safe lifting in healthcare setting

1. BACK INJURY PREVENTION FOR
HEALTHCARE WORKERS

2.  USE THE FOLLOWING ACRONYM AS A
GUIDE WHEN ENGAGING IN PATIENT
HANDLING:
B ACK STRAIGHT
A VOID TWISTING
C LOSE TO BODY
K EEP SMOOTH

3.  DISCS OF THE BACK CAN TOLERATE LARGER
COMPRESSIVE LOADS WHEN THE BACK IS STRAIGHT.
 DISCS OF THE BACK ARE WEAKER WHEN LIFTING IN A
FLEXED POSITION.
 MAINTAIN THE SPINES NEUTRAL CURVES. THIS KEEPS
THE SPINE ALIGNED AND MOVING SMOOTHLY AND
MINIMIZES STRESS ON THE SPINE.

4.  DISKS OF THE BACK ARE WEAKER WHEN
LIFTING IS COMBINED WITH TWISTING.
 THE JOINTS IN THE BODY ARE DESIGNED TO
AVOID ROTATION, SO, IF YOU TWIST WHEN YOU
LIFT THE JOINTS BECOME INFLAMED AND SORE.

5.  IF AN OBJECT IS AT A GREATER DISTANCE FROM YOUR
BODY FOR LIFTING, YOUR BACK MUSCLES AND JOINTS
HAVE TO WORK HARDER TO LIFT THE WEIGHT CREATING
GREATER STRESS ON YOUR BACK.
 BUT, IF YOU KEEP THE EXACT SAME LOAD CLOSE TO YOUR
BODY, THE LESSER DISTANCE CREATES A LIGHTER LOAD
AND LESS STRESS ON YOUR BACK.

6.  USE SMOOTH AND SLOW
MOTIONS. DO NOT
HURRY. TAKE YOUR TIME.
DO NOT USE JERKY
MOTIONS BECAUSE THIS
INCREASES THE LOAD ON
THE DISCS OF THE SPINE.

7.  ALWAYS CONSIDER THE USE OF A
MECHANICAL AID.
 DURING PATIENT HANDLING, USE YOUR
LEG AND HIP MUSCLES, AND KNEE
JOINTS TO LIFT. NOT YOUR BACK.
 WHEN LIFTING A PATIENT OR OBJECT,
TIGHTEN YOUR ABDOMINAL AND PELVIC
MUSCLES AND KEEP THE PATIENT OR
OBJECT CLOSE TO YOUR BODY TO
PREVENT INJURY.

8.  AVOID REACHING OVER YOUR HEAD TO LIFT TO PREVENT
STRAIN ON THE JOINTS OF THE SPINE.
 LIFT IN STAGES IF YOU NEED TO. IF THE PATIENT OR
OBJECT SLIPS, LOWER THEM TO THE FLOOR WHILE
TIGHTENING YOUR ABDOMINAL MUSCLES AND AVOID
ANY ROTATION.

9.  THE ASSESSMENT IS IMPORTANT
BECAUSE IT:
 HELPS TO DETERMINE ANY RISK
FOR INJURY.
 PROMOTES CONTINUITY OF CARE.
 HELPS YOU TO BE PREPARED FOR
POSSIBLE RISKS.
 HELPS TO MINIMIZE THE RISK OF
INJURY FOR THE PATIENT AND
THE HEALTHCARE WORKER.

10.  CONSIDER THE FOLLOWING:
 IS THERE A MEDICAL CONDITION THAT
COULD MAKE THE PATIENT MORE
VULNERABLE TO INJURY;
 DIZZINESS
 CONFUSION
 DEAFNESS
 MEDICATION
 MUSCLE SPASMS
 RECENT SURGERY
 SENSITIVE SKIN

11.  PHYSICAL ABILITY; HOW WELL CAN THE
PATIENT SIT UP, STAND UP, OR WALK ON
THEIR OWN.
 ARE THEY AMBULATORY?
 HAVE THEY HAD A STROKE AND ARE WEAK
ON ONE SIDE?
 ARE THEY WEIGHT BEARING?
 HOW IS THEIR UPPER BODY STRENGTH?

12.  ACUITY; HOW WELL DO THEY FOLLOW
INSTRUCTIONS?
 BEHAVIOR; WHAT THE PERSON MIGHT DO;
 HOW GOOD IS THEIR GENERAL UNDERSTANDING?
 ARE THERE ANY LANGUAGE PROBLEMS OR
BARRIERS?
 ARE THEY COMBATIVE?
 ARE THEY COOPERATIVE OR UNCOOPERATIVE?
 ARE THEY UNPREDICTABLE?

13. • USE THE ASSESSMENT TO DECIDE THE
APPROPRIATE TYPE OF ASSIST EQUIPMENT
OR DEVICES, THE TECHNIQUES AND
NUMBER OF PEOPLE NEEDED AND OTHER
RELEVENT CONSIDERATIONS.
• ALWAYS CHECK THE PATIENT OR
RESIDENT EACH TIME BEFORE YOU BEGIN
AND DURING THE ACTIVITY. THEIR
CONDITION CAN CHANGE FROM DAY TO
DAY, DURING THE DAY, AND EVEN
DURING THE ACTIVITY.

14.  INDEPENDENT TRANSFERS: THIS SHOULD
BE USED WHEN A CLIENT IS ABLE TO
MOVE WITHOUT RISK OF INJURY AND IS
COMFORTABLE WITH THE USE OF
MOBILITY AIDS.
 SUPERVISED TRANSFERS: THIS SHOULD
BE USED WHEN THE CLIENT IS ABLE TO
MOBILIZE, BUT MAY REQUIRE VERBAL OR
MINIMAL PHYSICAL CUEING. TRANSFER
BELTS SHOULD BE USED IN ALL CASES.

15.  ONE PERSON TRANSFER BELT/PIVOT
TRANSFER: THIS SHOULD BE USED WHEN
A PATIENT CAN STAND UNSUPPORTED
OR CAN WEIGHT BEAR WITH ASSISTANCE
OF ONE PERSON WHO WILL PROVIDE LESS
THAN 40LBS (18KG) OF ASSISTANCE.
 WALKER TRANSFER: SHOULD BE USED
WHEN THE PATIENT CAN BEAR WEIGHT
THROUGH AT LEAST ONE LEG, AND
WHOSE UPPER BODY STRENGTH AND
MOBILITY ARE ADEQUATE.

16.  TWO PERSON STANDING PIVOT
TRANSFER: THIS TRANSFER SHOULD BE
USED WHEN A CLIENT CAN BEAR
WEIGHT WITH THEIR LEGS BUT IS HEAVY
AND UNRELIABLE. THIS TECHNIQUE
REQUIRES TWO HEALTHCARE WORKERS,
WITH THE TALL PERSON BEHIND THE
PATIENT. A TRANSFER BELT SHOULD BE
USED.

17.  TOTAL MECHANICAL LIFT: SHOULD BE
USED WHEN A CLIENT CAN ONLY
MINIMALLY TRANSFER OR IS NOT ABLE
TO ASSIST WITH WEIGHT BEARING. THIS
SHOULD ALSO BE USED IF THE CLIENT IS
COGNITIVELY UNRELIABLE OR
UNCOOPERATIVE, HAS POOR HEAD
CONTROL OR SITTING BALANCE OR IS
EXTREMELY LARGE OR HEAVY AND
REQUIRES ASSISTANCE.

18.  SLIDE SHEETS: SHOULD BE USED IN
REPOSITIONING A PATIENT IN BED WHO IS
UNABLE TO MOVE THEMSELVES
INDEPENDENTLY. TWO CAREGIVERS ARE
REQUIRED. SLIDE SHEETS CAN BE USED TO
MOVE A PATIENT FROM BED TO STRETCHER
OR IN AN EMERGENCY SITUATION WHERE
THE PATIENT HAS FALLEN IN A CONFINED
SPACE OR THE MECHANICAL LIFT OR OTHER
TRANSFER METHODS CANNOT BE USED.
 TRANSFER BELT: SHOULD BE USED WHEN A
CLIENT NEEDS ASSISTANCE WITH A
TRANSFER OR MOBILIZATION.

20.  WHEN LIFTING OR TRANSFERRING A
PATIENT, REMEMBER TO:
 USE YOUR LEG MUSCLES. NOT YOUR BACK
 BEND YOUR KNEES. NOT YOUR WAIST
 MAINTAIN A NEUTRAL BACK POSTURE.
 HAVE SOMEONE HELP YOU WHENEVER
POSSIBLE.
 USE LIFTING EQUIPMENT WHENEVER
NECESSARY.

22.  THE BEST LIFTING TECHNIQUES DON’T
ALWAYS WORK WHEN WHAT YOU ARE
LIFTING IS A PERSON. IT IS DIFFICULT TO USE
GOOD BODY POSTURES AT ALL TIMES WHEN
LIFTING DEPENDENT NURSING HOME
RESIDENTS. WHY?
 RESIDENTS CAN FALL, SLIP, OR JERK WHEN YOU
LEAST EXPECT AND YOU CAN BE THROWN OFF
BALANCE BY THE SUDDEN CHANGE IN WEIGHT.
 RESIDENTS CAN BE CONFUSED, SCARED, OR
UNCOOPERATIVE, MAKING IT DIFFICULT FOR
THEM TO FOLLOW INSTRUCTIONS.

23.  A COMBATIVE RESIDENT MAY BE DIFFICULT TO
HOLD IN THE PROPER POSITION FOR LIFTING
AND TRANSFERRING.
 EQUIPMENT AND FURNITURE GET IN THE WAY
AND THE WEIGHT OF THE RESIDENT CANT
ALWAYS BE HELD CLOSE TO THE BODY.
 IN A CONFINED SPACE LIKE A RESIDENTS
BATHROOM OR AT AN AWKWARD ANGLE, YOU
CANT ALWAYS STAND WITH YOUR LEGS APART.
 NOT EVERYONE HAS THE STRENGTH IN THEIR
LEGS TO LIFT FROM THEIR LEGS.
 MANY LIFTING TECHNIQUES REQUIRE TWO
PEOPLE.

24. ONE OF THE MOST
IMPORTANT THINGS
THAT YOU CAN DO TO
PREVENT HURTING
YOUR BACK AT WORK IS
TO GET HELP WHEN
YOU NEED IT.

25.  EXAMINE YOUR WORK ENVIRONMENT.
 COMMUNICATE THE PLAN OF ACTION TO THE
PATIENT AND OTHER EMPLOYEES TO ENSURE
THE TRANSFER WILL BE SMOOTH AND WITHOUT
SUDDEN UNEXPECTED MOVES.
 AVOID AWKWARD OR SUSTAINED POSTURES OR
REPETETIVE MOVEMENTS BY VARYING YOUR
WORK ACTIVITIES THROUGHOUT THE DAY.
 AVOID FORCEFUL MOVEMENTS WITH A HIGH
LOAD TO AVOID BACK INJURY.
 MAINTAIN A NEUTRAL RELAXED POSTURE.
 MAINTAIN PATIENT HANDLING EQUIPMENT.
 ENSURE THAT YOUR WORK PROVIDES EASY
ACCESS TO PATIENTS.

26.  PLAN AHEAD SO THAT YOU HAVE CONSIDERED ALL
THE FACTORS BEFORE ENGAGING IN CLIENT
HANDLING PROCEDURE.
 GET HELP WHEN LIFTING OR TRANSFERRING
PATIENT.
 CONSIDER THE USE OF MECHANICAL AIDS FOR
PATIENT TRANSFERS.
 EXERCISE SUCH AS STRENGTH AND CONDITIONING
HELPS MAINTAIN FUNCTIONAL ABILITY AND HELPS
PREVENT MUSCLE SPRAINS, LOW BACK PAIN,
SHOULDER INSTABILITY AND KNEE INSTABILITY
AND PAIN.
 STRETCHING SHOULD BE INCORPORATED INTO AN
EXERCISE PROGRAM TO HELP IMPROVE FLEXIBILITY.
 BE ALERT FOR SIGNS OF TROUBLE.