Professional Documents
Culture Documents
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Review existing controls
Document controls immediately
implemented
Recommend appropriate and practical
controls
Ergonomics (Musculoskeletal) Risk Assessment Project
Fraser Health Authority xiii
Identify department or work area to contact
for risk assessment.
Priority for ergonomics (MSI) risk assessment has
been assigned using a weighting scheme from a 3-year
review of incidents at LMH (See Section 2.0).
1
Contact designated person for department to
introduce the project and determine
appropriate time and duration for job
observations.
Designated contact list has been pre-established.
Ask contact person to identify all occupations
and/or work areas for review (if appropriate).
Describe participatory nature of the project,
employees and other resources (e.g. Rehab,
supervisors, JOSH Committee members) may
assist with the assessment.
2
Send memo explaining the project to the
contact person and ask that this information
be communicated to staff prior to the
assessments taking place.
Include a copy of the MSI Employee Symptom Survey
(Appendix C-4) for information. Surveys may be
completed prior to the risk assessments.
3
Send department-specific MSI incident
analysis report to the contact person.
Department-specific MSI incident analysis report (see
Section 2.2.4.2) will provide an overview of where MSI
injuries are occurring in the department, as well as
providing a comparison with LMH statistics.
4
If appropriate, meet with department
contact name and employee representatives
prior to the onset of risk assessments.
Meeting can be conducted to review Risk Assessment
Process (Flow Chart, Appendix C-3a) and forms,
review symptom survey, establish employee team to
assist and/or determine specific tasks to be reviewed.
This step is likely to occur with larger departments
and/or more complex tasks.
5
Collect and review background information
on department and occupations.
For example, job descriptions and/or list of duties,
work processes and procedures, research studies,
nursing manuals, MSIP program information,
equipment inventory etc. Establish preliminary task
list using Task Analysis Worksheet (Appendix C-5).
6
Distribute employee symptom survey to staff.
Collect completed forms and compile results.
Employee Symptom Survey (Appendix C-4) contains
questions related to MSI awareness, psychosocial
factors, body discomfort and severity, identification of
problem tasks and suggestions for improvement.
7
Appendix C - 3a
Ergonomics (MSI) Risk Assessment Process Flow Chart
Ergonomics (Musculoskeletal) Risk Assessment Project
Fraser Health Authority xiv
Appendix C - 3a
Repeat from Step 8. Revised December 4, 2001
Conduct job observations: observe
(shadow) a minimum of two employees
conducting the job tasks, if available.
Measure and record information as
appropriate (e.g. written notes,
measurements, photos, video).
Use worksheets (See Appendices C-7 to C-11) and
measurement/observation equipment (e.g. force
gauge, camera, tape measure).
Introduce and explain project to employees. Ask if
they have any questions.
Request that symptom survey forms be completed.
If possible, review symptom surveys during the
observation period. Determine if workers have
indicated signs/symptoms and if there are additional
tasks for review.
8
Compile findings and document risk
identification and assessment in draft in final
report format.
9
Review, document and recommend
appropriate control measures.
Identify and assess risk factors using checklists and
worksheets (Appendices C-7 Ergonomic Risk Factor
Identification Worksheet, C-8 General Ergonomics
Risk Checklist, C-9 Office Ergonomics Checklist, C-10
Manual Material Handling Checklist, C-11 Patient
Handling Checklist.
10
Review findings of the risk assessment (in
draft), including recommendations with
contact person and others as appropriate.
Review completed Sample Final Report form
(Appendix C-6):
Agree on proposed risk controls, including control
of immediate hazards.
Assign responsible person for each recommended
control.
11
.
Revise and issue final risk assessment report
to department contact person.
Ask contact name and/or team members to assist
in the communication as appropriate (e.g. e-mail
summaries, short report, posters etc).
Information is entered into database.
12
After pre-determined time frame, request
update from contact person and/or team
members regarding the status and
effectiveness of recommended controls.
Request specific information on status of controls and
if not implemented, indicate reasons why.
13
Re-evaluate to determine if controls have
been effective.
Suggestions: Review incident statistics, absenteeism
reports, WCB costs, re-issue symptom survey.
14
Re-assess as necessary.
For example, if incidents or WCB reports indicate
review is necessary, if job tasks change, if new
equipment is introduced.
15
Using Sample Final Report form (Appendix C-6):
Review existing controls.
Document controls immediately implemented.
Recommend appropriate and practical controls.
Ergonomics (Musculoskeletal) Risk Assessment
Fraser Health Authority xv
Appendix C - 3b
Department Specific Risk Assessment Process with Consultation
STEP Description of Step Consultation
1
Identify department or work area to
contact based on prioritization.
The weighting scheme for prioritization
(based on a 3-year review of MSI
incidents) was reviewed for input with
Steering Committee and JOSH.
I
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T
I
F
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A
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I
O
N
2
Contact designated person (to
describe project, establish job
observation times, identify
occupations and/or work areas).
Department list and contact names
were finalized with assistance from
Senior Leadership Team.
3
Send memo explaining the project to
contact person. Request that this
information be communicated to staff.
Employees were invited to direct
questions or comments on the project
to Steering Committee or JOSH
Committee members (names provided).
I
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N
T
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A
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I
O
N
4
Send department specific MSI
incident analysis information to
contact person to provide an
overview of MSI injuries (e.g.
occupations, tasks, type of injury,
body part injured).
Final MSI incident report and sample
department specific reports were
reviewed for input and finalized with
Steering Committee and JOSH via e-
mails and monthly meetings.
Department specific reports are
available on request.
5
If appropriate, meet with department
prior to the onset of risk
assessments.
Department employees were provided
with an overview of the project, and
their participation was encouraged.
6
Collect and review background
information (e.g. job descriptions, list
of duties, work processes and
procedures etc.) Use information to
establish a preliminary task list.
Draft task analysis worksheets or task
lists were reviewed for input with
department employees.
I
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N
T
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F
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A
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I
O
N
7
Distribute employee symptom survey
to staff. Collect completed forms and
compile results.
Survey content was reviewed for input
and finalized with Steering Committee
and JOSH.
All employees were encouraged to fill
out survey (various communication
vehicles were used).
Ergonomics (Musculoskeletal) Risk Assessment
Fraser Health Authority xvi
Appendix C - 3b
A
S
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S
M
E
N
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9
Compile findings of the risk
identification steps and document in
final draft format describing risk
factors identified, and including an
assessment/evaluation of their
severity.
10
Review existing controls, document
controls immediately implemented
and recommend appropriate and
practical controls.
C
O
N
T
R
O
L
11
Review findings of the risk
assessment report including
recommendations with contact
person and others as appropriate.
Process for risk assessment and
development of controls was reviewed
for input with Steering Committee and
JOSH.
A listing of occupations to assess and
their status (e.g. complete, draft, not
started) was provided to Steering
Committee and JOSH.
It was communicated that specific
assessments are available on request.
Suggested controls were reviewed with
department staff as appropriate.
Draft final report was reviewed with
contact person and input from staff was
encouraged.
12
Revise and issue final risk
assessment report. Ask contact
person to communicate report to staff
(e.g. post report, discuss at group
meetings etc.).
Steering Committee and JOSH were
updated as to recently completed
reports.
Contact person was requested to
communicate findings to staff.
13
After pre-determined time frame,
request update from contact person
and/or team member regarding status
and effectiveness of recommended
controls.
Steering Committee and JOSH were
provided with progress reports as to
status of controls, including monthly
review of implemented controls.
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T
I
O
N
14
Re-evaluate to determine if controls
have been effective (e.g. look at
incident statistics, absenteeism
reports, WCB costs, re-issue
symptom survey).
Process (means) for re-evaluation and
findings of re-evaluation to be reviewed
with Steering Committee and JOSH.
15
Re-assess as necessary (e.g. if
incident or WCB reports indicate
further review is necessary, if job
tasks change, if new equipment is
introduced).
Repeat from Step 8.
Ergonomics (Musculoskeletal) Risk Assessment
Fraser Health Authority xvii
Appendix C - 4
Employee MSI Symptom Survey
This survey is anonymous. Please do not include your name. The information will be used to determine potential ergonomics
(MSI) risk factors in your work setting and provide an opportunity for you to indicate problem areas and make suggestions for
improvements.
1. Date: ____________________________________________________________________
2. Department or Work Area: ___________________________________________________
3. Occupation: _______________________________________________________________
4. Hours worked on average: Per week: ___________________ Per shift: _______________
5. How often do you work overtime?
Never Seldom Sometimes Always
6. Experience in THIS occupation:
Less than 3 months 3 months to 1 year Greater than 1 year to 5 years
Greater than 5 years to 10 years Greater than 10 years
7. Have you received any training on musculoskeletal injuries (MSIs or strains/sprains) with this employer?
YES NO
8. What are the signs and symptoms of musculoskeletal injury (e.g. strains/sprains)?
_____________________________________________________________________________________
_____________________________________________________________________________________
9. What should you do if you experience any signs or symptoms of musculoskeletal injury (e.g. strain/sprain)?
_____________________________________________________________________________________
_____________________________________________________________________________________
10. Are you aware of risk factors in your workplace that may put you at risk of musculoskeletal injury (e.g. strain/sprain)? If yes,
please describe.
_____________________________________________________________________________________
_____________________________________________________________________________________
11. Please circle the appropriate number for each statement. Consider both mental and physical aspects of your job.
strongly
disagree disagree undecided agree strongly agree
a. I have freedom to decide how I do my work. 1 2 3 4 5
b. I have a lot to say about what happens on my job. 1 2 3 4 5
c. My job is very hectic. 1 2 3 4 5
d. I have enough time to get the job done. 1 2 3 4 5
e. It is very hard to keep up with my workload. 1 2 3 4 5
f . There are always deadlines to meet. 1 2 3 4 5
Ergonomics (Musculoskeletal) Risk Assessment Project
Fraser Health Authority xviii
Appendix C - 4
12. Have you had any recurring pain or discomfort during the last year?
YES NO
13. If yes, place an X on the drawing in the area(s) that you feel discomfort. For any area that you mark, rank the level of discomfort on
a scale from 1 to 5. Place the numbers on the drawing beside the corresponding X.
1 = slight discomfort 2 3 4 5 = severe pain
14. For each area marked, what do you think causes the pain or discomfort?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
15. What job task or tasks that you perform are the most difficult or most in need of changing, and why?
____________________________________________________________________________________
____________________________________________________________________________________
b. What do you suggest can be done?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
16. What other suggestions or ideas do you have for improving your workstation or work area?
____________________________________________________________________________________
____________________________________________________________________________________
If you have additional comments, please provide them on the back of this sheet.
Thank you for filling in this survey!
Return to LMH Workplace Health and Safety
Ergonomics (Musculoskeletal) Risk Assessment
Fraser Health Authority xix
Appendix C - 5
Ergonomic (MSI) Risk Factor Identification and Assessment
Ergonomics Risk Assessment Project
Department/Work Area: Occupation:
Specific Location: Contact Name:
Assessed By: Assessment Date:
Task Analysis Worksheet
Job Summary:
Where possible, transfer list of job tasks from job description onto this sheet. Determine whether ergonomics
(MSI) risk assessment is required, if no, provide rationale.
Tasks and Description of Activities Frequency/Duration
Risk Assessment
Required?
TOTAL
100%
Ergonomics (Musculoskeletal) Risk Assessment
Fraser Health Authority xx
Appendix C - 6
Ergonomic (MSI) Risk Factor Identification and Assessment
Sample final report
Ergonomic (MSI) Risk Factor Identification and Assessment
Ergonomics Risk Assessment Project
Department/Work Area: Medical Unit Occupation: LPN Medical Unit
Specific Location: 4
th
floor, South Tower LMH Contact Name: Department Manager
Assessed By: Assessor Assessment Date: December 2001
Task Analysis Worksheet
Job Summary: Performs nursing procedures such as sterile dressings in addition to patient care duties relating
to feeding, personal hygiene and transporting patients.
Where possible, transfer list of job tasks from job description onto this sheet.Determine whether ergonomics
(MSI) risk assessment is required, if no, provide rationale.
Tasks and Description of Activities Frequency/Duration
Risk Assessment
Required?
1. Report: sit and discuss patient information,
current happenings, changes, family information
hour 45 min.
No
Discussion only
2. Conduct rounds for personal care: bathing,
dressing, getting patients up or back to bed,
getting patients ready to send to appointments,
assisting with toileting needs
Takes approximately 1-2 hours
each, typically done 2-3 times
per shift
Yes
3. Perform nursing procedures such as changing
dressings, catheterizations, taking/recording blood
pressure, temperature and pulse.
As required per shift; 9-10
patients per LPN
Yes
4. Assist with patient handling; repositioning in bed
reported to be problematic
As required; number per shift
varies
Yes
5. Assist patients with meals such as serving and
collecting meal trays and feeding designated
patients.
Takes approximately 1.0 hours,
typically done 2 times per shift
Yes
6. Chart patient information.
15-30 minutes per shift; may be
sporadic or completed all at
once
Yes
TOTAL 100%
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Department/Work Area: Medical Unit Occupation: LPN Medical Unit
Specific Location: 4
th
floor, South Tower LMH Contact Name: Department Manager
Assessed By: Assessor Assessment Date: December 2001
Description of workstation: Medical unit with nursing station. Patients in single or 4-bed rooms, with 3 isolation rooms, 3 designated palliative care rooms.
Hours of Work/Shift Schedule: 4 South is currently staffed 0730 - 1930 with LPNs. Shifts are 6.5 or 10.5 hours.
Discomfort noted on surveys: neck, shoulder, elbow, lower back, leg/knee, foot
Tasks for Ergonomics Risk Assessment (from Task Analysis worksheet): Frequency of Task:
1. Conduct rounds for personal care.
2. Perform nursing procedures such as changing dressings and checking vital signs.
3. Assist with patient handling, including repositioning in bed.
4. Assist patients with meals.
5. Chart patient information.
2-4 hours per shift
as required
as required
2 hours per shift
hour per shift
25-35%%
varies
varies
20-25%
10%
Task Risk Factors Freq/Dur Mag/Range Assessment / Observations / Comments
Awkward
posture
(reaching,
bending,
twisting)
Total time
per round is
1-2 hours,
about 15-
30
min/patient
Neck >20
0
Shoulder 20-90
0
Elbow 0-60
0
and >100
0
Wrist >15
0
Trunk 20-60
0
+
Various hygiene-related duties with patients including
bathing, dressing and toileting.
Awkward postures including reaching, bending, and
twisting to access, adjust and position patient and to see.
Problems reported with commodes (broken, brakes not
working)
Patient can be asked to assist as possible. Bed height
should be adjusted, side rails down to improve posture.
Awkward
posture
Force
Up to 2
baths/shift
As above Tub does not adjust in height. Tub chair is crank-style.
I
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C
A
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I
O
N
Conduct
rounds for
personal
care
Force As above Varies
depending on
weight of the
limb
A
S
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S
S
M
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N
T
Force required when supporting limbs, amount varies
depending on patient characteristics.
Pillows can be used as additional supports.
Night tables are difficult to move as they have only 2
wheels with casters.
Risk Factors to consider:
q Joint posture: wrist,
elbow, shoulder, neck,
back, knees
q Awkward posture:
reach, twist, bend,
stoop, squat, climb,
static
q Force: lift, lower, carry,
push/pull, pinch or
power grip, surface
q Repetition, frequency,
duration, exposure
q Object weight, location,
size, shape, handles,
stability
q Work height, layout,
seating, space
q Tool/equipment use
q Contact Stress
q Environment: layout,
flooring, temp., noise,
light, glare, vibration
q Work Organization:
recovery, schedule,
workload, task
variability, pace, PPE
use, interruptions
q Psychosocial variables
q Other
Ergonomic (MSI) Risk Factor Identification and Assessment
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Department/Work Area: Medical Unit Occupation: LPN Medical Unit
Specific Location: 4
th
floor, South Tower LMH Contact Name: Department Manager
Assessed By: Assessor Assessment Date: December 2001
Task Risk Factors Freq/Dur Mag/Range Assessment / Observations / Comments
Rounds
(continued)
Static posture As above Typically 1-2
minutes
Static posture required when supporting limbs.
Quick stretches to relieve static positioning are recommended.
Awkward
posture
(reaching,
bending,
twisting)
As required Neck >20
0
Shoulder 20-
90
0
Elbow 0-60
0
and >100
0
Wrist >15
0
Trunk 20-60
0
+
Including changing dressings and checking vital signs.
Optimize postures by adjusting bed height and lowering side rails to reduce
reaching, asking patients to reposition themselves to assist.
Force As required Not measured Amount of force will vary depending on task and patient characteristics.
Perform
nursing
procedures
Static posture As required Up to 1 minute Depending on nature of task, static positioning may be required.
Quick stretches after tasks are recommended.
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A
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I
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N
Patient
handling
including
repositioning
in bed
Awkward
posture
(shoulder,
elbow, trunk)
As required Trunk 20-60
0
Shoulder 45-
90
0
Elbow 0->100
0
A
S
S
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S
S
M
E
N
T
The number and type of transfers varies from shift to shift.
Key points: staff can optimize posture by adjusting bed height to appropriate
position (and use Trendelenberg position), lowering bed rails and getting
help from other staff. Instruct patient to ensure they are aware of the transfer
and count so that the move is done at the same time by both (or all) staff
involved.
Deficiencies with some transfers observed; primarily with repositioning in bed
(e.g. count not synchronized, incorrect body mechanics, reliance on upper
body muscles).
Comments on beds (from 2 staff): brakes are hard to access, dont know if
the brakes are on, rails are hard to put up. Prior to bed purchase, there was
a review of various models and input from various hospital staff.
Patient assessments are conducted by RNs or Rehab, can be re-assessed
by Rehab at the request of the RNs or LPNs. Staff should be reminded of
this, as well as provided with tips for patient assessment.
Ergonomic (MSI) Risk Factor Identification and Assessment
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Ergonomic (MSI) Risk Factor Identification and Assessment
Department/Work Area: Medical Unit Occupation: LPN Medical Unit
Specific Location: 4
th
floor, South Tower LMH Contact Name: Department Manager
Assessed By: Assessor Assessment Date: December 2001
Task Risk Factors Freq/Dur Mag/Range Assessment / Observations / Comments
Patient
handling
including
repositioning
in bed
(continued)
Force As required No measured Forces vary depending on nature of transfer or reposition, patient
characteristics, staff available.
Equipment available reported by staff to be adequate: some beds are
equipped with monkey bars; 1 Arjo Maxi lift with 3 slings (one each size), and
2 Saras.
Assist patients
with meals
Awkward
posture
Static posture
- 1 hour
per shift
Neck 0-20
0
Shoulder 20-
45
0
, >90
0
Elbow 60-
>100
0
Trunk 20 -
60
0
+
Static postures may be assumed when feeding.
Working postures can be optimized by possibly alternating between sitting
and standing or choosing the best posture relative to the patient, getting as
close as possible to the patient to reduce joint angles associated with
reaching, and adjusting bed position.
Additional various upper extremity work required to serve and collect trays,
and prepare food (e.g. open beverages, put jam on toast, peel eggs etc).
I
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Chart patient
information
Awkward
posture
15-30
minutes per
shift
Individual
charts < 2 kg
Neutral
postures,
seated
A
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S
S
M
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N
T
Charting can be done at various times throughout the shift or completed all at
once.
Patient charts (binders) are filed in a circular storage, above shoulder reach
to access if seated (charts sit in slots, middle is 113 cm high).
Nursing station: adjustable chairs available (adjustable height and backrest)
to allow for adjusting working postures. Seated counter height is 77 cm,
standing counter height is 116 cm. No concerns noted.
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Ergonomic (MSI) Risk Factor Identification and Assessment
Department/Work Area: Medical Unit Occupation: LPN Medical Unit
Specific Location: 4
th
floor, South Tower LMH Contact Name: Department Manager
Assessed By: Assessor Assessment Date: December 2001
*Control Priority Note: 1 = recommended for implementation to reduce risk factors; 2 = optional, for consideration as a means of reducing risk factors; 3 = not
for immediate action but for future consideration as appropriate.
Risk Factor Potential Cause Recommended Controls Control
Priority*
Responsible
Person
Status
(May 2002)
Static
posture
Rounds,
nursing
procedures
1. Sample stretching exercises will be provided. 1 Name Not complete
2. MSIP training (4-hour sessions) are available and all staff should be
encouraged to attend. New staff are scheduled to attend, and
sessions are available for existing staff. Sessions provide practical
demonstrations and hands-on opportunities for various transfers.
1 Name Ongoing
3. Schedule awareness campaigns on a regular basis (bi-monthly).
Include topics as identified from the risk assessment. Posters,
handouts and statistical information to be provided.
What to do when patient has fallen
Initial patient assessment tips (e.g. ongoing determination of what
type of transfer is appropriate) and when and how to request
reassessment
Key tips for optimizing posture (e.g. adjusting bed height, lowering
side rails, asking patient to assist, neutral postures)
Correct use of transfer belts
Bed repositioning tips: e.g. adjust bed height, lower rails,
Trendelenberg position, ask for assistance, coordinated counting
1 Name Implemented
May 2002;
first MSIP
Minute was
on initial
patient
assessment
Awkward
posture
Static
posture
Force
Patient
transfers and
repositioning,
nursing
procedures,
rounds
Emphasis on
repositioning in
bed
4. Specific to bed repositioning: Trial slide sheet and request employee
feedback on their use.
1 Name Trials started
5. Check on existing commodes and request maintenance (reported that
some are broken and the brakes do not work) or investigate purchase
of new ones.
1 Name Complete;
new
commodes
purchased
Awkward
posture
Force
Rounds,
toileting,
washing
6. Consider replacing the legs on the night tables with casters (check
with Maintenance). This would make it easier to move the tables
around within the working area.
2 Name Not complete
C
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T
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S
Awkward
posture
Force
Patient
handling
7. For purchases, continue to ensure that staff have input (as was done
with the new beds) and request possible trials with the equipment to
ensure it will meet the needs of the unit.
1 Name Ongoing
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Ergonomic (MSI) Risk Factor Identification and Assessment
Department/Work Area: Medical Unit Occupation: LPN Medical Unit
Specific Location: 4
th
floor, South Tower LMH Contact Name: Department Manager
Assessed By: Assessor Assessment Date: December 2001
Additional Comments:
For long term planning, consider a tub that is height adjustable with a pneumatic chair for patient handling. This will reduce awkward postures and forces
associated with bathing patients. Consider ceiling lifts for future budgets. Vendor information to be provided.
Thank you for the opportunity to review the work area. If you have any questions regarding this report, please contact the assessor (contact information
provided).
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Ergonomic (MSI) Risk Factor Identification and Assessment
Department/Work Area: Occupation:
Specific Location: Contact Name:
Checklist Completed By: Date:
Force Awkward Posture ACTIVITY Frequency
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Static
Positions
(>30 sec)
Other Risks
(e.g. contact
stress,
repetition,
layout,
environment)
Causes / Comments
Risk factors to consider: object awkward? stable? bending or twisting? adequate space to move? beds adjustable? adjusted?
heavy lifting? appropriate handles? stooping or squatting? slippery floors? handling aids available?
forceful pushing or pulling? pinch/power grip required? reaching out or up? brakes work? accessible? clutter in aisle ways?
long carry distance? working height appropriate? prolonged (static) posture? rails adjust? accessible? doorways wide enough?
Ergonomics (Musculoskeletal) Risk Assessment
Fraser Health Authority xxvii
Appendix C - 8
Department/Work Area: Occupation:
Specific Location: Contact Name:
Checklist Completed By: Date:
Use this sheet as a prompter. A no response indicates a potential risk factor/problem that may require investigation.
General Ergonomics Risk Factor Checklist Yes No Comments
Policies and Procedures
Are MSIP policies and procedures in place?
Is incident reporting and investigation in place?
Do staff members know how to report an injury or unsafe
condition?
Is management supportive and involved in health and
safety program initiatives?
Consultation Processes
Is communication with employees conducted by e.g.
meetings, bulletin boards, in-service sessions?
Are consultative channels available through workplace
committees?
Education and Training
Is there an education and training strategy for MSIP in
place?
Is MSI awareness information/training available to all
employees?
Is MSIP training available on orientation?
Is MSIP job-specific training available?
Is MSIP refresher and in-service training available?
Hazard Identification and Risk Control Strategies
Is incident information captured in a database?
Are incident statistics analyzed to identify trends?
Are follow-up activities conducted to ensure implementation
and evaluate effectiveness of controls?
Are risk assessments conducted based on priority needs
including risk factor identification, assessment and
recommendation of controls?
Equipment and Building Design
Is there adequate mechanical equipment available for use?
Is equipment in good working order?
Is there a process for equipment repair in place and is it
effective, including identifying and tracking?
Are staff aware of process for equipment repair?
Is there a process for routine equipment maintenance?
Is there adequate space to store equipment?
Do purchases include stakeholder feedback prior to
purchase? e.g. maintenance, housekeeping
Are design changes reviewed prior to implementation?
Evaluation, Review and Promotion
Is MSIP information regularly promoted (e.g. newsletters,
staff bulletins, intranet postings and presentations)?
Are ergonomics program initiatives regularly reviewed to
evaluate effectiveness?
Are risk controls implemented regularly reviewed to
evaluate effectiveness?
General Ergonomics Risk Factor Checklist
Ergonomics (Musculoskeletal) Risk Assessment Project
Fraser Health Authority xxviii
Department/Work Area: Occupation:
Specific Location: Contact Name:
Checklist Completed By: Date:
Use this sheet as a prompter. A no response indicates a potential risk factor/problem that may require investigation.
Office Ergonomics Checklist Yes No Comments
Awkward Posture
Are feet supported by the floor or a footrest?
Is the lower back supported by the backrest?
Are chair adjustment features functioning and does the
employee know how to adjust them?
Are the keyboard and monitor in front and aligned?
Are the keyboard and mouse at seated elbow height?
Does the keyboard angle allow for neutral wrist posture?
Are the keyboard supports or feet down?
Is the mouse at the same height and beside the keyboard?
Is the monitor about arms length away?
Is the top line of print about seated eye level?
If using bifocals, is neutral neck positioning maintained?
Is a document holder or desk slant used if necessary?
Is cradling the handset between ear and shoulder avoided?
Is a headset used if necessary?
Force
Is minimal force used on keyboard and mouse?
Is the mouse moved with the whole arm, with the
movement initiated at the shoulder?
Are the muscles relaxed and in a neutral position?
Repetition and Static Posture
Are adequate pauses taken?
Is the work self-paced?
Is there flexibility around the performance of tasks?
Are tasks completed using both hands?
Contact Stress
Is the seat pan cushioned with a rounded edge?
Is there clearance between the front edge of the seat pan
and the back of the legs?
Are the arm rests positioned slightly below elbow level and
used for periods of non-activity only?
Is a wrist rest available and used appropriately?
Are the forearms not resting on the desk edge?
Environment
Are lighting levels appropriate?
Is the screen free of reflected glare? (e.g. angled down
slightly, curtains used, controls adjusted)
Is additional task lighting used if necessary?
Are other environmental aspects appropriate (e.g. noise,
temperature)?
Work Layout and Work Organization
Are frequently used resource materials and equipment
within easy reach and easy to access?
Is the underside of the desk free of clutter?
Are desk top materials organized to maximize space and
minimize clutter?
Are changes in posture made throughout the day?
Is sitting for long periods of time avoided by varying tasks?
Are stretching exercises conducted?
Office Ergonomics Checklist
Appendix C - 9
Ergonomics (Musculoskeletal) Risk Assessment
Fraser Health Authority xxix
Manual Material Handling Checklist
Department/Work Area: Occupation:
Specific Location: Contact Name:
Checklist Completed By: Date:
Use this sheet as a prompter. A no response indicates a potential risk factor/problem area that may require further
investigation.
Manual Material Handling Checklist Yes No Comments
Object/Load Characteristics
Have excessive weights been reduced?
Have excessive push/pull forces been reduced?
Can the load be made smaller or lighter?
Are objects easy to grasp?
Are the objects stable?
Are handholds or handles available?
Handling Characteristics
Are objects handled infrequently/short duration?
Is repetition avoided by job rotation or task variety?
Are there sufficient rest pauses?
Are materials moved over minimum distances?
Are ramps designed appropriately?
Can the objects remain close to the body?
Are working heights appropriate or adjustable?
Are movements between knee and shoulder height?
Is handling from a seated position avoided?
Are static positions avoided?
Are twisting motions avoided?
Are bending or stooped motions avoided?
Is excessive forward, backward or side reaching
avoided?
Is help available for heavy or awkward lifts?
Equipment
Are lifting devices including carts and trolleys
available and used whenever possible?
Is equipment in good working condition?
Is there a preventive maintenance program for
equipment?
Is faulty equipment tagged and reported?
Environment
Are the floors clean, dry, even and well lit?
Is the work area uncluttered and free of obstacles?
Is there enough room to maneuver?
Administration/Organization
Do staff wear appropriate clothing and footwear?
Are staff trained in the use of available equipment?
Are staff trained in correct material handling
procedures?
Do staff follow correct procedures?
Do staff know how to report an injury or unsafe
condition?
Are difficult lifts discussed with supervisor and co-
workers?
Other:
Other:
Other:
Appendix C - 10
Ergonomics (Musculoskeletal) Risk Assessment
Fraser Health Authority xxx
Department/Work Area: Occupation:
Specific Location: Contact Name:
Checklist Completed By: Date:
ACTIVITY CHECKLIST Freq? Difficult? Comments
Repositioning in bed side to side
Repositioning up in bed
Repositioning in chair
Holding/supporting whole body
Holding/supporting extremities
Transfer bed to chair
Transfer bed to stretcher
Transfer bed to walker
Transfer bed to commode
Transfer bed to bath
Transfer chair to stretcher
Transfer chair to walker
Transfer chair to commode
Transfer chair to toilet
Other transfer:
Other transfer:
Other transfer:
Transport in stretcher
Transport in wheelchair
Transport in bed
Assisting with ambulation
Bathing in bed
Bathing in bath room
Feeding
Changing clothing
Changing in bed
Picking patients up from floor
Weighing a patient
Moving patient with mechanical lift
Moving mechanical lift only
Moving carts (e.g. linen, food)
Moving equipment (e.g. monitors)
Moving furniture (e.g. tables)
Making occupied bed
Making unoccupied bed
Handling laundry bags
Handling food trays
Restocking supplies
Replacing O2 tanks on stretchers
Changing IV bags
Wound care/changing dressings
Dispensing medications
Taking vitals
Other:
Risk factors to consider heavy lifting? appropriate handles? rails adjust? accessible?
bending or twisting? forceful pushing or pulling? working height appropriate? beds adjustable? adjusted?
stooping or squatting? long carry distance? adequate space to move? handling aids available?
reaching out or up? pinch/power grip required? slippery floors? clutter in aisle ways?
prolonged (static) posture? object awkward? stable? brakes work? accessible? doorways wide enough?
Patient Handling Checklist
Appendix C - 11
Ergonomics (Musculoskeletal) Risk Assessment
Fraser Health Authority xxxi
Patient Handling ChecklistCont.
ADMINISTRATIVE/ORGANIZATION CHECKLIST Yes No Comments
MSIP Policies and Procedures
Is incident reporting and investigation in place?
Is MSI awareness information/training available?
Are MSIP policies and procedures in place?
Is MSIP patient handling training in place?
Is MSIP patient handling training comprehensive?
Does MSIP patient handling training include hands-on
practice and competency measures?
Have staff attended MSIP patient handling training in the
last 2 years?
Have staff been shown how to use mechanical
equipment?
Can Physiotherapy staff can be called upon to provide
additional guidance on ward?
Mobility Assessment
Is initial mobility assessment conducted on admission?
Is there a process for mobility re-assessment in place
and effective?
Are staff aware of process for re -assessment?
Is mobility information written on ADL card and/or patient
care plan?
Is appropriate mobility logo posted at bedside?
Patient/Resident Handling
Are patient/resident assessments immediately prior to
the transfer conducted?
Are patients/residents encouraged to assist?
Are recommended handling procedures and techniques
used by staff?
Is the bed height adjusted and side rails lowered?
Do staff use a standard starting sign for transfers?
Are difficult transfers discussed with supervisors and co-
workers?
Equipment
Is there adequate mechanical equipment and slings
(supplementary checklist available)?
Is equipment in good working order (e.g. brakes, wheels,
adjustable beds)?
Is there a process for equipment repair in place and is it
effective, including identifying and tracking?
Are staff aware of process for equipment repair?
Is there a process for routine equipment maintenance in
place?
Is there adequate space to store equipment?
Do equipment purchases include user feedback prior to
purchase?
Environment
Are hallways and rooms uncluttered and free of
obstacles?
Is there enough room to maneuver?
Other
Is workload distributed equally among employees or
shifts?
Do staff know how to report an injury or unsafe
condition?
Is communication with employees conducted by
meetings, bulletin boards, in-service sessions?
Appendix C - 11
Ergonomics (Musculoskeletal) Risk Assessment
Fraser Health Authority xxxii
RISK ASSESSMENT STANDARDS AND
GUIDELINES
The following is a listing of available standards and
guidelines for ergonomics risk assessment.
Risk Identification and Assessment
ACGIH threshold limit values for physical
hazards The American Conference of
Governmental Industrial Hygienists (ACGIH),
Thresholds Limit Values for Chemical Substances
and Physical Agents in the Work Environment, and
Biological Exposure Indices (TLVs and BEIs),
including Hand Activity Level (HAL) tool for
measuring upper extremity activity. Available for
purchase at the ACGIH web site at www.acgih.org.
ANSI S3.34-1986 (R1997) Hand Arm Vibration
Standards American National Standard Guide
for the Measurement and Evaluation of Human
Exposure to Vibration Transmitted to the Hand.
ANSI S3.34-1986 (R1997). Available for purchase
at the ANSI web site at www.web.ansi.org/
default.htm.
ANSI Draft Ergonomics Checklist ANSI
(1996). American national standard: control of
work-related cumulative trauma disorders. Part I:
upper extremities. New York, NY: American
National Standards I nstitute, Z-365-1996.
Unpublished draft.
CSA Office Ergonomics CSA Z412 Guideline
on Office Ergonomics, 2000, available from CSA
International www.csa-international.org
Caution zone jobs J obs where an employees
typical work activities include any of the specific
physical risk factors identified in Washington State
WAC 296-62-05105 Appendix B. These jobs have
a sufficient degree of risk to require ergonomics
awareness education and job hazard analysis.
Available from www.1ni.wa.gov/ wisha.
ErgoWeb Fitting the J ob to the Worker: An
ergonomics program guideline http:/ / ergoweb.com
/ resources/ reference/ guidelines/ fittingjob.cfm
US Department of Energy ErgoEASER
Ergonomics Education, Awareness, System
Evaluation and Recording (ErgoEASER) software
package. US Department of Energy, Office of
Environment, Safety, and Health (1995). Can be
downloaded from the Department of Energy web
site at www.tis.eh.doe.gov/ others/ ergoeaser/
download.htm.
GM UAW Risk Factor Checklist UAW GM
Ergonomics Risk Factor Checklist RFC2, United
Auto Workers General Motors Centre for
Human Resources, Health and Safety Centre, 1998.
Copies available from UAW GM Centre for
Human Resources, Health and Safety Centre, 1030
Doris Road, Auburn Hills, MI 48326.
Job Strain Index The Strain Index: A proposed
method to analyze jobs for risk of distal upper
extremity disorder, Moore, J .S. and A. Garg, (1995).
Published in American I ndustrial Hygiene
Association J ournal, volume 56, pages 443-458.
Web site at http:/ / sg-www.satx.disa.mil/ hscoemo/
tools/ strain.htm for a web-based version of this
tool.
NIOSH Lifting Equation, 1991 Waters, T.R.,
Putz-Anderson, V., Garg, A., and Fine, L.J . (1993).
Revised NI OSH equation for the design and
evaluation of manual lifting tasks. Published in
Ergonomics, volume 36 (7), pages 749-776. For a
manual on using the lifting equation see:
Application Manual for Revised Lifting Equation,
Appendix C - 12
Ergonomics (Musculoskeletal) Risk Assessment Project
Fraser Health Authority xxxiii
Waters, T., Putz-Anderson, V., Garg, A. (1994).
Available from the National Technical Information
Centre (NTIS), Springfield, VA 22161.
Calculator available from Healthcare Benefit
Trust, Vancouver BC.
Calculator web site at :
www.industrialhygiene.com/calc/lift.htm.
Application guideline web site at
www.cdc.gov/niosh/94-110.html
NIOSH Elements of Ergonomics Programs, 1997
US Department of Health and Human Services,
Public Health Service, Centres for Disease Control
and Prevention, National Institute for Occupational
Safety and Health. Publication No. 97-117.
Available at www.cdc.gov/niosh/homepage.html.
Ovako Working Posture Analysis System (OWAS)
OWAS provides a method for evaluating postural
load during work. OWAS assigns the evaluated
posture a rating that indicates the urgency of taking
corrective measures to reduce the postures potential
to expose workers to injury. For more information
on OWAS, visit the Tampere University of
Technology web site at http://turva.me.tut.fi/owas/
.
Rapid Entire Body Assessment tool (REBA)
Hignett, S. and McAtamney, L. (2000) Rapid entire
body assessment (REBA). Published in Applied
Ergonomics volume 31, pages 201-205.
Copies available from Elsevier Science,
www.elsevier.com.
Rapid Upper Limb Assessment (RULA)
McAtamney, L and Corlett, E.N. (1993) RULA: A
survey method for the investigation of work-related
upper limb disorders. Published in Applied
Ergonomics, volume 24 (2), pages 91-99. Copies
available from Elsevier Science, www.elsevier.com.
RULA contains a handy one-page worksheet that is
great for establishing joint posture ranges with
comparison to neutral ranges.
Snook Push/Pull Hazard Tables Snook, S.H. and
Ciriello, V.M., (1991) The design of manual
handling tasks: revised tables of maximum
acceptable weights and forces. Published in
Ergonomics, 1991 34(9), pages 1197-1213. You may
obtain a copy from Taylor & Francis,
www.tandf.co.uk/journals.
Task Analysis Kirwan and Ainsworth (1992). A
Guide to Task Analysis. Taylor and Francis,
London. This book reviews many methods of task
analysis and is specifically geared to practical
techniques. A large proportion of the book is about
industrial case studies.
WCB of BC MSI Booklets The WCB provides
publications to assist with implementing the
Ergonomics (MSI) Requirements. Preventing
Musculoskeletal Injury (MSI): A Guide for Employers and
Joint Committees provides a seven-step process to
assist with the application of the ergonomics
requirements along with procedures to investigate
incidents of MSI and a table of common control
measures. Understanding the Risks of Musculoskeletal
Injury (MSI) is intended to help employers with the
requirements of section 4.51(1) to educate workers
in risk identification, signs and symptoms of MSI,
and their potential health effects. Information and
publications available at www.worksafebc.com.
Appendix C - 12
Ergonomics (Musculoskeletal) Risk Assessment
Fraser Health Authority xxxiv
Risk Control
National Safety Council, 1988 - Making the J ob
Easier An ergonomics idea book. National Safety
Council, 1121 Spring Lake Drive, Itasca, IL 60143-
3201.
NIOSH Elements of Ergonomics Programs, 1997
US Department of Health and Human Services,
Public Health Service, Centres for Disease Control
and Prevention, National Institute for Occupational
Safety and Health. Publication No. 97-117.
Available at www.cdc.gov/ niosh/ homepage.html.
WCB of BC MSI Booklets The WCB provides
publications to assist with implementing the
Ergonomics (MSI ) Requirements. Preventing
Musculoskeletal Injury (MSI): A Guidefor Employers
and J oint Committees provides a seven-step process
to assist with the application of the ergonomics
requirements along with procedures to investigate
incidents of MSI and a table of common control
measures. Understanding theRisks of Musculoskeletal
Injury (MSI) is intended to help employers with the
requirements of section 4.51(1) to educate workers
in risk identification, signs and symptoms of MSI,
and their potential health effects. Information and
publications available at www.worksafebc.com.
Appendix C - 12
Ergonomics (Musculoskeletal) Risk Assessment Project
Fraser Health Authority xxxv
Ergonomics Risk Assessment Project
7/17/02
Assessment Date: 12/1/01 Assessment Type: Ergonomics (MSI)
HSA: Langley Health Site: LMH Dept: LMH - 4 SOUTH Occup: LPN Year: 2001
Contact Name: RV Assessed By:DH Shift: variable
Employees Observed:
Job Summary: Performs nursing procedures such as sterile dressings in addition to patient care duties relating to feeding, personal
hygiene and transporting patients.
Task Conduct rounds Frequency/Duration: occasional Risk Assessment
Required
Task Long: Conduct rounds for personal care: bathing, dressing, Freq/Duration text: 1-2 hours each round,
getting patients up or back to bed, getting patients ready to typically done 2-3 times
send to appointments, assisting with toileting needs per shift
Identification:
Risk Factors Freq/Duration Mag/Range AssessmentObservations/Comments Freq Code
awkward posture 1-2 hours total neck > 20 Various hygiene-related duties with patients O
shoulder 20-90 including bathing, dressing and toileting.
Part Code Body Part elbow 0-60 Awkward postures including reaching, bending,
HA Hand/Wrist/Fingers wrist >15 and twisting to access, adjust and position patient
LB Lower Back trunk 20-60 and to see tasks.
Problems reported with commodes (broken, brakes
NE Neck not working)
SH Shoulder Patient can be asked to assist as much as
ELB Elbow possible. Bed height should be adjusted with side
rails down to improve posture.
force as above varies Force required when supporting limbs, amount V
varies depending on patient characteristics.
Pillows can be used as additional supports.
Night tables are difficult to move as they have only
2 wheels with casters.
static posture typically 1-2 Static posture required when supporting limbs. O
minutes Quick stretches to relieve static positioning are
recommended.
Recommendations:
Risk Factor Potential Cause Recommended Controls Person Date
static posture rounds, nursing Sample stretching exercises will be provided. DH 7/31/02
procedures
Comments: Status: Outstanding
Ctl Code: Information/handout
awkward rounds, toileting Check on existing commodes and request maintenance (reported RV 7/31/02
posture, force that some are broken and the brakes do not work) or investigate
purchase of new ones.
Comments: New commodes have been purchased and are in use. Status: Implemented
Ctl Code: Major equipment
awkward rounds, toileting, Consider replacing the legs on the night tables with casters (check RV 7/31/02
posture, force washing with Maintenance). This would make it easier to move the tables
around within the working area.
Comments: Status: Outstanding
Ctl Code: Maintenance
Ergonomic (MSI) Risk Factor Identification and Assessment
Sample Database Report
Appendix D
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Appendix D-2: Ergonomics Risk Assessment Project Status of Recommendations
ID Assessment Site, department, occupation Job Summary 07/31/02
15 01-Dec-01 LMH, LMH - 4 SOUTH, LPN Performs nursing procedures such as sterile dressings in addition to patient care
duties relating to feeding, personal hygiene and transporting patients.
Task Short: Conduct rounds for personal care Task Long: Conduct rounds for personal care: bathing, dressing, getting patients up or back to bed,
getting patients ready to send to appointments, assisting with toileting needs
Counter Risk Factor Potential Cause Recommendations Status Date Control Code Control Status
51 static posture rounds, nursing procedures Sample stretching exercises will be 7/31/02 Information/ Outstanding
provided. handout
Counter Risk Factor Potential Cause Recommendations Status Date Control Code Control Status
52 awkward posture, force rounds, toileting Check on existing commodes and request 7/31/02 Major Implemented
maintenance or investigate purchase of new. capital
Counter Risk Factor Potential Cause Recommendations Status Date Control Code Control Status
53 awkward posture, force rounds, toileting, washing Consider replacing the legs on the night 7/31/02 Maintenance Outstanding
tables with casters to make it easier to move
the tables around the work area.
38 Task Short: Perform nursing procedures Task Long: Perform nursing procedures such as changing dressings, catheterizations,
taking/recording blood pressure, temperature and pulse.
Counter Risk Factor Potential Cause Recommendations Status Date Control Code Control Status
54 awkward posture, force patient handling, For purchases, continue to ensure that 7/31/02 Work Existing
repositioning, staff have input (as with the new beds)
moving beds and request possible trials to ensure it will
meet the needs of the unit.
39 Task Short: Assist with patient handling Task Long: Assist with patient handling; repositioning in bed reported to be problematic
Counter Risk Factor Potential Cause Recommendations Status Date Control Code Control Status
55 awkward posture, patient transfers and repositioning MSIP training (4-hour sessions) are 7/31/02 Training In progress
static posture, available and all staff should be
force encouraged to attend. Sessions include
practical demonstrations and hands-on
opportunities for various transfers.
Counter Risk Factor Potential Cause Recommendations Status Date Control Code Control Status
56 awkward posture patient transfers and repositioning Schedule awareness campaigns on a 7/31/02 Information/ In progress
static posture regular basis (bi-monthly). Include handout
force suggested topics as identified from the
risk assessment.
Counter Risk Factor Potential Cause Recommendations Status Date Control Code Control Status
57 awkward posture patient transfers and repositioning Specific to bed repositioning: Trial slide 7/31/02 Minor Outstanding
static posture sheet and request employee feedback on
force their use.
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Ergonomics (Musculoskeletal) Risk Assessment
Fraser Health Authority xxxvii
Workplace Health and Safety
POLICY
The South Fraser Health Region is committed to
promoting a safe and healthy workplace for all
employees. One of our goals is to minimize the
risk of injury to all employees, physicians,
volunteers and the general public. By providing
appropriate facilities, equipment, training,
education, procedures and performance standards,
we will effectively manage workplace health and
safety risks inherent to healthcare and exceed
regulatory requirements.
All employees, physicians and volunteers will
actively participate in the elements of the
Workplace Health & Safety Program to ensure that
all work is performed in a safe manner.
PROCEDURES
Executive Team and Senior Leadership Teams
will:
Ensure that all levels of management are
accountable for workplace health and safety
performance in their area of responsibility.
Initiate the development of health and safety
goals and objectives and review annually.
Ensure that health and safety concerns are
addressed in all aspects of strategic planning.
Managers and Supervisors will:
Develop and implement safe work
procedures.
Provide adequate direction and instruction to
employees in the safe performance of their
duties.
Ensure appropriate education is provided to
staff so that work is performed in accordance
with established safety standards and
practices.
Conduct quality accident investigations to
determine the causes of work related injuries
and to recommend corrective actions to
eliminate the hazard.
Consider health and safety factors in their
decision-making process.
Employees, Physicians and Volunteers will:
Follow all health and safety requirements
according to WCB Occupational Health and
Safety Regulations and the Regions policies
and procedures.
Report all unsafe acts and/ or conditions.
Workplace Health & Safety Department will:
Provide consultation, education and subject
matter expertise to guide compliance with
regulatory and workplace standards in safety
and health.
Coordinate, develop and implement the
Regions Workplace Health & Safety
Program according to Regional requirements
and applicable legislation.
Joint Occupational Health & Safety Committee
will:
Promote safe work practices and working
conditions by raising awareness through
various activities.
Assist in creating a safe place of work by
recommending corrective measures to
management.
Approved by: Executive Team
Appendix E
Ergonomics (Musculoskeletal) Risk Assessment
Fraser Health Authority xxxviii
NO MANUAL LIFT POLICY
THE SOUTH FRASER HEALTH REGION IS COMMITTED TO MINIMIZING THE RISK OF INJURY TO STAFF AND PATIENTS/
RESIDENTS THROUGH ENGINEERING CONTROLS.
THE SOUTH FRASER HEALTH REGION RECOGNIZES THE PHYSICAL RISKS ASSOCIATED WITH MANUALLY LIFTING,
TRANSFERRING OR REPOSITIONING PATIENTS/RESIDENTS.
NO MANUAL LIFTING OF PATIENTS/RESIDENTS* SHALL BE PERFORMED BY SOUTH FRASER HEALTH REGION STAFF, EXCEPT
IN LIFE THREATENING SITUATIONS.
All patients/residents shall be assessed for their ability to weight bear prior to any
attempt by staff to transfer and/or ambulate, except in life threatening conditions.
A mechanical lift shall be used when any patient/resident is unable to weight bear.
* In the case of infants and small children, where the use of a mechanical lift may be
unsafe, the lift method shall be assessed on an individual basis.
MUSCULOSKELETAL INJURY PREVENTION PROGRAM
NO MANUAL LIFT POLICY
Appendix E
Ergonomics (Musculoskeletal) Risk Assessment
Fraser Health Authority xxxix
Summary Of Recommendations From Risk Assessments
Variable
Totals or
Average
Individual
computer
workstations
Multi-user
computer
workstations
Material
handling
Patient
Handling
Number of reports reviewed 100 20 20 25 35
Average number of
recommendations per report
6 4 6 6 6
Type of Recommendations
% of recommendations
related to training, including
providing written materials
31% 40% 23% 26% 36%
% of recommendations
related to work process
33% 31% 37% 38% 28%
% of recommendations
related to maintenance
8% 4% 10% 8% 8%
% of recommendations
related to minor capital
expense (< $2000)
24% 25% 29% 26% 16%
% of recommendations
related to major capital
expense (> $2000)
4% 0% 1% 2% 12%
Total 100% 100% 100% 100% 100%
Status of Recommendations
% of recommendations that
are complete
45% 86% 78% 36%
20%
(+16% in
progress)
% of recommendations that
are on capital list
2% 0% 0% 1% 6%
% of recommendations that
are not complete
53% 14% 22% 63% 58%
Total 100% 100% 100% 100% 100%
Costs of Recommendations
% of reports with total costs
of $0
26% 25% 25% 28% 26%
% of reports with total costs
of < $500
46% 75% 74% 44% 21%
% of reports with total costs
of $500-2000
9% 0% 0% 16% 7%
% of reports with total costs
of > $2000
19% 0% 1% 12% 46%
100% 100% 100% 100% 100%
Appendix F - 1
Ergonomics (Musculoskeletal) Risk Assessment
Fraser Health Authority xl
Project Outcomes: Percent Change in Pre-Project Values vs. Post-Project Values
All data was derived from Workplace Health and Safety database.
Variable
PRE-PROJECT
(Baseline
2000)
POST-PROJECT
(Upon project
completion)
% change
Frequency
1
and severity
2
rates
Frequency rate for all incidents +10%
Severity rate for all incidents -28%
Frequency rate for MSIs only +2%
Severity rate for MSIs only -43%
Costs of WCB claims
WCB direct claims costs all incidents -34%
WCB direct claims costs MSIs only -44%
Average cost per MSI WCB claim (lost time only) $3020 $1809 -40%
Average days lost per MSI WCB claim
22.3 12.1 -46%
% of costs that are MSI, year of incident only 89% 75% -15%
% of days lost that are MSI, year of incident only 91% 74% -19%
Incidents and MSIs
% reported incidents that are MSIs 55% 51% -7%
% lost time that are MSIs 77% 72% -6%
Extended/Acute Facility
% of MSI incidents at extended care facilities 40% 20% -50%
% of MSI incidents at acute care facility 60% 80% +33%
Activity at time of MSI
% of MSI incidents related to patient transfer 25% 13% -48%
% of MSI incidents related to patient repositioning 12% 13% +8%
% of MSI incidents related to material handling 15% 21% +40%
% of MSI incidents related to other activities 48% 53% +10%
Occupation
% of MSI incidents for long term care aide 35% 24% -31%
% of MSI incidents for RNs 15% 27% +80%
% of MSI incidents for food service workers 13% 11% -15%
% of MSI incidents for cleaners 9% 7% -22%
% of MSI incidents for LPNs 8% 7% -12%
% of MSI incidents related to other occupations 20% 24% +20%
Body Part Affected
% of MSI incidents to multiple sites, including back,
neck or shoulder
10% 19% +90%
% of MSI incidents to back only 32% 18% -44%
% of MSI incidents to neck and/or shoulder only 26% 10% -61%
% of MSI incidents to other body parts 32% 53% +65%
1
Frequency rate: (Number of lost time incidents * 100) / number of FTEs
2
Severity rate: (Number of days lost (per SFVHR) *100) / number of FTEs
Appendix F - 2
Ergonomics (Musculoskeletal) Risk Assessment
Fraser Health Authority xli
Appendix F - 3
FOLLOW-UP SURVEY FOR MANAGERS
Ergonomics Risk Assessment Project at LMH
Thank you for taking time to complete this survey! The information will be used to evaluate the ergonomics
project at LMH and make improvements to the process for future risk assessments that are conducted at
facilities throughout the health authority.
1. Date: ____________________________________________________________________
2. Department (optional): _______________________________________________________
3. Were you aware that an ergonomics risk assessment project was taking place at LMH and within your
department?
YES NO
4. Are you aware of any changes made in YOUR department as a result of this project?
YES NO
If yes, please list examples:
____________________________________________________________________________________
____________________________________________________________________________________
5. Are you aware of any changes made in OTHER departments as a result of this project?
YES NO
If yes, please list examples:
____________________________________________________________________________________
____________________________________________________________________________________
6. Do you feel that this was a worthwhile project for your department and staff?
YES NO
7. Do you feel that this was a worthwhile project for LMH?
YES NO
8. What did you like about the project or what do you think worked well?
____________________________________________________________________________________
____________________________________________________________________________________
9. Do you have any suggestions as to how the project and process could have been improved?
____________________________________________________________________________________
____________________________________________________________________________________
10. Additional comments (please use the back if more room is required):
____________________________________________________________________________________
Thank you for completing this survey!
Please return to Workplace Safety and Wellness, LMH
Useful Web Sites
References
Ergonomics (Musculoskeletal) Risk Assessment Project
Fraser Health Authority xlv
Useful Web Sites
ASSTSAS
Association for health and safety in the workplace,
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California OSHA
A Back Injury Prevention Guide for Health Care
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Garg, Arun. (1999)
Long-Term Effectiveness of Zero-Lift Program in
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Government of Western Australia
Strategies To Reduce The Risk Of Back Strain In
Nursing Homes. Available from web site:
http://www.safetyline.wa.gov.au/pagebin/
pg001136.htm
Health Care Health and Safety Association of
Ontario.
Resource guides:
http://www.hchsa.on.ca
National Institute for Occupational Safety and
Health, NIOSH,
http://www.cdc.gov/niosh/homepage.html
National Occupational Health and Safety
Commission, Commonwealth of Australia
http://www.nohsc.gov.au
National Research Council,
Panel on Musculoskeletal Disorders and the
Workplace, Commission on Behavioral and
Social Sciences and Education. Musculoskeletal
Disorders and the Workplace: Low Back and
Upper Extremities. From National Academies
Press:
http://www.nap.edu/books/0309072840/html/
index.html
Occupational Health and Safety Agency for
Healthcare in British Columbia, OHSAH,
http://www.ohsah.bc.ca
Occupational Safety and Health
Administration, OSHA,
U.S. Department of Labour, Hospital E-Tool
http://www.osha-slc.gov/SLTC/hospital_etool/
index.html and Nursing Home eCAT
http://www.osha-slc.gov/SLTC/
nursinghome_ecat/ergo/ergo.html
Occupational Safety and Health Service of the
Department of Labour, New Zealand
http://www.osh.dol.govt.nz
Ergonomics (Musculoskeletal) Risk Assessment Project
Fraser Health Authority xlvi
Patient Safety Center of Inquiry, Tampa
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www.patientsafetycenter.com
Prevention Dynamics, Portal for Ontario
Health and Safety Associations
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U.S. Department of Health and Human
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Washington State Department of Labour and
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Washington State WAC 296-62-05105 Appendix B.
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Workers Compensation Board of B.C.
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Workplace Health Safety and Compensation
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Workplace Safety and Insurance Board,
Ontario.
http://www.wsib.on.ca/wsib/wsibsite.nsf/public/
PreventionHSSI
Ergonomics (Musculoskeletal) Risk Assessment Project
Fraser Health Authority xlvii
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Acknowledgements:
Project Steering Committee Members:
Warren Ballard
Representative
Hospital Employees Union
Kathy Churchill
Representative
British Columbia Nurses Union
Larry DeGusseme
Occupational Hygienist, Industry Services
Workers Compensation Board of British
Columbia
Deanna Harrison
Ergonomist, Workplace Safety and Wellness
Fraser Health Authority
Alison Hutchison
Disability Prevention Consultant, Workplace
Safety and Wellness
Fraser Health Authority
Frances Hutchison
Disability Prevention Consultant, Workplace
Safety and Wellness
Fraser Health Authority
Dave Keen
Director, Workplace Safety and Wellness
Fraser Health Authority
Stephen Symon
Industry Specialist, Industry Services - Healthcare
Workers Compensation Board of British
Columbia
Maggie Walters
Representative
British Columbia Government and Service
Employees Union
Assessment Project Report Designed by:
Gordon Jang
Media Services Technician
Fraser Health Authority
Copyright Nov. 2002