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Safe lifting

This document provides guidelines for healthcare workers to prevent back injuries while handling patients. It recommends maintaining a neutral back posture, avoiding twisting and keeping loads close to the body. Various patient transfer techniques are described such as using belts, walkers, or mechanical lifts depending on the patient's abilities. Getting help from others and using lifting equipment can help avoid back strain or injury when transferring dependent patients. Proper planning, communication and exercise are also emphasized.

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BACK INJURY PREVENTION FOR HEALTHCARE WORKERS
 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
 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.
 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.
 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.
 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.
 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.
 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.
 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.
 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
 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?
 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?
• 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.
 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.
 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.
 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.
 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.
 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.
 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.
 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.
 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.
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.
 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.
 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.