The background to update of the 2003 NZPHG (New Zealand Patient Handling Guide) to the “Moving and Handling of People - The New Zealand Guidelines 2012”: An ACC perspective
Dr John Wallaart PhD, MBA, DBS, Dip.Chem., Dip.OH&S MgtProgramme Manager ACC Corporate Office
Background• Industry – Heavy metal (aluminium), Pulp and paper, etc• Research – The world’s first FPBR (Fan Supplied Positive Pressure Respirator)• ACC - programme management – Agriculture, e.g. FarmSafe – Construction, e.g. SiteSafe – NIHL (including “Dangerous Decibels”) – Road transport – Health - etc• Aviation – CPL/Instrument Rating, etc – Flew post around the southern part of NZ in evenings
Overview• The history and background• The 4 reports that led to the update of the guidelines• The process in updating the guidelines• Where to from here?
ACC Work RelatedEntitlement DPI Claims inHealth Services Sector
DHB and residential/aged care services, by duration of claim (on year) 700 $3,500,000 600 $3,000,000 500 $2,500,000Active Entitlement Claims Active Entitlement Costs 400 $2,000,000 Active Entitlement 300 $1,500,000 Cost of Active Claims 200 $1,000,000 100 $500,000 0 $0 th ths hs ars ars ars ars rs rs on mon ont 2 ye 3 ye 4 ye 5 ye 0 yea yea 1m 6 2m 1- 2- 3- 4- 1 20 an 1 to to 1 5 - 10 - th 6 le ss
DHB and residential/aged care services, by injury site (one year) 250 $4,000,000 $3,500,000 200 $3,000,000 Active Entitlement CostsNew Entitlement Claims 150 $2,500,000 New Claims $2,000,000 100 Cost of Active Claims $1,500,000 $1,000,000 50 $500,000 0 $0
DHB and residential/aged care services, by cause of claim 2008/2009 400 $6,000,000 350 $5,000,000 300 $4,000,000 Active Entitlement Costs 250New Entitlement Claims New Claims 200 $3,000,000 Cost of Active Claims 150 $2,000,000 100 $1,000,000 50 0 $0
Taxonomy-Residential care (2009) Patient Human handling 50%925 claims 72% 353 > 60 days Equipment handling 16% Falls to the Gravitational same level 25% 17% Lift 37% Patient handling Push/Pull 5%
The “lead-up” to thenew guidelines• Thomas D and Y L. (2010). Survey of users of the New Zealand Patient Handling Guidelines.• Thomas D et al. (2009). Report on the review of the New Zealand Patient Handling Guidelines.• Thomas et al. (2009). Patient Handling Guidelines: Literature Review.• Ludcke J and Kahler R. (2009). Taxonomy of injuries in Residential Care.
Survey of previous users• Remove the 16kg weight limit• Simplify forms and audit tools• Make clear who the audience is for each section• More information about training for patient handling• Techniques for handling disabled or non-compliant patients• Update injury stats data - etc
Report on the review of the2003 NZPHG• Many providers had done very little to develop an adequate safety culture related to safe patient handling• Review Panel strongly supported the guidelines as a single comprehensive document• The document is a resource for a wide range of organisations• The 2003 guidelines needed revision• Cost/benefit information needed to be provided.
Literature Review• Health care workers vulnerable because of: – Job strain – High physical workload – Lack of lifting or other devices - Etc• Lateral transfers particularly• Psychosocial• Multi-factorial approaches• Cost-Benefit analysis
Literature Review• Cost-Benefit analysis• Increasing weight of patients• Legislative enforcement?Many studies are limited in their usefulness - etc
Moving and handling of people- the New Zealand guidelines 2012• Produced by a panel of people with different backgrounds• People with relevant experience brought in periodically• Written by Prof. D. Thomas followed by – International expert (SME) review – Public submissions
Chapters increased from 9 (2003)to 14 (2012)Has taken into account:• Changing use of equipment• Bariatric patients and other developments – Recommendations based on best available information – It is not a Code of Practice• Aiming to set a benchmark for future development and improvement
Where to from here?• Freely available – CD/DVD format – Online format• Supported by short versions for front-line staff• Translated versions• Posters, etc• Regional seminars planned for May and June
Immediate future plans• Home Care industry – Addition to the Guidelines• Extramural course (co-operative alliance between universities)• Other views/ideas?