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Creating Partnerships
- 1. Creating Partnerships February 13, 2014 Randall Tresidder, PT
- 2. “…body mechanics, is still the foundation of many of the educational programs…despite the technological, scientific, and evidencebased revolution...” Audrey Nelson, Safe Patient Handling and Movement
- 3. • “We used to work on ultrasound machines and 90 percent of sonographers would end with lost time injuries on their shoulders over time. • “It was just because they were badly designed machines.” – Nancy Paris, Director of PART, BCIT
- 4. Injuries In Sonography • Injuries using ultrasound: – – – – More than 80% scanning in pain 20% of above – career ending injury Onset of pain within 5 years Other
- 5. Body Mechanics/Basic Ergonomics • Well identified. • Consensus Conference (WRMDS) – Equipment Control Measures – Administrative Control Measures – Professional Control Measures • Very little help.
- 6. Cardiac Sonography • Pain in shoulder, wrist and thumb. • Caused by trying to get image. • Require more force for larger patients. • Prolonged scans. • Administrative controls. • WCB ergonomic recommendations.
- 7. The Problem • Peak pinch force injury (thumb/wrist) – 10 Newtons (approx 0.45 kg) • Push forces (female) at 6 seconds: – 11-14 kg – Less for sustained forces
- 8. The Problem • Biomechanical Model – Cannot reduce forces appropriately. – Forcing the employee to fit the machine. • Ergonomics – Try to get the machine to fit the worker.
- 9. Possible Solution • Introduce to NSCC Engineering. – Dan Bolivar, Faculty NSCC – Three Engineering Students • Alan Lock • Ben Bates • Coady Carter – Project to reduce overall forces. – Eventually, Karen Richards, ergoCentric
- 10. Prototype – April 2014
- 11. “The quality of your life is determined by the quality of your relationships. The quality of your business is no different.” Harvey Mackay
- 12. Questions ?
Editor's Notes
- There are many different types of slings on the market. Some are meant for lifting and transferring patients, some are for repositioning, etc. The needs of the patient need to be assessed in order to determine the appropriate sling. Each company has their own sling sizing. I will present a generic method, but you need to check the specific sling instructions to see what is appropriate for that sling.
- See http://commons.bcit.ca/update/2012/07/bcit-researchers-win-excellence-in-bc-health-care-award/
- From www2.worksafebc.com/PDFs/ergonomics/Best_Practices_DMS/Overview.pdf Medical literature suggests that: 80% of sonographers seek medical treatment for MSIs, many either miss work due to: symptoms (17%) reduce their duties (15%) use sick leave (21%) or vacation days (12%) to recover.
- The various body mechanics and some basic ergonomics have been well documented. In the past there was a Consensus Conference on Work-Related Musculoskeletal Disorders in Sonography to come up with various options (www.soundergonomics.com/pdf/WRMSDweb.pdf). You see the main heading for control measures on the screen. These have provided some help, but still high incidence of injuries.
- We were approached last summer about an employee in Cardiac Sonography that was off work due to pain in her wrist, thumb and shoulder. Her manager has implemented administrative controls of reduced hours scanning per day and other shift changes within her control. WCB had provided ergonomic recommendations. Here we see an example of the sound head that is used for cardiac sonography. It needs to be small enough to fit between the ribs. This means that the medical sonographer needs to use a tighter grip in order to control the sound head. This puts excessive forces through her fingers, wrist, forearm and shoulder.
- When you look at the amount of force that is required to increase risk of injury for the wrist, hand and shoulder, it is no wonder that this person had the injury she had. Administrative and ergonomic controls can help to reduce risk of injury, but not eliminate it.
- A standard approach in reducing injuries in healthcare seems to be, “let’s use better body mechanics.” There is a place and time for this. However, as noted in the previous slide, the forces required to obtain a good image are higher than the employees can generally tolerate.
- In the desire to create partnerships and to try to look at this problem outside of the box of healthcare, Dan Bolivar at Nova Scotia Community College was approached with request to design something to help reduce injuries. There were 3 students that wanted to take this project on. They are listed on the screen. As the first term went on, the students came up with an idea to alter a chair where the sonographer could rest their arm on an armrest and then use foot pedals to try to apply the force necessary, thus reducing the muscular forces at the shoulder and possibly wrist. They needed parts to work on a prototype. From there they were introduced to Karen Richards from ergoCentric.
- This is a computer generated drawing for the prototype. The completed prototype is expected to be completed by April 2014. It is with the desire to engage in partnership with the community and fostering relationships that this project has taken a different direction that the standard practice. It is hoped that this will help the medical sonography community. Only time will tell. But this is a success story of engagements and relationships.