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Manual HandlingManual Handling

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What Is Manual Handling?What Is Manual Handling?

Any event that involves:Any event that involves: LiftingLifting LoweringLowering PushingPushing PullingPulling CarryingCarrying Moving, holding or restraining anythingMoving, holding or restraining anything

Look, Think and PlanLook, Think and Plan

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Ensure the Load is not too HeavyEnsure the Load is not too Heavy

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Why is it important?Why is it important?

Because you do not want to injure yourself, a colleague or a patient!!

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Remember:Remember:

Prevention is better than cure!Prevention is better than cure!

If the lift/move is not necessary do not do it!If the lift/move is not necessary do not do it!

Always use the appropriate equipment or technique.Always use the appropriate equipment or technique.

Ensure you are adequately trained to use equipment - if not Ensure you are adequately trained to use equipment - if not DO NOT DO NOT

USE ITUSE IT

Report faulty equipment, or lack of.Report faulty equipment, or lack of.

Ensure you colleagues comply with the work place procedure. Ensure you colleagues comply with the work place procedure.

Continuous assessment and evaluation Continuous assessment and evaluation

You can do just a few of the stretches anytime during the day. You can do just a few of the stretches anytime during the day.

Stretch prior to doing any manual handling tasks.Stretch prior to doing any manual handling tasks.

Exercise and take short breaks frequently Exercise and take short breaks frequently

Cool down after any heavy lifting/manual handling.Cool down after any heavy lifting/manual handling.

Exercise is one of the best ways you can improve your posture. Exercise is one of the best ways you can improve your posture.

Include a variety of movements in your workday. Include a variety of movements in your workday.

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Manual HandlingManual Handling

Types of patient transfersTypes of patient transfers

Turn client using a slide sheet * Move client up a bed with slide sheet * Getting client out of bed * Standing client * Assisting client to walk * Assist client form floor to Chair (Verbal Instruction) * Getting client out of bed (Stand Hoist) Getting client bed to chair (Sling Hoist) Assisting client from floor (Sling hoist) Move client from bed to bed using slide board

* Assessed* Assessed

Manual Handling Legislation

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Risk AssessmentRisk Assessment

(1) An employer must ensure that any manual handling that is likely to be a risk to health and safety is identified and assessed.

(2) An assessment undertaken for the purposes of this regulation must take into account the following factors:

a) The actions and movements involved in the manual handling. b) The workplace and workstation layout. c) The postures and positions that must be taken by each person

involved in the manual handling. d) The duration and frequency of the manual handling. e) The location of the loads and the distances that they must be

moved f) The weights and forces involved g) The characteristics of the loads and of any equipment that is used

in the task.

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Risk AssessmentRisk Assessment

h) The organisation of work at the workplace. i) The work environment. j) The skill and experience of each person who must carry out

the manual handling. k) The personal characteristics of each person who must carry

out the manual handling. l) The clothing that is worn during the manual handling. m) Any other relevant factor (as identified by the employer or

any employee, health and safety representative or health and safety committee, or registered association consulted by the employer).

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Risk controlRisk control

(1) If a manual handling task is assessed as being a risk to health and safety, the employer must take such steps as are reasonably practicable to control the risk.

(a) the employer must— (i) redesign the manual handling task to

eliminate or control the risk factors (ii) ensure that the employees involved in the

manual handling task receive appropriate training, (including training

in safe manual handling techniques) Appropriate supervision.

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Risk controlRisk control (b) where redesign is not reasonably practicable, or as a short-term or

temporary measure, the employer must— (i) take one, or a combination of two or more, of the following measures

as may be appropriate: (A) provide mechanical aids (B) provide personal protective equipment (C) arrange for team lifting (ii) Ensure that the employees receive appropriate training, supervision

in: Correct use or application of any mechanical aids Personal protective equipment. Team lifting procedures.

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Duties of employeesDuties of employees

An employee must So far as is reasonable (but without

derogating from any common law right) Apply any training provided for the

purposes of this Division. Comply with any instruction given in

supervision of the manual handling task.

Manual Handling TechniquesManual Handling Techniques

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General HoistGeneral Hoist

General hoist is a mobile device for moving patients. Vary in safe working load (SWL) Hoists can be manual (hydraulic) or electric (battery

powered). Sling is used for attaching the patient to the hoist. Coded for size (S, M, L, XL) and load capacity Two main types of sling: Total body sling with head support Toileting sling.

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General HoistGeneral Hoist

Hoists can also be fitted with a variety of attachments.

Used for moving a patient who is incapable of weight bearing for the duration of the task.

Repositioning the patient in bed • Transferring the patient between the items of

origin and destination E.g. Bed/stretcher, Bed/chair, Chair/chair Toileting Lifting the patient from the floor.

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General HoistGeneral Hoist

Select the correct sling and place it under patient

Patient in bed or on the floor the sling is applied by rolling the patient.

Patient is sitting, rock patient forwards and then sideways to get the sling under them.

Secure brakes item of origin Secure brakes item of destination Sling breaks off.Sling breaks off.

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General HoistGeneral Hoist

Position the hoist, lower boom and attach sling at all points.

Ensure the patient’s arms are either contained within the sling or holding on to the spreader bar.

Actuate the control to raise the patient sufficiently to just clear the item of origin

Check all four points of sling contact. Move the hoist to the point of destination. During movement the patient is kept as low as possible. Point of destination, position the patient accurately and

lower slowly. Use the spreader handle or handles on the sling to

improve patient positioning.

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PrecautionsPrecautions

Do not attempt to adjust the sling once the patient is raised.

Use the spreader to increase the width of the hoist and improve stability.

Hoists can tip if pushed over any sloping surfaces. Ensure the weight of the patient does not exceed the

capacity of sling / hoist of sling / hoist Applying the brakes to the hoist prevents the hoist from

adjusting itself to the load. When parking the hoist after use, the brakes should be

activated.

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RollingRolling

Rolling over is used for a number of activities. Preparation for a number of nursing care

activities: Changing the bed , , Patients positioning for pressure care, Position slings, slide sheets, slide boards. Preparation for getting out of bed

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RollingRolling

Ensure the brakes are on. Take all but one pillow out from behind the head . . Back rest down. Patient to bend up knees or bend one or both up for them. Patient to move arm in the direction of the rolling or place it

for them. Patient to turn head in the direction they are rolling. One nurse stands on destination side and holds the patient Nurse on origin side pushes on the patient’s legs, then

uses the hip and shoulder to roll the patient.

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PrecautionsPrecautions

If one nurse technique. Ensure that the bedrail is up on the side

that the patient is rolling to. Some orthopaedic conditions require a

patient rolled without twisting.

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SlidesheetSlidesheet

Description A rectangle of thin slippery fabric that can either

be used singly or in combination with a second slide sheet or slide board.

The slide sheet is placed under the patient to facilitate moving them in the bed.

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SlidesheetSlidesheet

Specific preparation Roll the patient onto their side and place the

partially rolled up sheet under the patient. Position the open side of the slide sheet on the

same side as the pulling action is to occur: for rolling – your side towards the shoulders of the patient for pulling

up the bed.

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SlidesheetSlidesheet

Specific preparation. Ensure the slide sheet covers the heaviest part

of the patient (Shoulders to past the hips.) Bed brakes on. Moving the patient up the bed.

Encourage them to assist by bending their legs up and pushing down with their feet.

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SlidesheetSlidesheet

Technique One handler – stands on the side of the movement. (Open

end of slide sheet) One HandlerOne Handler – stand on other side of the bed. (Direction

patient will face.) Maintain arms straight but with elbows relaxed and pull on

the top layer of the slide sheet, shifting weight on to the back foot.

Adopt a lunge position. 1st handler pulls top of slide sheet. 2nd handler assists by pushing patient through movement.

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Slide SheetSlide Sheet

Precautions A single slide sheet is unidirectional. Two slide sheets can be multidirectional - used

to move across, up, down the bed. Variation in slipperiness of the fabric, which can

impact on both noise and forces required to use.

Bed sliding devices can be unpredictably slippery (Be aware of force required!) (Be aware of force required!)

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Standup HoistStandup Hoist

Description A stand up hoist is a mobile device for moving weight-bearing

patients. Hoists vary in safe working load (SWL) and function Can be manual (hydraulic) or electric (battery powered). SSling is used for attaching the patient to the hoist. Slings are coded for size (S, M, L, XL) Slings have a SWL. The sling is applied around torso about level waist and secured

around the chest.

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Standup HoistStandup Hoist

Indications for use Used for moving a patient who is capable of

weight bearing for the duration of the task, but who can be unreliable.

Transferring the patient between the items of origin and destination.

Toileting. Dressing or undressing. Changing incontinence pads or dressings. Rehabilitation activities.

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Standup HoistStandup Hoist

Specific preparation. Select the correct sling and place it around the

patient. Secure the chest band or buckles. Position the hoist and attach sling at two points. Position the patient’s feet on the foot platform. Ensure the patient’s arms grip the handles. Ensure the brakes are on the items of origin

and destination

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Standup HoistStandup Hoist

Technique Actuate the control to raise the patient

sufficiently to just clear the item of origin.. Raise the patient to clear the supporting

surface. Move the hoist to the point of destination or to

perform the required activity. At the point of destination, position the patient

accurately and lower slowly.

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Standup HoistStandup Hoist

Precautions Patient must be cooperative. Able to weight-bear and hang on to the hoist handles for

the duration of the activity. Ensure that the sling is adjusted correctly. correctly. Do not attempt to adjust the sling once the patient is

raised. Use the spreader to increase the width of the hoist and

improve stability. Ensure the weight of the patient does not exceed the

capacity of hoist or sling.

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Sit to Stand – Single PersonSit to Stand – Single Person

Technique. (walk belts can be used here.). (walk belts can be used here.) Patient’s feet should be positioned under the chair ie

behind their knees. Patient should slide forwards on the chair. Position your feet and knees outside the patients – you

can block one of the patient’s knees with your own. When the patient is ready Get them to push down on the armrests as you lean

back pulling the patient towards you. Standing slightly to the side to avoid obstructing their

head. Step back as patient approaches the upright position.

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Getting up From the Floor -Getting up From the Floor -Able Bodied PatientsAble Bodied Patients

Patient should roll onto their side and flex their knees. Patient then places one hand on the floor and rolls onto their knees. As the other hand frees, the patient should place that on the floor so

they assume a crawl position. Place a chair in front of them. Patient should grab the chair with each arm in turn, then place one

foot on the ground. Instruct the patient to push down (or pull up) on the chair and raise

themselves. Bring another chair in behind patient. Patient raises self just enough to allow second chair to be place

under buttocks. Patient then sits onto second chair

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Action: Sit to stand – two Action: Sit to stand – two personspersons

Walk belts can be used here. Patient’s feet should be positioned under the chair ie behind their

knees. Patient should slide forwards on the chair. Patient should move their shoulders forward and position their

hands on the armrest. Each nurse stands either side of the patient Can block the patient’s foot with your own if this is comfortable and

does not compromise your balance. Squat (lunge) and each grasp one handle at the front and one

handle at the back of the walkbelt. (If using) (If using) When the patient is ready and in accordance with your ‘lifting

command’, guide the patient forwards and upwards.

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Manual Handling and Manual Handling and StretchingStretching

Simple stretches to reduce the Simple stretches to reduce the risk of suffering an injuryrisk of suffering an injury

By completing the following stretches prior to undertaking any manual handling task, you are

reducing the risk of injury.

If any of the following stretches cause you pain or discomfort, STOP the stretch immediately.

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StretchesStretches

PositionPosition

Stand with the feet shoulder width apart Stand with the feet shoulder width apart

and the arms behind the bodyand the arms behind the body

ActionAction

Grasp the left wrist with the right hand. Grasp the left wrist with the right hand.

Pull the left arm down and to the right. Pull the left arm down and to the right.

Tilt the head to the right. Hold this Tilt the head to the right. Hold this

position for 10-15 seconds. Repeat the position for 10-15 seconds. Repeat the

action with the right wrist, pulling the action with the right wrist, pulling the

right arm down and to the left. Tilt the right arm down and to the left. Tilt the

head to the left.head to the left.

Neck & Shoulders

PositionPosition

Stand and extend the arms upward and over Stand and extend the arms upward and over

the head. Interlace the fingers with the the head. Interlace the fingers with the

palms turned upward.palms turned upward.

ActionAction

Stretch the arms up and slightly back. Hold Stretch the arms up and slightly back. Hold

this position for 10-15 seconds.this position for 10-15 seconds.

VariationVariation

This stretches the rectus abdominous This stretches the rectus abdominous

muscles. Stretch to one side, then the other. muscles. Stretch to one side, then the other.

Return to the starting position.Return to the starting position.

Abdominal

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PositionPosition

Stand and interlace the fingers behind Stand and interlace the fingers behind

the back.the back.

Action Action

Lift the arms behind the back so that Lift the arms behind the back so that

they move outward and away from thethey move outward and away from the

body. Lean forward from the waist. Holdbody. Lean forward from the waist. Hold

this position for 10-15 seconds. Bendthis position for 10-15 seconds. Bend

the knees before moving to the uprightthe knees before moving to the upright

position. Return to the starting position.position. Return to the starting position.

PositionPosition

Stand with the arms extended to theStand with the arms extended to the

front at shoulder height with the fingersfront at shoulder height with the fingers

interlaced and palms facing outward.interlaced and palms facing outward.

ActionAction

Extend the arms and shoulders forward.Extend the arms and shoulders forward.

Hold this position for 10-15 seconds.Hold this position for 10-15 seconds.

Return to the starting position.Return to the starting position.

Chest Upper Back Stretch

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PositionPosition

Stand with the feet shoulder widthStand with the feet shoulder width

apart. Raise the right arm, bending theapart. Raise the right arm, bending the

right elbow and touching the right handright elbow and touching the right hand

to the back of the neck.to the back of the neck.

Action Action

Grab the right elbow with the left hand,Grab the right elbow with the left hand,

and pull to the left. Hold this positionand pull to the left. Hold this position

for 10-15 seconds. Return to thefor 10-15 seconds. Return to the

starting position. Do the same stretch,starting position. Do the same stretch,

and pull the left elbow with the rightand pull the left elbow with the right

hand for 10-15 seconds.hand for 10-15 seconds.

PositionPosition

Stand. (For variation, lie on the stomach.)Stand. (For variation, lie on the stomach.)

ActionAction

Bend the left leg up toward the buttocks.Bend the left leg up toward the buttocks.

Grasp the toes of the left foot with the rightGrasp the toes of the left foot with the right

hand, and pull the heel to the left buttock.hand, and pull the heel to the left buttock.

Extend the left arm to the side for balance.Extend the left arm to the side for balance.

Hold this position for 10-15 seconds.Hold this position for 10-15 seconds.

Return to the starting position. Repeat withReturn to the starting position. Repeat with

the right leg. Extend the right arm forthe right leg. Extend the right arm for

balance. Hold this position for 10-15balance. Hold this position for 10-15

seconds. Return to the starting position.seconds. Return to the starting position.

Overhead Arm Pull

Thigh Stretch

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PositionPosition

Lunge slowly to the left while keepingLunge slowly to the left while keeping

the right leg straight, the right footthe right leg straight, the right foot

facing straight ahead and entirely onfacing straight ahead and entirely on

the floor.the floor.

ActionAction

Lean over the left leg while stretchingLean over the left leg while stretching

the right groin muscles. Hold thisthe right groin muscles. Hold this

position for 10-15 seconds. Repeatposition for 10-15 seconds. Repeat

with the opposite leg.with the opposite leg.

Groin Stretch

Standing

Calf Stretches

PositionPosition

Stand straight with the feet together, armsStand straight with the feet together, arms

extended downward, elbows locked, palmsextended downward, elbows locked, palms

facing backward and head and eyes facing front.facing backward and head and eyes facing front.

ActionAction

Move the right foot to the rear about two Move the right foot to the rear about two

feet, and place the ball of the foot on thefeet, and place the ball of the foot on the

ground. Slowly press the right heel to theground. Slowly press the right heel to the

ground. Slowly bend the left knee whileground. Slowly bend the left knee while

pushing the hips forward and arching the pushing the hips forward and arching the

back slightly. Hold for 10-15 seconds. back slightly. Hold for 10-15 seconds.

Return to the starting position. Repeat with Return to the starting position. Repeat with

the left foot. the left foot.

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PositionPosition

Stand with the back straight and feetStand with the back straight and feet

shoulder width apart. Extend the armsshoulder width apart. Extend the arms

outward to shoulder height.outward to shoulder height.

ActionAction

Rotate the shoulders forward, and make aRotate the shoulders forward, and make a

large circular motion with the arms. Repeatlarge circular motion with the arms. Repeat

the action in the opposite direction. Do thisthe action in the opposite direction. Do this

three times in each direction.three times in each direction.

PositionPosition

Stand with your feet shoulder widthStand with your feet shoulder width

apart and hands on your hips.apart and hands on your hips.

ActionAction

Rotate the hips clockwise while keeping Rotate the hips clockwise while keeping

the back straight. Repeat the action in a the back straight. Repeat the action in a

Counter clockwise direction. Do this Counter clockwise direction. Do this

three times in each directionthree times in each direction

Arm StretchesHip Stretches

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ReferencesReferences

WorkCover NSWHead office phone: 13 10 50Fax: (02) 4325 4145 www.workcover.nsw.gov.au (visited17/02/09) Further Information NSW Nurses’ AssociationPhone: www.nswnurses.asn.au WorkCover SAwww.workcover.com National Occupational Health and Safety Commissionwww.nohsc-

eu.gov.au Design4 Healthwww2.dir.qld.gov.au/design4health/ http://vetvirtual.external.utas.edu.

au/csh/assets/manualhandling/index.htm