Bariatric Times - February 2009 - (Page 22) 22 Patient Management Perspective Bariatric Times • February 2009 WHAT IS ERGONOMICS? WHAT IS THE SAFETY HUDDLE? Ergonomics is a relatively new term that describes the specialty designed to help prevent injuries by identifying and alleviating risk factors that put strain on the body in a wide variety of occupations. Ergonomics is practiced not only in lifting and patient care, but in all aspects where the work environment and the worker interface. programs have found significant cost saving in terms of human and economic costs. For example, one study indicated workers’ compensation costs decreased by 61 to 95 percent, insurance premiums dropped 50 percent, medical and indemnity costs decreased by 92 percent, lost work days decreased by 66 to 100 percent, and restricted work days decreased by 38 percent.14, 15 Several cost-benefit analyses show initial investment in lifting equipment and training can be recovered in 2 to 3 years through reductions in workers’ compensation benefits.16 Each of these studies serve to advance administrative interest and support. Introduction of equipment is an important next step. Equipment must meet the realistic needs of the patient, caregiver, and facility. Because bariatric equipment is larger, heavier, and wider, it can be more cumbersome to move and use. Practical considerations to bariatric equipment include ergonomic qualities (e.g., ease of use) and patient-specific qualities (e.g., width and weight limit). Specially designed wheels, steering systems, and powered units are safety features integrated into not only bariatric patient care equipment, but also clinical and nonclinical equipment that require physical exertion. Equipment selection is the task of those closest to the patient. When renting equipment, consider delivery time, set up, training, and cost. When purchasing equipment, ask questions such as the following: Is there an option for a service agreement? What is the cost? Who will maintain, store, or set up the equipment? Staff members who evaluate equipment should report on ease of use, effectiveness, storage, patient comfort, and patient and staff member safety. Implementation plans should include staff training in the safe and effective utilization of new patient handling equipment. Ideally, the training would include thorough demonstrations for the staff on techniques and propert equipment usage, with opportunities for the staff to perform demonstrations that show competency (i.e., trainthe-trainer programs). Identify, in a discreet fashion, weight limits of bariatric equipment to ensure maximum safety for patients who use the equipement. For example, a simple number or colored sticker placed in the same place on each piece of equipment might serve this purpose. Title III of the Americans with Disabilities Act requires reasonable accommodation in public spaces, which can be interpreted to mean in the general areas of public and private hospitals and clinics. Wider, heavy-duty chairs with adequate weight capacity in patient rooms and waiting areas are essential, especially in a facility that provides a medical or surgical weight management services. Patient and visitor bathrooms should provide floor-mounted toilets and sinks as there is some question as to the actual weight limit of many wallmounted structures when force is added to weight. Specially designed rooms furnished and equipped to meet the needs of the larger, heavier patient on a unit with trained staff members have been a successful safety strategy in some facilities. Appropriately sized furniture, gowns, blood pressure cuffs, patient handling equipment, and resuscitation equipment should be located in or near the patient rooms for easy, discreet access.11 Policies and procedures that guide processes for moving and lifting larger, heavier patients and explain use of equipment are an Safety huddles are patterned after the military’s after-action review (AAR) process and have been used in industry for many years. Safety huddles are brief meetings (no longer than 10 minutes) covering a specific safety topic or type of hazard. A huddle can be held with a group of workers to review hazards of a job that is about to be started— for example, how to use a lift system for the first time to transfer a 500-pound dependent patient. A safety huddle is also used to review causes and corrective action for a recent accident or near miss (e.g., a weight loss surgery patient nearly falling off the OR table when transferring to a gurney). The ideal size for a safety huddle is 6 to 10 workers. Sometimes larger groups are necessary; however, if the group is too large, there is the risk of side discussions or simply the failure of workers to enter into discussions. Normally, a supervisor leads a huddle, simply because it is his or her responsibility to know clinicians, the nature of the job to be undertaken, and its associated hazards. important part of the safety equation. Consider the work done by the Patient Safety Center, Tampa Florida, where the Safe Bariatric Patient Handling Toolkit has been developed and is available online for use.17 The goal of the toolkit is to promote safety for both patients and caregivers by providing just-in-time training for staff members, which is training delivered specific to a particular situation and as needed, and is designed to foster dignified, comfortable, and safe care for bariatric patients. The toolkit includes clinical tools, resources, policies, safety tips, and training ideas. Training is an important component of success. However, in years past, the most common training approach included body mechanics classes, of which recent evidence suggests is not an effective strategy in safe handling.18 The new training paradigm incorporates onunit mentoring as compared to an approach using an annual safety day that reviews body mechanics and other safety ideas during an all-day program, which attendees are expected to recall in the event they are faced later with a safety challenge. An on-unit mentor or back injury resource clinical specialist is more involved with the day-to-day safety issues, with responsibilities such as providing expertise in patient-handling assessment, offering techniques on
For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.