MRTs take steps to minimize their exposure to dangerous manual lifting tasks through the appropriate use of equipment, teamwork and technique
Impact of improper patient handling
- MRTs frequently handle patients as part of their day to-day duties:
- Wheelchair transfers
- Stretcher/bed transfers
- Assisting ambulatory patients off of imaging beds
- There are significant clinical consequences for both the MRT and the patient with improper patient handling and movement.1
- For the patient, improper handling can cause fear and anxiety, affect comfort and in some cases lead to physical injury.2,3
- For the MRT, the primary consequence of improper patient handling is an increased risk for musculoskeletal injury.1,4,5
- Patient handling is the top cause of injury among health care workers5,6,7
- Musculoskeletal injuries related to patient handling can result from cumulative long-term physical effort or from acute effects (e.g., accidents during transfers or one-time tasks that require the body to perform above its capacity)
- These injuries contribute to secondary issues such as increased medical leave, lower job retention, etc.
- MRTs are aware of musculoskeletal injury risk factors associated with manual lifting, as well as the signs and symptoms of injury and the potential long-term health effects.
Assessment of requirements
- An assessment should be performed before each handling activity, particularly patient transfers, to determine the proper transfer method and the need for assistance (mechanical or lift team).5,7,9
- Where possible (e.g., for patients with pre-booked appointments), this assessment should be made in advance of a patient interaction
- A basic evaluation of the functional abilities of the patient is performed3,4,9:
- Ability of patient to support their weight during the transfer (e.g., actual vs. perceived ability)
- Physical characteristics of the patient that affect mechanical lifting (e.g., height, weight)
- Sensory capabilities (e.g, sight, hearing, touch)
- Cognitive ability (e.g., understanding, confusion)
- Communication level and ability (e.g., language, comprehension)
- Patient risk factors (e.g., injuries, presence of tubes, history of falls, osteoporosis, fractures, pressure ulcers, splints, history of spasms, etc.)
- Patient demeanour (e.g., cooperative or not)
- An evaluation of the environment is performed and assesses3,9:
- Type of equipment available
- Lighting
- Obstacles which may be hazardous
- Safety of floor surfaces
- Adequate space
- An evaluation of the capabilities of MRTs is also considered:
- Education and training
- Factors that affect their ability to do the transfer safely (e.g., physical limitations, stress, fatigue)3
Optimal patient handling
- Optimal patient handling is emphasized throughout MRT education and facility training.4,7
- MRTs participate in education and training on patient transfers, including the proper use of transfer aids and patient handling equipment
- Best practices injury prevention programs have shown to reduce patient handling injuries and compensation costs 3,8
- Patient transfer makes the most efficient use of available transfer aids and equipment to minimize the risk of musculoskeletal injury6:
- Mechanical lifts
- Slide sheets
- Slide boards
- Transferring and repositioning techniques that pose the lowest risk of injury to the worker
- All equipment and aids are maintained to ensure they are safe and in working order when called into use.3,7
- Equipment and aids are well suited to the patient’s condition, adjusted, immobilized, well placed, or nearby9
- Transferring and repositioning techniques that pose the lowest risk of injury to the worker are used where practicable4,6
- Proper body mechanics are used in all patient transfers or when lifting objects.
- The BACK acronym is a useful mnemonic to encourage best patient handling practices5:
- Back straight
- Avoid twisting
- Close to your body
- Keep smooth
- Report signs and symptoms of musculoskeletal injury to your supervisor and Occupational Health Department (if your worksite has one). You must also report unsafe acts or conditions to your supervisor, including the failure of mechanical patient handling equipment.6
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References
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Murphey SL. Safe patient handling in diagnostic imaging. Radiol Manage. 2010 July-Aug;32(4):46-52.
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Nelson A, Baptiste A. Evidence-Based Practices for Safe Patient Handling and Movement. Online journal of issues in nursing. 2004 Sep;9(3). Available from: www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume92004/No3Sept04/EvidenceBasedPractices.aspx. [Accessed 4 Jan 2018]
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Work Safe Alberta (Alberta Labour). No Unsafe Lift Workbook. July 2015. Available from: https://work.alberta.ca/documents/WHS-PUB_nounsafelift_workbook.pdf. [Accessed 4 Jan 2018]
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Canadian Centre for Occupational Health and Safety. Ergonomic Safe Patient Handling Program. COHS. Nov 2012. Available from: http://www.ccohs.ca/oshanswers/hsprograms/patient_handling.html. [Accessed 15 Dec 2017]
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Occupational Health Clinics for Ontario Workers Inc. Patient handling for healthcare workers. 2nd ed. OHCOW. Available from: http://www.ohcow.on.ca/edit/files/general_handouts/Healthcare%20Workers%20Patient%20Handling.pdf. [Accessed Dec 2017]
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Work Safe BC. Patient Handling. WorkSafeBC. Available from: https://www.worksafebc.com/en/health-safety/industries/health-care-social-services/topics/patient-handling. [Accessed 4 Jan 2018]
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United Food and Commercial Workers Union (UFCW Canada). Health and Safety and Environment: Patient/Client Lifting. Available from: http://www.ufcw.ca/index.php?option=com_content&view=article&id=1982&Itemid=180&lang=en. [Accessed 15 Dec 2017]
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Collins JW, Wolf L, Bell J, Evanoff B. An evaluation of a ‘‘best practices’’ musculoskeletal injury prevention program in nursing homes. Inj Prev (BMJ). 2004;10:206-211. DOI: 10.1136/ip.2004.005595
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Association paritaire pour la santé et la sécurité du travail du secteur affaires sociales (ASSTSAS). PDSB training: Steps involved in preparation. Asstsas.qc.ca. Jan 2018. Available from: http://asstsas.qc.ca/sites/default/files/publications/documents/Affiches/A99A_pdsb_pos2013_steps_preparation4.pdf. [Accessed 10 May 2018.]