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Safe Patient Handling
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Hazards and Solutions Training and Additional Resources State Legislation Starting a Safe Patient Handling Program
One major source of injury to healthcare workers is musculoskeletal disorders (MSDs). In 2017, nursing assistants had the second highest number of cases of MSDs. There were 18,090 days away from work cases, which equates to an incidence rate (IR) of 166.3 per 10,000 workers, more than five times the average for all industries. This compares to the all-worker days-away from work rate of 30.5 per 10,000 workers.
These injuries are due in large part to overexertion related to repeated manual patient handling activities, often involving heavy manual lifting associated with transferring, and repositioning patients and working in extremely awkward postures. Some examples of patient handling tasks that may be identified as high-risk include: transferring from toilet to chair, transferring from chair to bed, transferring from bathtub to chair, repositioning from side to side in bed, lifting a patient in bed, repositioning a patient in chair, or making a bed with a patient in it.
Sprains and strains are the most often reported nature of injuries, and the shoulders and low back are the most affected body parts. The problem of lifting patients is compounded by the increasing weight of patients to be lifted due to the obesity epidemic in the United States and the rapidly increasing number of older people who require assistance with the activities of daily living.
The consequences of work-related musculoskeletal injuries among nurses are substantial. Along with higher employer costs due to medical expenses, disability compensation, and litigation, nurse injuries also are costly in terms of chronic pain and functional disability, absenteeism, and turnover. As many as 20% of nurses who leave direct patient care positions do so because of risks associated with the work. Direct and indirect costs associated with only back injuries in the healthcare industry are estimated to be $20 billion annually. In addition, healthcare employees, who experience pain and fatigue, may be less productive, less attentive, more susceptible to further injury, and may be more likely to affect the health and safety of others.
Industries where patient handling tasks are performed include:
- Long-Term Care (includes facilities that provide skilled or non-skilled nursing care);
- Acute Care - (includes hospitals, out-patient surgical centers, and clinics);
- Home Healthcare workers; and
- Others - such as physical therapists, radiologists, sonographers, etc.
Some examples of areas of a facility that may be identified as high-risk include: bathing rooms, extended care wings, and diagnostic units (e.g., radiology, emergency department, spinal unit, orthopedics department).
Given the increasingly hazardous biomechanical demands on caregivers today, it is clear the healthcare industry must rely on technology to make patient handling and movement safe. Patient transfer and lifting devices are key components of an effective program to control the risk of injury to patients and staff associated with lifting, transferring, repositioning or movement of patients. Essential elements of such a program include management commitment to implement a safe patient handling program and to provide workers with appropriate measures to avoid manual handling; worker participation in the assessment and implementation processes and the evaluation and selection of patient handling devices; a thorough hazard assessment that addresses high risk units or areas; investment in equipment; care planning for patient handling and movement; training for staff; and program review and evaluation processes. The education and training of healthcare employees should be geared towards assessment of hazards in the healthcare work setting, selection and use of the appropriate patient lifting equipment and devices, and review of research-based practices of safe patient handling.
The use of assistive patient handling equipment and devices is beneficial not only for healthcare staff, but also for patients. Explaining planned lifting procedures to patients prior to lifting and enlisting their cooperation and engagement can increase patient safety and comfort, and enhance their sense of dignity.
Hazards and Solutions (Transfer, Repositioning, and Lifting Devices)
Acute Care and Long Term Healthcare Workers
- Safe Patient Handling Tools and Resources. OSHA has developed a series of online resources to help hospitals develop and implement safe patient handling assessments, policies, procedures, programs, training, and patient education.
- Beyond Getting Started: A Resource Guide for Implementing a Safe Patient Handling Program in the Acute Care Setting. Association of Occupational Health Professionals in Healthcare (AOHP), (2014). This resource guide addresses patient handling with the goal of providing the necessary tools for occupational health professionals to implement a safe patient handling program.
- Guidelines for Nursing Homes: Ergonomics for the Prevention of Musculoskeletal Disorders. OSHA, (Revised 2009). These guidelines provide recommendations for nursing home employers to help reduce the number and severity of work-related musculoskeletal disorders (MSDs) in their facilities.
- Safe Lifting and Movement of Nursing Home Residents. U.S. Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication, No. 2006-117, (November 2006). This guide is intended for nursing home owners, administrators, nurse managers, safety and health professionals, and workers who are interested in establishing a safe resident lifting program. This guide also presents a business case to show that the investment in lifting equipment and training can be recovered through reduced workers' compensation expenses and costs associated with lost and restricted work days.
Home Healthcare Workers
- Home Healthcare Workers: How to Prevent Musculoskeletal Disorders. U.S. Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication No. 2012-120, (February 2012). This is one in a series of six fast fact cards developed to provide practical advice for home healthcare workers and is based on NIOSH Hazard Review: Occupational Hazards in Home Healthcare, NIOSH Pub No. 2010–125. Lifting and moving clients create a high risk for back injury and other musculoskeletal disorders for home healthcare workers.
- NIOSH Hazard Review; Occupational Hazards in Home Healthcare; Department of Health and Human Services, Center for Disease Control and Prevention. National Institute for Occupational Safety and Health (NIOSH). The document aims to raise awareness and increase understanding of the safety and health risks involved in home healthcare and suggests prevention strategies to reduce the number of injuries, illnesses, and fatalities that too frequently occur among workers in this industry.
- The Ergonomics Module of the OSHA Hospital e-Tool is relevant to safe patient handling concepts in the field of physical therapy.
- The Radiology Module of the OSHA Hospital e-Tool is relevant to patient handling concepts in the field of radiology.
- The Sonography module of the OSHA Hospital e-Tool is relevant to safe patient handling concepts in the field of sonography.
- Preventing Work-Related Musculoskeletal Disorders in Sonography. U.S. Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication, No. 2006-148, (November 2006). NIOSH recommends appropriate engineering controls, work practices, hazard communication, and training to prevent these work-related musculoskeletal disorders in healthcare workers giving sonograms.
Training and Additional Resources
- Safe Patient Handling -- Preventing Musculoskeletal Disorders in Nursing Homes. OSHA Publication 3108, (February 2014).
- Safe Patient Handling Training for Schools of Nursing. U.S. Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication No. 2009-127, (November 2009). The NIOSH "Safe Patient Handling and Movement" presentation and CD-ROM download are also available at:
- Safe Patient Handling and Movement. A web-based training presentation based on NIOSH Publication No. 2009-127, (March 2010). Provides an overview of safe patient handling principles. A CD-ROM is also available for advanced users.
A-1136 safe patient handling legislation signed into law October 2011.
SB 879 safe patient handling legislation signed into law April 2007.
HB 712.2 safe patient handling legislation signed into law May 2007.
S-1758/A-3028 safe patient handling practice act signed into law January 2008.
Title 1-A of Article 29-D, added to the Public Health Law by Chapter 60 of the Laws of 2014, Part A, §20
House Bill 67 was signed into law on March 21, 2006, Section 4121.48. Repealed effective June 20, 2015.
House 7386 and Senate 2760 passed on July 7, 2006.
Senate Bill 1525 was signed into law on June 17, 2005.
House Bill 1672 was signed into law on March 22, 2006.
Starting a Safe Patient Handling Program
Through the Alliance between OSHA and the Association of Occupational Health Professionals (AOHP) (concluded 10/2012), AOHP and OSHA produced "Beyond Getting Started: A Resource Guide for Implementing a Safe Patient Handling Program in the Acute Care Setting."
The Alliance recognized that patient handling practices impact not only healthcare workers but also patients. Safe patient handling practices reduce the risk of the patient falling or experiencing other negative outcomes. In addition, implementing safe patient handling practices will reduce a healthcare facility's financial burden with regard to patient claims and workers' compensation claims.
Safe patient handling programs frequently are initiated by or become the responsibility of healthcare providers themselves. In some cases, this new responsibility may not include the additional resources to implement a program effectively and efficiently.
"Beyond Getting Started: A Resource Guide for Implementing a Safe Patient Handling Program in the Acute Care Setting":
- Provides background information and reviews the differences between acute and long term care facilities;
- Builds a foundation for a successful safe patient handling program;
- Describes the process (assessment, planning, implementation and evaluation) of establishing a safe patient handling program;
- Provides examples of forms, checklists, job descriptions, etc. which can be developed in support of a safe patient handling program; and
- Lists additional references for more information.
This resource guide identifies the basic steps and processes necessary to implement a safe patient handling program in a comprehensive manner, including the need for adequate funding. Whereas this guide was initially focused upon occupational health care providers, much of the information holds true, is transferrable, and may be easily augmented to address safe patient handling programs in other healthcare fields as well.
Safe patient handling and mobility involves the use of assistive devices to ensure that patients can be mobilized safely and that care providers avoid performing high-risk manual patient handling tasks. Using the devices reduces a care provider's risk of injury and improves the safety and quality of patient care.
- Principles of Safe Manual Handling -Position the feet. ...
- Get a secure grip. ...
- Keep the load close to the body. ...
- Maintain good posture throughout the procedure. ...
- Use the leg muscles. ...
- Principles of Safe Manual Handling – Use body momentum.
Putting boxes on shelves, painting, gardening, cleaning, writing and typing are some examples of manual handling tasks.
- EMS is in the moving business. Four tips for safer lifting and moving of EMS patients. ( ...
- How much weight is safe to lift? ...
- 4 tips for safer patient lifting. ...
- Stop lifting from the floor. ...
- Use handles for lateral transfers. ...
- Work together to safely lift patients. ...
- Slow down, ensure safety.
- Use monitoring technology. ...
- Make sure patients understand their treatment. ...
- Verify all medical procedures. ...
- Follow proper handwashing procedures. ...
- Promote a team atmosphere.
the nature of the task itself; 2. the weight and type of load being moved; 3. the ability of the individual person carrying out the task; 4. the environment in which the activity is being carried out.
A safe patient handling policy provides for a safer approach to patient/client handling whereby the manual lifting of patients/clients is eliminated or minimised wherever possible and so far as reasonably practicable.
Tasks may involve bending and twisting, repetitive motions, carrying or lifting heavy loads, and maintaining fixed positions for a long time. As with other risks in the workplace, the first rule is to look at a way to avoid the need for manual handling in the first instance.
It is defined as any activity that requires an individual to exert a force to push, pull, lift, carry, lower, restrain any person, animal or thing. As a nurse or a personal care worker, this means that Manual Handling is more than just moving and assisting our clients.
Bend and lift with the knees, not at the waist. Bending at the waist puts unnecessary stress on your lower spine. Avoid twisting your body, especially while bending, for the same reasons as above. Hold the patient close to your body while lifting and transferring them.
Patient Lifting Techniques - YouTube
How to Use a Manual Lift to Get a Person In and Out of Bed - YouTube
What is Patient Safety? Patient Safety is a health care discipline that emerged with the evolving complexity in health care systems and the resulting rise of patient harm in health care facilities. It aims to prevent and reduce risks, errors and harm that occur to patients during provision of health care.
- Medication/drug errors. ...
- Healthcare-associated infections. ...
- Surgical errors and postoperative complications. ...
- Diagnostic errors. ...
- Laboratory/blood testing errors. ...
- Fall injuries. ...
- Communication errors. ...
- Patient identification errors.
Educating patients on their post-discharge care is a simple, yet effective, example of how nurses can improve patient safety. By working with patients to ensure they have a thorough understanding of their medical condition and self-care routine before they are discharged, nurses help facilitate a smooth recovery.
Five important components in biomechanics are motion, force, momentum, levers and balance: Motion is the movement of the body or an object through space. Speed and acceleration are important parts of motion. Force is a push or pull that causes a person or object to speed up, slow down, stop or change direction.
Why is it important to develop and implement a safe patient handling policy for rehabilitation centers? ›
Safe patient handling practices will reduce the risk of the patient falling or experiencing skin breakdown from repositioning or lateral transfers in bed. In addition, implementing safe patient handling practices will reduce the facility's financial burden with regard to patient claims and workers' compensation claims.
The patient should help support their weight on their good leg during the transfer. Pivot towards the wheelchair, moving your feet so your back is aligned with your hips. Once the patient's legs are touching the seat of the wheelchair, bend your knees to lower the patient into the seat.
Information for healthcare professionals and the public about the Pfizer/BioNTech vaccine.
Published 2 December 2020. Last updated 16 August 2022 + show all updates 16 August 2022 Updates to the SmPC and PIL to include information about receiving a heterologous booster dose in individuals aged 18 years and over.. 24 December 2021 Information for Healthcare Professionals and UK recipients on COVID-19 Vaccine Pfizer/BioNTech (Regulation 174) was updated. 15 November 2021 Updated sections of the Summary of Product Characteristics and Patient Information Leaflet for COVID-19 Vaccine Pfizer/BioNTech (Conditional Marketing Authorisation documents) to include information about receiving a 3rd/booster dose.. 27 October 2021 Update to the summary of product characteristics and patient information leaflet for the Pfizer/BioNTech vaccine condition marketing authorisation documents. 9 September 2021 Updated sections of Information for Healthcare Professionals on COVID-19 Pfizer/BioNTech (Regulation 174) and Information for UK recipients on COVID-19 Vaccine Pfizer/BioNTech (Regulation 174) to include information about receiving a third dose.. 11 August 2021 Updates to the Conditional Marketing Authorisation SmPC and PIL and updates to the Regulation 174 Information for Healthcare Professionals and Information for recipients. 9 July 2021 We have published the Summary of Product Information, Patient Information Leaflet and Conditions document for the GB Conditional Marketing Authorisation of the Pfizer/BioNTech vaccine.. 4 June 2021 Updated Conditions of Authorisation, Information for Healthcare Professionals and Information for UK Recipients documents in line with an extension to the current UK approval of the Pfizer/BioNTech COVID-19 vaccine that allows its use in 12- to 15-year-olds.. 20 May 2021 Updated the Information for Healthcare Professionals, Information for UK recipients and Conditions of Authorisation documents.. 9 March 2021 Added information on fevers to Section 4 of Information for UK Recipients and section 4.8 of Information for Healthcare Professionals.. 30 December 2020 Updated the Information for UK recipients and the Information for healthcare professionals documents, to reflect changes to the dosage interval, advice for women who are pregnant or breastfeeding and to those with allergies.
Handle with care, ensure you follow SPHM best practices.
Tap Comprehensive Patient Assessment & Algorithms , and tap Conduct an assessment for multiple tasks .. The Patient Mobility Tool allows you to assess your patient’s mobility level and the degree of assistance that might be needed by helping you calculate a patient handling functional score for individual patients based on their mobility and the speciﬁc task they need to perform.. Tap the Information icon (white circle with an “i”) in the right corner of the Scoring & Algorithms for Specific Tasks screen and the Patient Mobility Tool will open in a new window.. Tap Scoring & Algorithms for Specific Tasks , and then tap a specific task from the choices available, and an assessment will appear in the right pane of your screen based on the task you have chosen.. Tap Calculate Score and you will go to a Task Chosen & Recommendations screen, where you will see the patient’s score and the recommendations for how to approach a task based upon your patient’s score.
Since the passage of HIPAA in 2004, patient confidentiality has played a pivotal role in the healthcare industry. Learn more about protecting patients.
They are responsible for patient confidentiality , as per HIPAA’s Privacy Rule, which states that medical professionals cannot legally share patient information without their consent.. U.S. Department of Health and Human Services (HHS), Health Information Privacy — Comprehensive information about HIPAA, guidance on how to apply HIPAA during the COVID-19 epidemic, individuals’ rights, civil rights laws regarding HIPAA, and more Centers for Disease Control and Prevention, Confidentiality and Consent — Information about the legal and ethical concerns of patient confidentiality American Medical Association (AMA), HIPAA — HIPAA privacy and security resources, including articles, FAQs, and tools. Patients are more likely to disclose health information if they trust their healthcare practitioners.. Though HIPAA offers privacy and confidentiality protections for patients, some scenarios allow healthcare practitioners to breach patient confidentiality.. Ensuring HIPAA compliance in healthcare data requires understanding the rules.. Below are some examples of when physicians are legally permitted to share their patient’s health information without permission:. A healthcare professional can breach patient confidentiality to protect a patient’s safety.. The HHS reports that healthcare professionals covered under HIPAA rules are “legally authorized to do so to prevent or control the spread of the disease.” Health outcomes.. Therefore, physician cybersecurity is vital for protecting patient health records.. HIPAA’s Security Rule of 2003 set standards for protecting patient confidentiality.. In addition to federal HIPAA rules, healthcare practitioners need to know additional rules regarding patient confidentiality in their state.. This HHS summary of the HIPAA Security Rule includes information on required safe Establishing facility-wide procedures and protocols for handling patient information.. The following resources provide additional information on how healthcare professionals can help ensure patient confidentiality:. By not disclosing critical health information, patients can hamper the efforts of the medical professionals trying to provide them with the best care possible.
An overview of NHS Test and Trace, including what happens if you test positive for coronavirus (COVID-19) or have had close contact with someone who has tested positive.
if you have any of the main symptoms, even if they’re mild, stay at home and self-isolate straight away and get a PCR test (a test that is sent to a lab), to check if you have COVID-19 as soon as possible if you have any of the main symptoms you should stay at home to self-isolate and not have visitors until you get your test result – at this stage (until the test result is known), people you have been in contact with do not need to self-isolate, but they should follow advice on how to avoid catching and spreading COVID-19 if you do not have symptoms, but test positive on a home LFD test, you should report your result and self-isolate – you do not need to take a follow-up PCR test if you test positive for COVID-19, and are asked by NHS Test and Trace, you must share information promptly and accurately about members of your household you should also share information about other recent contacts through NHS Test and Trace to help us alert other people who may need to be advised to get tested and/or to self-isolate if you have had close contact with someone who has COVID-19, you should follow any advice you are given on getting tested and you must self-isolate if NHS Test and Trace advises you to do so if you are arriving from travel abroad it is important to follow the rules on testing and check whether you need to follow additional rules on quarantine and testing. If you are notified by NHS Test and Trace of a positive PCR test result or notified by NHS Test and Trace to self-isolate after reporting a positive LFD result, you must self-isolate and will be given guidance on when your self-isolation period can end.. If you test positive for COVID-19, you may be contacted by the NHS or your local council and must provide information to help the NHS alert your close contacts.. If you develop symptoms, you may wish to alert the people with whom you have had close contact over the last 2 days.. If you get a positive PCR test result or report a positive LFD test result, NHS Test and Trace will contact you and ask you to share information about any close contacts you had just before or after you developed symptoms or, if you did not have symptoms, just before or after the date of your test.. call you from 0300 013 5000 – local contact tracers will contact you from a local council number but if you’re unsure if this is genuine, contact your local council for advice send you text messages from ‘NHStracing’ ask you to sign into either NHS Test and Trace or NHS Test and Trace contact tracing ask for your full name to confirm your identity, and postcode to offer support if you are required to self-isolate ask about the COVID-19 symptoms you have been experiencing ask you to provide the name, telephone number and/or email address of anyone you have had close contact with in the 2 days prior to your symptoms starting ask if anyone you have been in contact with is under 18 or lives outside of England. take an LFD test every day for 7 days, or until 10 days since your last contact with the person who tested positive for COVID-19 if this is earlier take this daily LFD test before you leave the household for the first time that day. If you were fully vaccinated at the time you had close contact with a positive case, you will not be required to self-isolate but should follow the guidance above on daily testing.. You should stay at home until you receive your test result and follow the guidance for people with COVID-19 symptoms .. If you’re notified by NHS Test and Trace that you have tested positive for COVID-19 you will need to self-isolate regardless of whether you are exempt from self-isolation as a contact.. If you’re exempt from self-isolation, you are not required to inform your employer that you have been contacted by NHS Test and Trace and notified that you are a contact of a positive case, but you may choose to do so.. If you are identified as someone who has had close recent contact with – or live in the same household as – a person who has tested positive for COVID-19 and you are not exempt from self-isolation as a contact, we will notify you that you must self-isolate in line with medical advice and the law.. If you live in the same household as someone who has tested positive and you are told to self-isolate, you must self-isolate until 10 full days after the person who tested positive first developed symptoms or, if they did not have symptoms, 10 full days after the date of their test.
See current COVIDSafe Settings for business and industry in Victoria
not require them to attend the workplace direct the worker to get tested as soon as possible – additional requirements will apply if the worker tests positive for COVID-19 and attended the workplace during their infectious period (see below).. If an employer or operator becomes aware that a worker attended the workplace in the 48 hours prior to becoming symptomatic, the employer must follow mandatory steps, including advising other workers at the worksite to:. If a worker tests positive for COVID-19 and is required to isolate, and their employer becomes aware they attended the workplace during their infectious period, the employer has additional obligations .. Workers who test positive after working indoors while infectious are obligated to notify their employer and social contacts (including in the workplace) if they are required to isolate.. Summary of relevant exemption periods and requirements for a recently confirmed case A worker that has isolated from COVID-19 in the previous 4 weeks is exempt from specified testing, notification and isolation requirements due to their recent COVID-19 infection.. Length of time between the end of the worker’s previous COVID-19 isolation and the new infectious period* Requirements for a worker who is a recently confirmed case:Less than 4 weeks since the worker’s previous COVID-19 isolation periodIf less than 4 weeks have passed since the end of the previous isolation period, the following do not apply:. the recommendation to test if symptomatic a requirement to self-isolate for 7 days if a test is COVID-19 positive - isolation is recommended if symptomatic a requirement to notify any close contacts or social contacts if a worker is a close contact - a requirement to self-quarantine as a household close contact or undertake surveillance testing to leave home if the worker is a social contact - a recommendation to test as a social contact.. More than 4 weeks since the end of the worker’s previous COVID-19 isolation period If more than 4 weeks have passed since the end of the previous isolation period then all the requirements that apply to a diagnosed person, probable case, close contact and social contacts continue to apply, including:. a recommendation to test if symptomatic a requirement to self-isolate for 7 days if a test is COVID-19 positive a requirement to notify any close contacts or social contacts if a worker is a close contact - a requirement to self-quarantine as a household close contact or undertake surveillance testing to leave home if the worker is a social contact - a recommendation to test as a social contact.. Mandatory requirements apply to a person who is a close contact or a social contact of a person diagnosed with COVID-19.. wear a face mask in indoor settings notify any education facility they are enrolled at or a work premises they are likely to attend for work within 24 hours of becoming a close contact undertake five Rapid Antigen Tests (RATs) during the self-quarantine period with a negative result each time, with a minimum of 24 hours between each test need to escape the risk of harm (including harm relating to family violence or violence of another person at the premises) are required to do so by law, or in an emergency situation.. A close contact must not attend certain settings – such as a hospital or care facility – unless they have approval from a relevant hospital or care facility executive or unless they are a worker of those facilities then special requirements apply.. Operators of healthcare and aged care facilities can also allow an unvaccinated or partially vaccinated worker onsite under exceptional circumstances, provided the relevant facility operator takes all reasonable steps to ensure that the worker wears PPE, at all times while on the premises of the facility.
Professional guidance on the safe and secure handling of medicines
Medicines are used in all healthcare settings and the safe and secure handling of medicines is essential to ensure patient safety.. 2.15 Specific policies or procedures in line with relevant guidance and appropriate standards exist for each process that supports the safe and secure handling of medicines.. 2.26 The quality assurance system for the safe and secure handling of medicines defines the organisational audit and monitoring processes which are used to check the standards of practice that are being delivered.. 3.47 Procedures are in place to ensure that security is maintained in any storage area.. 3.60 The risks associated with the processes of handling of any medicine are assessed for both staff and patients.. All the principles in the core guidance regarding the safe and secure handling of medicines apply when storing medicines – this is in addition to the guidance in this Appendix.. A15 All patients’ own medicines are stored securely.. Professional guidance on the administration of medicines in healthcare settings