use certain physical interventionstrategies. This is relatively rare and once the reasons for not using this type of hold areunderstood they can be limited to situations where there is no other option available.When taking an open palm hold: Position close and at an oblique angle where possible Stay in balance and relax down Reach a little further than you need to allow your arm to come back to a relaxed position Support the person with as much of your body as you can e.g. arm, shoulder, trunk Do not cling to the person but adjust your hold as appropriate When working with a colleague it often helps if the shorter one takes their hold first Check that the person feels secure and comfortableLong Low HoldA long low hold may be used to give good support around a person’s trunk. It may be usedaround a person’s back or across their front, by a carer who is standing or kneeling at anoblique angle to them. Use an open palm and reach as long and low as is comfortablearound the person, and allow your arm to settle where comfortable. The aim is to maximisethe contact between your arm, shoulder, trunk and hand with the person.Forearm holdPosition close at an oblique angle and take an open palm hold under the person’s forearmand support it close to their body. Take care not to elevate their shoulder.Upper arm holdPosition close at an oblique angle and take an open palm hold to support the person’supper arm in a relaxed position close to their side. 7
    • Shoulder holdPosition close at an oblique angle and take an open palm hold in front of the shoulder. Theheel of your hand should gently ‘mould’ into the hollow of the person’s shoulder.Trunk holdAn open palm hold may be taken on any part of a person’s trunk provided that you respecttheir gender, and medical condition e.g. under the rib cage, side of the rib cage.Ankle/leg holdPosition close at an oblique angle and take an open palm hold of a person’s leg or foot toraise or adjust it. Avoid direct ankle holds since these are very uncomfortable.Working PositionsIn most situations it is best to work at an oblique angle (approximately 45º) to the personbeing assisted. This allows them to be as close as possible to your line of gravity(plumbline) and is perceived by most people to be more pleasant than when being squareon to them since it gives as much personal space as possible whilst providing good support. Stop and think Keep close Stable position Avoid stooping Use a secure hold Avoid twisting Lead with the head Move smoothly Vary positions Adopt and adapt the principles according to you! 8
    • For further information and referenceshttp://www.wales.nhs.uk/documents/NHS_manual_handling_passpor.pdf 9