Potential hazard Workers that provide physical care to patients are at risk for musculoskeletal injuries (MSI) if the task requires awkward body positions and considerable physical effort. These MSIs usually affect the back, neck, shoulders, and wrists.
Note: in this document, “patient” may refer to a patient, resident or client.
How to control the hazard
Employers may reduce the risk of injuries by taking the following action:
- put engineering controls in place and supervise to ensure workers use these controls, and
- put safe work procedures in place and ensure that workers follow them.
- train workers on safe lifting and moving
Engineering controls may include making physical changes to the workplace or using equipment/devices that improve worker safety when performing a task.
Devices such as patient lifts, transfer belts and sliders
reduce the physical force needed by workers to move or lift patients. This equipment helps to reduce the risk of injury for workers and patients. Use these devices according to the manufacturer’s guidelines. Note: an incontinence pad, (commonly referred to as a soaker pad) is not a sliding device and is not designed to re-position patients.
Safe Work Procedures
Develop and put safe work procedures (SWPs) in place that will reduce workers’ risks for MSI. These procedures will outline the steps, safe body positions and appropriate equipment for workers to move patients safely. Employers must ensure that workers are trained in these procedures and follow them.
Some common situations that may lead to a MSI are described below. These situations should be addressed in your SWPs.
Incorrect bed height:
A bed that is positioned too low will force a worker to use an awkward body posture (bending forward) to work with a patient. This will increase the stress placed on a worker’s back and may increase the risk for an injury. Beds should be positioned near the upper hip level of the shorter worker, when two workers are providing care or repositioning a patient.
“Catching” a Falling Patient:
Trying to “catch” a falling patient may put a worker at risk for an MSI. The following will help to prevent this situation:
- Accurate patient assessments will help workers to know the patient’s ability to balance, support their weight, or areas of poor muscle control, etc.
- Train workers to recognize when a specific patient transfer procedure may not be safe for the patient or worker due to a sudden change in the patient’s condition.
- When exercising a patient, use equipment that will support them if they lose control or begin to fall.
- Train workers in the safest method to lower a patient in an emergency.
Poor Body Position and Movement:
Using awkward body postures (such as rounding or twisting the back) while moving patients will increase a worker’s risk for a MSI. The safe work procedures at your workplace should include the following points on safe postures:
- When preparing to slide, turn, or transfer a patient, keep a wide sideways stance or wide walking stance with your hips and knees bent.
- Safe posture includes keeping your back straight, shoulders back, elbows in and wrists straight.
- When moving a patient, keep your upper body still and shift your weight through your legs and hips to move forward, backward, or side to side.
In addition to engineering controls and safe work procedures, your workplace must have a system in place to identify the type of assistance needed by each patient. Logos/signs must be kept current and posted near patients so that workers can easily identify their needs.
Reference to legal requirements under workplace safety and health legislation
- Musculoskeletal Injuries: Manitoba Regulation 217/2006 Part 8
- Health Care Facilities: Manitoba Regulation 217/2006 Part 39