Wpc 108935

7/27/2019 Wpc 108935

1/30

51

section 3

Contents

Whyriskassessmentisimportant

Risksrelatedtomovingandhandling

Identifyinghazardsinworkplaces

Workplacehazardmanagementandriskcontrols

Theriskassessmentprocess

Riskassessmenttools

Monitoringriskassessment

Referencesandresources

Appendices:Resourcesforriskassessment.

Risk assessment

7/27/2019 Wpc 108935

2/30

2

3. 1 Why risk

assessment is

importantAriskreferstothepossibilityof

somethinghappening.Inmoving

andhandling,thetermrisk

isusuallyusedtorefertothe

possibilityofaninjuryorother

negativeoutcomeoccurring.A

lowriskmeansalowlikelihoodof

anegativeoutcome.Ahazardis

afeatureofataskorenvironmentthatmayleadtoinjuryorharmto

acarerortoaclient.Thepurpose

ofriskassessmentistoidentify

andmanagehazardstoreducethe

likelihoodofincidentsoccurringthatcouldcauseharmorinjuryforcarersandclients.

Riskassessmentisakeypreliminaryprocedureforalltypesofmovingandhandling.

Itneedstobeundertakenpriortomovingandhandlingpeopletoensurehazardsare

eliminated,isolatedorcontrolled.

Inmanycountries(e.g.Australia,Canada,theUnitedKingdomandtheUnitedStates)local,regionalandnationalhealthauthoritiesnowhaveguidelinesandcodes

ofpracticethatincludeconductingriskassessmentsbeforemovingandhandling

people.1Aprimaryfocusinclientmovingandhandlingguidelinesisthathazards

relatedtomovingandhandlingclientsshouldbeclearlyidentifiedandeliminated,

minimisedorcontrolledwherefeasible.

InNew Zealand,bestpracticeformovingandhandlinginworkplacescomesunderthe

jurisdictionoftheDepartmentofLabourandtheAccident Compensation Corporation

(ACC).The Health and Safety in Employment Act (1992) requiresemployerstoprovidesafe

placesofwork.Employersareexpectedtosetupsystemsandprocedurestoidentifyhazardsintheworkenvironment,assesstheirsignificance,providecontrolsand

evaluatetheeffectivenessofthecontrols.

1. Forexample,RoyalCollegeofNursing,2003;Johnson,2011.

Box 3.1

New Zealand legislation and

risk assessmentThe use of the term hazard in these

Guidelines is consistent with its use in the

Health and Safety in Employment Amendment

Act (1992), and the procedures recommended

for reducing risks are consistent with those

required of employers by that legislation.

We regard the lack of systems for

identifying and/or not regularly reassessing

hazards in places of work as being serious

noncompliance with the health andsafety legislation.

(Department of Labour, 2009a, p. 13)

7/27/2019 Wpc 108935

3/30

53

Section 3: risk assessment

3.2 Risks related to moving and handling

Severalresearchstudieshaveidentifiedthatclientmovingandhandlingtasks

areassociatedwithanincreasedriskofinjuries(Box3.2),includinganextensive

studybasedonACCclaimsin

New Zealand(Box3.3).The

identificationandcontrolof

hazardsrelatedtothesemoving

andhandlingtasksneedto

considerthefollowingfactors:

Workplaceorganisation,

suchaspoliciesand

procedures,shiftpatterns,

staffavailabletoassist,

workplacecultureand

trainingforstaff

Physicalworkenvironment,

suchasworkspaces,

layout offurnitureand

equipmentavailable

Clientcharacteristicssuchassizeandweight,theabilityandwillingnessofthe

clienttounderstandandcooperate,andanymedicalconditionsthatinfluencethechoiceofmethodfortransferringorrepositioningtheclient

Carersandthephysicaldemandsofatask,suchastheforcerequired,

awkwardposturesandthefrequencyanddurationofthetask.

Box 3.3

Moving and handling tasks associated with higher risks of injury for carers in

New Zealand residential care

A taxonomic study of ACC entitlement claims that involved 60 days or more off work betweenJuly 2007 and May 2009 reported that lifting patients was the most frequently reported task

leading to longterm claims. Lifting patients involved 74% (129) of the 176 claims for injuries

that occurred while moving and handling patients within the New Zealand residential care

(or retirement village) sector. Of the 129 claims involving patient lifting incidents, 61 had

information about the types of transfer during which the carers were lifting the patients.

Among these 61 claim incidents, 33 (54%) involved transferring patients to or from equipment

(e.g. bed, chair, wheelchair, toilet, commode), 15 (25%) involved catching falling patients, and

seven (11%) involved picking patients up from the floor.

Source: Ludke & Kahler, 2009, pp. 2728

Box 3.2

Client handling tasks associated with

injuries to carers

Transfers between bed and chair

Transfers between chair and toilet

Lateral transfers between bed

and stretcher

Repositioning in bed

Repositioning in a chair

Sitting to standing.

Sources: Nelson et al, 2003; Royal College of

Nursing, 2003; Waters et al, 2007

7/27/2019 Wpc 108935

4/30

4

3.3 Identifying hazards in workplaces

Forcontrollingrisksinworkplaces,thePrevention and Management of Discomfort, Pain

and Injury Programme(DPIProgramme),establishedbyACCin2006,describesseven

generalfactorsrelatedtoworkplacehazards(seeSection2).Thesesevenfactors

provideageneralcontextforidentifyinghazardsandcontrollingrisksrelatedto

peoplemovingandhandling.Hazardidentificationshouldbepartofriskassessment.

Fourspecificgroupsofhazardareoutlinedthatmakepeoplemovingandhandling

activitiespotentiallyhazardous.Thesehazardsneedassessmenttoreducetheriskof

injurytocarers.Itisimportanttobecomefamiliarwiththesehazardssothattherisks

canbemanagedbyeliminating,isolatingorcontrollingthem.

(i) Hazards related to workplace organisation and practices

Examplesofworkplacefeaturesthatarepotentiallyhazardousinclude:

Administrativepoliciesandprocedures.Alackof,orinadequate,policiesand

procedures,orpoliciesandproceduresthatarenotfollowed,canincreasethe

levelofriskassociatedwithperformingapeoplemovingandhandlingtask

Equipmentnotprovidedornotmaintainedadequately,forexamplewhena

hoistmaintenanceprogrammeisnotfollowed,fundingisnotprovidedfor

thereplacementofobsoleteequipment,sometypesofequipmentarenot

availablesuchasholdupsonslidesheetsorslingssenttolaundry,ornot

enoughequipmentisallocatedtospecificunits

Staffinglevels.Toofewstaffforthenumberofclientsandforpeoplemoving

andhandlingtaskscanresultinincreasedworkdemandsbeingplacedonthe

existingstaff,forexamplethroughmoretransfertasks(repetition)oneach

shiftandlongdurationsonmovingandhandlingtasks.Thiscanleadtofatigue

andreducedworkcapacity,andtostafftakingshortcutsandunsafepractices.

Understaffingiscommonduringpeaktimes,forexampleduringactivitiesfor

dailylivingsuchasbathinganddressing

Extendedworkdays.Longworkhours(morethaneighthours)canleadto

increasedexposuretotheriskofinjury,forexamplewhenovertimebecomesnecessarybecausestaffonthenextshiftaresuddenlyunavailable,orpeople

areworkingin12hourshiftscateringfordependentpeople(seeBox3.4)

Workinginisolation.Forexample,whencaringforadependentpersonintheir

home,acarergenerallydoesnothavetheopportunitytocallforassistance.

Theavailabilityofassistancetoacarerwillaffectthelevelofriskassociated

withperformingpeoplemovingandhandling actions

Lackofvariability.Thiscanincreasetheloadonbodytissuesowingtoalack

ofchangesinpostureandthereducedchanceofrecovery,forexampleby

performingoneactionrepeatedly,suchasholdingalimb

7/27/2019 Wpc 108935

5/30

55


Inadequaterestbreaks.Notallowingenoughtimebetweenpeoplemoving

andhandlingtaskscancontributetofatigueandoverexertion.Anexampleis

busyworkschedulesleadingtomissedworkbreaks

Lackofconsultationwithworkerswhenpurchasingnewequipment

Inadequatetraining

Workplaceattitudesandpracticesthatdonotsupportacultureofsafety.

Box 3.4

Long working hours reduce quality of care

A case brought before the New Zealand Health and Disability Commissioner involved a

person being cared for in her home by nursing agency staff. She had developed pressure

sores and foot ulcers as a result of inadequate care. The notes for this decision reportedthat: The records indicate that in the several months prior to Mrs As death, it was not

uncommon for one caregiver in particular to work in excess of 100 hours per week. There are

instances of staff working 24hour shifts with relief for only several hours in the morning or

early evening.

Source: Health and Disability Commissioner, Decision 02HDC08905, retrieved 19 August

2010 from www.hdc.org.nz/2010

(ii) Hazards in the physical work environment

Slip,tripandfallhazardssuchaswiresandwetfloors

Unevenworksurfaces

Spacelimitations(smallrooms,lotsofequipment,clutter)

Inadequatespacearoundbedsandtoilets

Facilitydesigninadequatefortransfertasksinthetransferareaandforthe

equipmentrequired

Inadequatelighting.

(iii) Hazards related to clients

Poormobility

Peoplewhoaredifficulttomovebecauseoftheirsizeorcondition

Variationinclientcooperation

Aclientsabilitytohear,seeandunderstand,whichmayaffecttheirmobility

andabilitytocooperate

Cognitiveissuessuchasconfusionanddementia

Languageandculturaldifferences

Unpredictabilityofclientwhenbeingmoved

7/27/2019 Wpc 108935

6/30

6

Clientanxietyandfearofmoving,whichcanlimitcooperation

Medicalattachmentstoclient,whichmaylimittheirabilitytohelp

Pain,whichcanaffectaclientsabilitytocooperate.

(iv) Hazards for carers and use of moving and handling techniques

Forcetheamountofphysicaleffortrequiredtoperformatask(suchaslifting,

pushingandpulling)andtomaintaincontrolofequipment

Repetitionperformingthesamemovementorseriesofmovements

frequentlyduringtheworkingday

Awkwardpositionsassumingpositionsthatplacestressonthebody,such

asleaningoverabed,kneelingortwistingthetrunkwhilemovingaclient,

reachingawayfromthebodyorovershoulderheightforlongperiodsand

whileexertingforce

Carerlacksknowledgeortraining

Carermaybewearinginappropriatefootwearandclothing

Insufficientnumberofcarersformovingandhandlingtasks

Carerworkinglonghoursorisfatigued

Nosuitableequipmentavailable

Unsupportiveworkplaceculture.

Uncooperative and aggressive clients

Whenaclientiscombativeoraggressive,thecarershouldnotattempttohoist,

transferorrepositiontheclientifthereisarisktothecarerspersonalsafety.Ifthere

isanactualorpotentialrisktotheclientifatransferisnotcarriedout,restraintmay

benecessary.Inthiscasethefactorsinfluencingthedecisionrelatingtorestraint

shouldbedocumentedandallcarersshouldbemadeawareofthesefactors.

HealthcarestandardsinNew Zealandrequirethatanyrestraintusedmustbethe

leastrestrictivefortheleastamountoftime,andusedonlyafteralllessrestrictive

interventionshavebeenattemptedandfoundtobeinadequate.Restraintisaserious

interventionthatrequiresclinicaljustificationandoversightandshouldbeusedonly

inthecontextofensuring,maintainingandenhancingsafety,whilemaintainingthe

clientsdignity.Ifaclientisbeingphysicallyrestrained,thecarermustbetrainedand

certifiedinrestraintpractice.Forcarersworkingaloneinthecommunity,thereshould

beanagreedprocedureforseekingassistance.Thisisessentialtopreventundue

distressandseriousharmtotheclientsbeingrestrained,andtomaintainthesafety

of carers.

Anuncooperativeoraggressiveclientwhoneedstobemovedandhandledfor

personalcaremayneedtobeassessedundertheMental Health (Compulsory Assessment

and Treatment) Act (1992).Insuchacase,acareplaninvolvingallmembersofthecare

7/27/2019 Wpc 108935

7/30

57


teamshouldbeinplace.Arestraintregister,orequivalentprocess,islegallyrequired

toprovidearecordofrestraintuseforauditpurposes,asdescribedintheStandards

New Zealanddocument:Health and Disability Services (Restraint Minimisation and Safe

Practice) Standards.2

Organisationsneedtodeveloptheirownpoliciesandproceduresoncalming

andrestraintthatcomplementtheirmovingandhandlingpolicies.Policies

shouldbebasedontheHealth and Disability Services (Restraint Minimisation and Safe

Practice) Standards.2

2. SeeStandardsNew Zealand,2008

7/27/2019 Wpc 108935

8/30

8

3.4 Workplace hazard management and risk controls

Workplacehealthandsafetypoliciesshouldincorporatemovingandhandlingand

aretheresponsibilityofmanagement.Theyshouldincluderiskassessmentandrisk

controlprocesses.

Typicalriskcontrolfeaturesinclude:

Writteninformationandprotocols(e.g.hazardregisterwithriskorhazard

controlplan,workplaceprofile)

Equipmentprovidedformovingandhandlingclients

Trainingprogrammeforclientmovingandhandling

Incidentandinjuryreportingsystems.

Carersshouldbefamiliarwiththeirworkplacehazardregistersandriskcontrol

policiesandprocedures.Thesubsequentstepsinworkplaceriskassessment

processesshouldbeconsistentwithriskcontrolandhazardmanagementpolicies.

Workplace profile

Furtherinformationondevelopingaworkplaceprofileinwhichworkplacerisk

controlsformovingandhandlingcanbeincluded,aredescribedlaterinthissection

(3.6Riskassessmenttools)andadetailedexampleisshowninAppendix3.2.For

somelocations,suchasresidentialcarefacilitiesandcommunitysettings,theworkplaceriskassessmentprocessmayneedtobeadaptedtocontrolrisksforcarers

andclients(seeBox3.5andAppendix3.5).

Client risk assessment (load)

Clientcharacteristicsthatcanaffectmovingandhandlingrisksinclude(butarenot

limitedto)sizeandweight,levelofdependencyandmobilityandextentofclient

compliance.Somespecificpointstonotearethat:

Aclientsphysicalcharacteristicsmustbeknownandpreparedforinplanning

Clientsmayhavespecificphysicalconstraintssuchastheirfragility,tiredness,

havingcontractures,beingunabletolieflat,intravenouslines,drainagebags,

intubationandframes

Clientscansometimesberesistive,unpredictable,confusedanduncooperative.

7/27/2019 Wpc 108935

9/30

59


Carer risk assessment (individual)

Thecapabilitiesofcarersinvolvedinmovingandhandlingclientsincludetheir

physicalability,trainingrelatedtomovingandhandling,levelofstressandfatigue

andthenumberofothercarersinvolved.Examplesofspecificrisksforcarersare:

Staffwhoareinexperienced,inadequatelytrainedorunfamiliarwithclients

andmovingandhandlingequipment

Continualmovingandhandlingofclientsforlongperiods

Inadequatestaffnumbersforsafemovingandhandling.

Box 3.5

Example of a community risk assessmentTask caring for a client in a low bed and on a double bed, including:

Clinical procedures carried out on the client in bed

Turning in bed

Moving up and down the bed

Sitting client to lying and vice versa

Bedbathing

Getting client in/out of bed.

People involved carers, including public health nurses, family members

and physiotherapists.

Identified risks

Prolonged stooped postures when attending to client

Awkward posture when moving client in bed.

Control measures the level of risk depends on the client and the environment and should

be assessed locally. For medium to high risks, consider using these options when working

with a client:

Place knee(s) on bed or floor to reduce stooping when attending to the client (considerinfectioncontrol issues)

Provide electric profiling bed

Provide hoists and sliding boards for transfers to and from bed

Keep the client in bed until equipment is available

Provide extra staff as required

Provide low stool for carers and staff.

An assessment may result in a recommendation to move furniture or provide equipment.

This would need to be discussed with the client and their family. The environment should

be managed appropriately, and if the client and family refuse assistive equipment, care may

need to be scaled down to avoid risks to carers.

Adapted from: Royal College of Nursing, 2003

7/27/2019 Wpc 108935

10/30

0

Task risk assessment

Ataskriskassessmentincludesidentifyingthespecifictypeofmovingandhandling

task,matchingthemovingandhandlingprocedurewiththeloadandtask,and

ensuringthattheequipmentneededforthetaskisavailable.Notethatthefollowing

arehigherrisktasks:

Repositioninginabed

Repositioninginachair

Transfersbetweenbedand chair

Transfersbetweenchairandtoilet

Lateraltransfersbetweenbedandstretcher

Sittostand

Prolongedorsustainedholds,suchasholdingalimbwhilechangingadressing

orchanging clothing.

Thetaskwillneedreplanningifcarersneedtodoanyofthe following:

Awkwardpostures,suchasprolongedorrepeatedbendingforwardor

sideways,twisting,andworkingatorbelowkneelevel

Exertinghighforce,suchaswhenholding,restrainingorpushingorwithloads

notequalforbothsidesofthebody

Reachingawayfromthebodyorovershoulderheightforlongperiodsorwhile

exertingforce(seeBox3.6).

Box 3.6

One carer or more than one carer needed?

A common question, particularly for clients receiving care in their homes, is whether

one carer or two or more carers is needed to transfer a client. Best practice is that, for

all new clients and clients whose status has changed, there must be a rigorous onsite

risk assessment carried out by a person who is experienced in moving and handlingassessments. The risk assessment should then be used to determine how many carers are

needed for specific types of client transfers. Where there is a significant change to a clients

mobility or following an incident, a risk assessment should take place as soon as possible.

7/27/2019 Wpc 108935

11/30

61


Environmental risk assessment

Anenvironmentalriskassessmentincludesthephysicalspace,equipmentavailable,

floorsurfaces,clutter,lighting,noiseandtemperature.Foracomprehensive

environmentalassessmentforaclient,somespecificenvironmentalfeaturesto

assessare:

Inappropriatefurnitureandfittings,suchaswindupandmanualadjustbeds,

lowbathsandlowclientchairs

Nograbrailsinbathrooms,toiletsorcorridors

Limitedspaceandaccesstoworkingareas

Equipmentnoteasilymoveable

Slipperyfloors Carpetsthatmakepushingequipmentdifficult

Narrowdoorwaysorramps

Changesoflevelatlifts.

Anexampleofaspecificsystemorapproachforclientriskassessment,knownas

theLITENUPapproach,isshowninAppendix3.1.LITENUPhasbeenusedin

somefacilitiesinNew Zealandsince2003andissuitableforusewhereahealthcare

providerwishestouseaspecificclientriskassessmentsystem.

7/27/2019 Wpc 108935

12/30

2

3.5 The risk assessment process

Beforeanymovingandhandlingofaclient,thereshouldbeasystematicrisk

assessmenttoidentifyrisksandorganisecontrols.Figure3.1providesanoverviewof

theprocessofriskassessment.

Figure 3.1 Overview of the risk assessment process

yesno

Do not move client

Considerotheroptions

Is moving the client necessary?

Workplace risk controls

Stafftraining,equipment,clientmovingprotocolsanddocumentation

5. Client ready to move

1. Client risk assessment

Capabilities,mobilitystatus,size,compliance.Consultclientprofile

2. Carer risk assessment

Carertraining,physicalcapacity,stress,tiredness,numberofcarersinvolved

3. Task risk assessment

Whatisthetask(e.g.chairtobed)?

Whathandlingtechniqueisappropriate?

Whatequipmentisneeded?

4. Environmental risk assessment

Floorcondition,spaceavailable,equipment accessible

Whenadecisionhasbeenmadethataclientshouldbemoved,thecarerneedsto

carryoutthespecificriskassessmentproceduresrelatingtotheclient,thecarer

(orcarers),thetaskandtheenvironmentinwhichthetaskwilltakeplace.The

componentsforthespecificriskassessmentsaredescribedinmoredetailbelow.

Theriskassessmentssetoutinthissectionareprimarilyrelevantforinpatients

orclientsreceivingongoingcare.Carerswhohaveonlybriefcontactwithclients

(e.g. ambulanceandfireservicestaff)shouldusebrieferchecklistsorassessments,

whichcanbeadaptedfromtheexamplesshowninthissection.

7/27/2019 Wpc 108935

13/30

63


3.6 Risk assessment tools

Thissectionoutlinesfiveassessmentproceduresthatcontributetotheoverallclient

assessment.Theassessmentproceduresincludetheworkplaceprofile,clientprofile

andclientmobility,fallsandpremovementriskassessments.Examplesofspecific

assessmenttoolsareincludedinthesectionappendices.Thesetoolsandexamples

illustratepossiblewaysforconductingriskassessments.Eachorganisationshould

adapttheexistingtoolsandformstosuititsspecificneeds,ordevelopitsowntools.

Developing a workplace profile

Theworkplaceprofileisaspecificmovingandhandlingauditoftheenvironmentin

whichcarerswork.Itcanincludebothpeoplehandlingandobjecthandling.Fromthe

workplaceprofile,controlsaredevelopedtomaximisestaffandclientsafetywithintheworkplace.Aworkplaceprofileandriskcontrolplanhelporganisationsmeettheir

legalresponsibilities.Itsetsoutwhattherisksare,whatwillbedoneaboutthem,

andwhenchangesshouldbemadeandbywhom.Theycanalsobeusedtorecord

andcontrolrisksandothersafetyissuesidentifiedduringclientmovingandhandling.

Theinformationgatheredshouldbeintegratedintotheorganisationalmovingand

handlingprogrammeandincludedintrainingprogrammes.

Theworkplaceprofilecanbeusedto:

Identifyandprioritisetheareasthatarepotentialrisksorneedimprovementtoreducemovingandhandlingrisks

Establishabaselinefromwhichtomeasureimprovements

Giveasnapshotoftheworkplace,includingaclientshomewhererelevant

informationthatcouldbeusefulwhendealingwithconsultants,designers,

suppliersandtechnicalexperts

Developinformationthatcanbecomparedwithotherworkunits

or organisations

Provideinformationneededtoprepareariskcontrolplan Provideinformationneededaspartoftheorganisationalmovingand

handling programme.

Who does the workplace profile?

Thewardorunitmanagerisresponsibleforcompletingordelegatingthetaskof

completingtheworkplaceprofileanddevelopingacontrolplantoaddresstherisks

identified.Theyshouldworkwiththeclientmovingandhandlingadviserorthehealth

andsafetycoordinatorandarrangefordiscussionsatstaffmeetingstogetfeedback

fromstaff.Theworkplaceprofileshouldbecompletedatleasteveryyear,and

updatedearlierwheneverthereisasignificantchangeintheworkplace.

7/27/2019 Wpc 108935

14/30

4

What does the workplace profile involve?

Theworkplaceprofileisintwoparts:

Workplace detailsthiscoversclientpopulations,staffnumbers,equipment

andfacilities

Workplace risk assessmentthisusesascoringsystemtoidentifyrisksand

prioritiseactionstobuildaneffectiveclientmovingandhandlingprogramme.

Risksyouwillneedtothinkaboutinclude:

EquipmentDoyouhavetherightequipmentforthetasksyoucarryout,

doyouhaveenoughequipment,whatsortofconditionisitinandisitreadily

accessibleforstafftouse?Arethereanequipmentmaintenancescheduleand

replacementplan?

StaffDoyouhaveenoughstaff,dotheyknowwhatisexpectedofthem,has

everyonedonethebasictrainingrequired,anddoyouhaveclearpoliciesand

procedurestoguidethem?Istheworkplaceculturesupportive?

EnvironmentIsthereenoughspaceformovingandhandlingoperations,can

youimprovethelayoutandremovecluttertoimproveconditions,andcanyou

providemobilityaidstohelpclientsbemoreindependent?

Incident reporting Doyouhaveacultureofreportingnearmissesand

accidentsrelatingtomovingandhandling?

Appendix3.2attheendofthissectionprovidesanexampleofaworkplaceprofile.

The client profile

Theclientprofilesummarisesaclientsdetails,capabilitiesandactionplan.Theclient

profileincludesinformationonindividualclientcharacteristicsandfactorsthatcould

affectclientmovingandhandling.Itprovidesinformationneededtomakedecisions

aboutthetechniquesandequipmentrequired,andothercontrolsforclientmoving

andhandling.Whererelevant,itcanincludeclinicalreasoningrelevanttospecific

recommendationsregardingequipmentandtechniques(seeBox3.7).

Theclientprofileshouldbesignedoffbyanauthorisedperson.Inhealthcarefacilities,

thiswillusuallybearegisterednurse,physiotherapistoroccupationaltherapist.The

profileprovidesaguideforallcarerswhoworkwiththeclient.Appendix3.3provides

anexampleofthesummarydetailsthatcanbeincludedinaclientprofile.Each

organisationneedstoensurethat,whatevertypeofclientprofileisused,itcontains

informationrelevanttomovingandhandling.

Who does the profile and when?

Foradmissionstohealthfacilities,usuallyaregisterednurse,occupationaltherapistorphysiotherapistcompletestheclientprofilewhenaclientisadmitted.Staffwho

arerequiredtocompleteorreviewtheclientprofileshouldbeidentifiedbythe

7/27/2019 Wpc 108935

15/30

65


organisationorunitmanagerandtrainedappropriately.Theprofileshouldbe

reviewedperiodicallyorascircumstanceschange,suchas:

Whentheclientscondition

ortreatmentchanges

Atagreedperiodsasper

policy(e.g.insomeDistrict

HealthBoardsitisevery

threedays)

Whenconditionsinthe

wardorunitchange

(forinstanceiflayoutor

procedureschange)

Whentheclientmovestoa

differentwardorservice

Whentherehasbeenan

incidentorinjuryinvolving

theclient.

Forresidentialcarefacilities,there

shouldbeaninitialriskassessment

atthetimeofadmissionofa

clientandatregularintervals

followingadmission.Theinitial

riskassessmentshouldbe

completedbyastaffmemberwho

hashadtraininginmovingand

handlingriskassessmentsandis

deemedqualifiedtodosobythe

organisation.Priortoanytransfer,theriskassessmentshouldalsobecheckedbythe

carerwhowillbemovingtheclient.

Forclientsinhomecare,aninitialonsiteriskassessmentshouldbecarriedoutbya

carerdeemedqualifiedbytheorganisation.Itshouldinvolvetheclient,theclients

familywhereappropriateandifapplicablethefunder.Theriskassessmentshould

notewhatmovingandhandlingequipmentwillberequired,whatchanges(ifany)

areneededinroomorbuildinglayout,andwhethertheclientwillrequireassistance

fromoneortwocarersforspecifictransfers(seeAppendix3.3).Thecarerassignedto

theclientwillberesponsibleforcarryingoutthecarespecifiedbytheriskassessment

priortoeachclienttransfer.Solecarersshouldbeabletorequestspecialistrisk

assessmentsfollowinganysignificantchangesinclientsmobility,profileor

environment,orfollowinganyindicationthatmorethanonecarerordifferentequipmentmayberequiredtotransferclients.

Box 3.7

Clinical reasoning in client

profile information

Including clinical reasoning for a technique

or equipment choice helps where staff may

later question a decision, or do not understand

why a specific choice was made. For example,

a carer has tried a simple turning device to

assist a standing turn from wheelchair to

bed, but the client feels unsteady because

they prefer to hold on to something duringthe turn. Instead, a turning device with a

handle is used. A new supervisor makes an

independent assessment and decides the

more expensive device is not necessary, failing

to consider the previous decision outcome

that the ordinary turn disc was unsuccessful.

The new supervisor restarts the process,

potentially leading to distress for the client

and frustration for other staff. Documented

clinical reasoning, especially in complex

situations, enables future assessors or

practitioners to understand the decisions

taken and review these appropriately.

Source: Carole Johnson, moving and handling

consultant, UK

7/27/2019 Wpc 108935

16/30

6

What information is included in the client profile?

Theclientprofilesummarisestheclientsdetails,capabilitiesandneedsandprovides

amovingandhandlingplanwhenneeded(seeAppendix3.3).Itconsistsoftwoparts:

1. The client risk assessmentcoversfactorsthatcanaffectclienthandlingand

increasemovingandhandlingrisks,suchaspain,medication,orthoticsand

compliance.Iftheassessmentshowsthereareanyriskfactors,thesecond

part,themovingandhandlingplan,mustbecompleted

2. The moving and handling planrecordsthetechniques,theequipment

consideredappropriateforeachmovingandhandlingtaskandthenumber

ofcarersrequired.Itshouldbefollowedbyeveryonecarryingoutthetasks,

unlesstheclientsconditionhaschanged.Forinstance,achangeinaclients

conditionormedicationmayhavealteredtheirbalanceorabilitytofollow

instructions.Noteveryclientwillneedamovingandhandlingplan,butthe

assessmentpartoftheprofileshouldbedoneforeveryclientandregularly

reviewedincasethingschange.

Theclientprofileprovidescarerswiththeinformationtheyneedinaclearand

consistentway.Itprovidesaquickoverviewoftheclientsconditionandanymoving

andhandlingneeds.Itsetsoutthetechniquesandequipmentmostsuitableforeach

movingandhandlingtask,andprovidesaquickchecklistofthefactorsthatcarers

needtoconsiderbeforetheycarryoutthetask.

Theclientprofileshouldbe:

Availabletoeveryonewhoworkswiththeclient

Considered,andifnecessaryreviewed,beforeeachmovingandhandlingtask

iscarriedout

Keptwiththeclientsmedicationandtreatmentcareplan(atthebedside)

Sentwiththeclientiftheymovetoanotherwardorservice.

Involvetheclientwherepossibleinthedevelopmentoftheclientprofile.Thiswill

assistwithintroducinganyspecialistequipmentrequired.Itisessentialtoexplainto

theclienthowtheequipmentworksandwhatthebenefitsare.Itisalsoimportant

thattheclientunderstandsthattheassessmentisreducingtheriskofinjurytocarers

andthemselves.

7/27/2019 Wpc 108935

17/30

67


Client moving and handling plan

Theclientmovingandhandlingplanincludes:

Clientmobilityassessment Fallsriskassessment

Equipment

Techniques

Staffrequired.

Aclientmobilityassessmentiscarriedoutwheneveranewclientisadmitted.It

assessestheclientsneedforassistance.Thereareseveralsystemsusedtoassess

clientmobilityordependency.Theserangefromsimpletoquitecomplicatedsystems.

Inmostcases,itisbettertohaveasimplesystemthatallowsforadditionalcommentswhenneeded.Theclientmobilityinformationshouldbeincorporatedinto

theclientprofileandshouldbeaccessibletoallstaffresponsibleforcaringforthe

client.Clientmobilityinformationshouldbeupdatedregularly.Thefrequencyof

updatingdependsontheclientsconditionandprogress.

Box3.8describessomecommonly

usedcategoriesofclientmobility

thatcanbeusedtoassessaclient

priortomovingthem.Theclients

mobilitystatuswilldeterminetheselectionofaspecifictechnique

forthemovingandhandlingtask.

Forclientscategorisedasassisted

movement,theassistance

requiredmayrangefrommoderate

tosubstantial.Thisisreflectedin

havingmorethanonetechnique

forsometransferswhereclients

needassistance.Thesevariationsshouldberecordedontheclient

profileform.

Eachfacilityneedstodevelop

itsownsystemthatcanbe

easilyconductedandclearly

communicatedtoallstaffinvolved

inmovingandhandlingclients.Examplesoftwosystemsforcategorisingclient

mobilityareshowninTable3.1.

Box 3.8

Assessment of client mobility

Independent: Client does not requireassistance, able to move on own

without supervision.

Supervised movement: Client can move on

own provided they are supervised. May need

oral instruction and some physical assistance

(such as lowering the bed or positioning a

chair) with preparation for a move.

Assisted movement: Client requires some

or considerable physical assistance. Client is

cooperative, willing to assist movement andhas weightbearing capacity.

Dependent: Client is completely dependent on

help from carers to move. Client is unable or

unwilling to assist.

7/27/2019 Wpc 108935

18/30

8

AnexampleofamorecomplexmobilityscaleisthePhysicalMobilityScale,developed

toassessmobilityinfrailolderpeople.3Inthisscale,eightmovementsarecovered

(Box3.9)andeachmovementisscoredonasixpointscale(0=unabletodounaided;

5=independent,noassistancerequired).

Box 3.9

Movements covered in Physical Mobility Scale

1. Rolling

2. Lying to sitting

3. Sitting balance

4. Sitting to standing

5. Standing to sitting

6. Standing balance

7. Transferring from bed to chair

8. Ambulation ability.

Source: Nitz et al, 2006

Table 3.1 Examples of mobility assessment tools

Example 1Hoist, Assist, Supervise, Independent(HASI)*

Example 2Patient Movement Classifications**

Hoistmovingandtransfersrequiretheuseof

ahoist

Total assist/max assistpatientperformsless

than50%oftaskanddemonstratesanyofthe

following:poorsafetyawareness,seriousgaitimpairment,poorsittingbalanceand/orweight

bearingrestriction(Redcolourcode)

Assistsomeassistanceisneededfromthe

carerand/oruseofequipment

Mod/min assistpatientperforms5075%of

taskbutmaybeunsteady,unpredictable,have

amotorplanningdeficitand/oraweightbearing

restriction(Orange colour code)

Superviseclientcanmovebyselfbutneeds

supervisionbyacarerduring movement

Supervision/mod independentpatient

performs100%oftaskbutrequiresassistance

settinguporusingequipment

(Greencolourcode)Independentclientcanmovewithout

assistanceorsupervision

*WaitemataDistrictHealthBoardprovidedthe

informationaboutHASI.

**SwedishMedicalCentre,2007,SafePatient

HandlingRiskAssessment.

3. Nitzetal,2006.

7/27/2019 Wpc 108935

19/30

69


Falls risk assessment

Whenaclientisassessedasbeingatriskoffalling,thisriskstatusshouldbe

communicatedtoallstaff,theclientandtheclientsfamily.Thisshouldberecorded

intheclientprofileandmentionedduringhandovercommunication,onsignage,and

inlinewithanylocalfallspreventionstrategy,policyordocumentation.Iftheclients

mobilityislikelytochangeoveraday,theclientprofileshouldreflectthesechanges

sothatinformationontheclientsmobilityisuptodate.Theriskratingshould

reflecttheclientsleastabletimes.Forexample,someonewhocanwalkwithanaid

andlotsofassistancemaystillneedhoistingat3amforatoiletvisit,sobothshould

be recorded.

Premovement risk assessment

Apremovementriskassessmentiscarriedoutimmediatelybeforemovinga

client.Staffandcarersshouldbefamiliarwiththeworkplaceprofileandtheclient

profile,andusetheinformationfromthesesourcesaspartofthepremovement

riskassessment.Thepurposesofthepremovementriskassessmentaretoidentify

specificriskspriortomovingaclientandtoplanthemovesothattherisksare

controlledorreduced.Thismayinvolveconsultationamongcarersorbetweenacarer

andunitmanager,especiallywhereseveralpremoveriskfactorsareidentified.An

exampleofapremovementriskassessmentformisshowninAppendix3.4.

Apremovementriskassessmentneedstobedonepriortoeverymove.Anychangesintheclientsconditionneedtobedocumentedintheclientsnotes.Ifacarerisin

doubtregardingtheclientscondition,theyshouldseekadvicefromtheirclinicalor

professionalsupervisor.

7/27/2019 Wpc 108935

20/30

0

3.7 Monitoring risk assessment

Thefinalstepintheprocessofmanagingexposuretotherisksassociatedwithpeople

movingandhandlingistomonitorandreviewtheeffectivenessofmeasures.Thisis

necessarytomakesurethesystemsareworkingasintended.Monitoringassesses

theextenttowhichorganisationalsystemsandcontrolmeasuresareworking

andensurestheyareimplementedsystematicallythroughouttheworkplace.Itis

importanttoconsultarangeofstaff,particularlythosewhohaveworkedwiththe

controlmeasures.

Aspecificpartofmonitoringandreviewistoconductauditsofriskassessment

procedures.Anauditreferstoaperformancereviewintendedtoensurethatwhat

shouldbedoneisbeingdone.Wheretherearegaps,anauditshouldprovide

informationthatenablesimprovementstobemade.Instructionsonhowtoconducta

riskassessmentauditaredescribedinSection13Audits.

7/27/2019 Wpc 108935

21/30

71


References and resources

ACC.(2008).Health Care Workers: Preventing and managing discomfort, pain and injury to

healthcare workers.Wellington:ACC.

DepartmentofLabour.(2009a).Keeping Work Safe: The Department of Labours policy

on enforcing the Health and Safety in Employment Act 1992 .Wellington:Department

of Labour.

DepartmentofLabour.(2009b).Managing the Risk of Workplace Violence to Healthcare

and Community Service Providers: Good practice guide.Wellington:Department

of Labour.

EuropeanAgencyforSafetyandHealthatWork.(2007).Risk Assessment in Health Care

(EFacts18).Retrieved9August2010fromhttp://osha.europa.eu.

EuropeanAgencyforSafetyandHealthatWork.(2008).Patient Handling Techniques to

Prevent MSDs in Health Care (EFacts 28).Retrieved31July2009from

http://osha.europa.eu.

Johnson,C.(2011).Manualhandlingriskassessment.InJ.Smith,(Ed.).The Guide to

the Handling of People: A systems approach(6thed.)(pp.1738).Middlesex,United

Kingdom:BackCare.

Ludcke,J.,&Kahler,R.(2009).Taxonomy of Injuries in Residential Care. Brisbane:The

InterSafeGroupPtyLtd.

Nelson,A.,Lloyd,J.D.,Menzel,N.,&Gross,C.(2003).Preventingnursingback

injuries:redesigningpatienthandlingtasks.AAOHN Journal,51(3),126134.

Nelson,A.,Matz,M.,Chen,F.,Siddharthan,K.,Lloyd,J.,&Fragala,G.(2006).

Developmentandevaluationofamultifacetedergonomicsprogramtoprevent

injuriesassociatedwithpatienthandlingtasks.International Journal of Nursing

Studies,43(6),717733.

Nitz,J.C.,Hourigan,S.R.,&Brown,A.(2006).Measuringmobilityinfrailolder

people:reliabilityandvalidityofthePhysicalMobilityScale.Australasian Journal on

Ageing,25(1),3135.(IncludesthePhysicalMobilityAssessmentScale.)RoyalCollegeofNursing.(2003).Manual Handling Assessments in Hospitals and the

Community.London:RoyalCollegeofNursing.

StandardsNew Zealand.(2008).Health and Disability Services (Restraint Minimisation and

Safe Practice) Standards.NZS8134.2:2008.Retrieved29April2011from

www.moh.govt.nz/moh.nsf/pagesmh/8656/$File/813422008nzsreadonly.pdf.

Waters,T.,Collins,J.,Galinsky,T.,&Caruso,C.(2006).NIOSHresearcheffortsto

preventmusculoskeletaldisordersinthehealthcareindustry.Orthopaedic Nursing,

25(6),380389.

7/27/2019 Wpc 108935

22/30

2

Waters,T.R.,Nelson,A.,&Proctor,C.(2007).Patienthandlingtaskswithhighrisk

formusculoskeletaldisordersincriticalcare.Critical Care Nursing Clinics of North

America,19(2),131143.

WelshAssemblyGovernment.(2009).All Wales Manual Handling Training Passport andInformation Scheme.Retrieved11August2010fromwww.wlga.gov.uk.

WorkplaceHealthandSafetyQueensland.(2001).Manual Tasks Involving the Handling of

People Code of Practice 2001.Brisbane:WorkplaceHealthandSafetyQueensland.

WorkSafeVictoria.(2009).Transferring People Safely: A guide to handling patients,

residents and clients in health, aged care, rehabilitation and disability services (3rded.).

Melbourne:VictorianWorkCoverAuthority.(Formoreinformationandupdates,

checktheWorkSafeVictoriawebsiteatwww.worksafe.vic.gov.au.)

7/27/2019 Wpc 108935

23/30

73


Appendices: Resources for risk assessment

Theseappendicesincluderesourcesrelatingtoriskassessment.Itisrecommended

thateachorganisationadaptexistingtoolsandformstosuititsspecificneeds,or

developitsowntools.ExamplesofothertoolsareinthereportslistedinReferences

andresources.

Appendix 3.1Exampleofariskassessmentsystem:TheLITENUPapproach

Appendix 3.2Exampleofaworkplaceprofile

Appendix 3.3Exampleofinformationincludedinaclientprofile

Appendix 3.4Exampleofpremovementriskassessmentform

Appendix 3.5Exampleofaclientassessmentprofileforhomecaregivers

7/27/2019 Wpc 108935

24/30

4

Appendix 3.1 Example of a risk assessment system:

The LITENUP approach

Thisappendixdescribesanexampleofaspecificsystemorapproachforclientriskassessment,knownastheLITENUPapproach.LITENUPhasbeenusedinsome

facilitiesinNew Zealandsince2003.Itissuitableforusewhereahealthcareprovider

wishestouseaspecificclientriskassessmentsystem.

ThepurposeofLITENUPistoensurethatclienthandlingissafeforbothcarersand

clients.RiskcanbeassessedusingtheLITEprinciplesoutlinedbelowinconjunction

withsuitableassessmentsofclientdependency.TheLITEprinciples,combinedwith

clientprofileinformation,providetheinformationneededtomakedecisionsabout

safeclienthandling.

The LITE principles

LITEisawaytorememberthekeyriskfactorsthatshouldbeconsideredwhen

preparingasafeclienthandlingstrategy.TheLITEprinciplesaredescribedinthe

tablebelow.

LITE principles

Load Loadreferstotheclientcharacteristicsthatcanaffectthehandlingrisk,such

asage,gender,diagnosis,comprehensionoforallanguage,dependency,

neurologicalstatus,size,weight,ability,extentofclientcooperation,client

disabilities,cultureandfallrisk.

Individual Individualreferstocarerswhoaremovingtheclient.Itincludesthecarers

knowledge,training,generalhealthandfatiguethatcanaffectonesabilityto

dothejob.

Task Taskreferstothenatureofthemovingandhandlingtasktobedone,howand

when.Differenttaskshavedifferentchallenges.Eachmovingandhandling

taskneedsassessmentandaspecificstrategy.

Environment Environmentmeanstheworkingenvironment,andcoversfactorssuchas

space,equipmentavailability,staffinglevels,workcultureandresources,whichallimpactonhowthetaskcanbedone.

IntheLITENUPapproach,riskfactorsarenotnecessarilyassessedintheorder

shown,andnotallriskfactorsneedtobecompletelyreassessedineverysituation.

InmostwardsorunitstheEnvironmentandIndividualfactorscanbeassessedby

staff(orotherpeoplewhoaretrainedinriskassessment)andappliedtomostclient

handlingsituations.Generally,carersmustconsiderallfourLITEprinciplesbefore

selectingahandlingtechniqueandorganisinganyequipmentrequired.Checkthe

informationintheclientprofile,relatedtoriskassessment,priortomovingtheclient

toensureappropriatehandlingproceduresareused.

7/27/2019 Wpc 108935

25/30

75


Appendix 3.2 Example of a workplace profile

Workplace profile (Part A)

Organisation

Lastreviewdate Nextreviewdate

Wardorunit Profilecompletedby Date

Profile of clients

Numberofbedsorplaces

(inunit)

Typesofclientadmitted(e.g.agerange,medicalconditions,shorttermorlongterm)

Profile of staff

Seniorstaff Permanentstaff

Newgraduates Casualandagencystaff

Nursingassistants Otherstaff

Numberofstaffinvolvedinmovingclients Proportionofstaffwhohaveattendedmanual

handlingtraining(onedayormore)

Person(orpeople)responsibleforpolicy,advice,training,practicesandequipmentmaintenance

relatingtomovingandhandlinginthisunit(listnames,jobtitlesand responsibilities)

Name Title Responsibility

7/27/2019 Wpc 108935

26/30

6

Workplace profile (Part A) Continued

Equipment inventory (list types of equipment available for use in unit)

Equipment item

(notenumberinunit)

Location

(noteifsharedwith

another unit) Maintenance

Ceilinghoists Performanceverification

stickermustbeindate

Mobilehoists Performanceverification

stickermustbeindate

Hoistslings(mobileand

ceiling hoists)

Disposableslingsareone

client,multipleuseperclient,

thendiscarded

Multipleuseslingsareoneclient,multipleuseperclient,

thenlaundered(greenbag)

Slidesheets(twoper

occupied bed)

Oneclient,multipleuseper

client.Launder(whitebags)

afterdischargeorsoiling

Patslides

Transferbelts

Electricbeds

Add other equipment items as needed

7/27/2019 Wpc 108935

27/30

77


Workplace profile (Part B)

Profile of facilities

Numberofbeds Numberoftoilets

Numberofelectricbeds Numberofbath/showerrooms

Equipmentstorageareas

Add other facility details as needed

Moving and handling activities

(training, communication, maintenance and upgrading)

Activity or event Describe arrangements Person responsible

Inductionbriefingfornewstaff

onmovingand handling

Ongoingmovingandhandling

trainingforstaff

Recordofstaff

training completed

Communicationofmovingand

handlingpoliciesandpractices

tostaffandclients

Clientmobilityassessments

Routineequipmentchecks

Equipmentrepair

and replacement

Riskcontrolplan

Incidentreporting

Injuryreporting

Riskassessmentaudits

Identificationandreportingof

facilityfeatures(e.g. buildings,

space,flooring)that

need upgrading

Add other activities as needed

7/27/2019 Wpc 108935

28/30

8

Appendix 3.3 Example of information included in a

client profile

Client profile

Organisation

Lastreviewdate Nextreviewdate

Wardorunit Profilecompletedby Date

Client details

Name Preferredname

Height Weight Dateofbirth

Relevantmedicalconditions

Clientmobilitystatus

Independent Supervise Assist Hoist

Noteanyspecificconditionsthataffectmovingtheclient

Fallingrisk Skinatrisk Medicalequipment

Inpain Incontinence Surgeryrisks

Impairedmovement Visionproblems Footwearneeds

Lossofsensation Hearingproblems Complianceissues

Othercommunicationissues Otherissues(e.g.cognitive

state).Describehere

Handling plan required? No____ Yes____ complete details below

Task (add tasks as needed)

Technique to be used,

number of carers,

equipment needed Comments*

Sittingandstanding

Walking

Movinginbed

*Forexampleclientcapabilities,clinicalreasoning

7/27/2019 Wpc 108935

29/30

79


Appendix 3.4 Example of a premovement risk

assessment form

Circle one Circle one

Client assessment Carer (staff) capability

Largeorverylarge(bariatric)

client

No Yes Staffnotadequatelytrained

fororconfidentaboutplanned

move

No Yes

Clientunabletoassist No Yes Continualhandlingofclients

formorethan30minuteson

shift

No Yes

Clientphysicalconstraints

(e.g.medicalequipmentinplace,spinalorotherinjury)

No Yes Insufficientstaffnumbersfor

move

No Yes

Clientmaybe

resistive, unpredictable

or uncooperative

No Yes

Task assessment Environmental assessment

Highriskmove* No Yes Limitedspaceoraccessto

workingareas

No Yes

Moverequiresawkward

postures,bending,twisting

No Yes Slipperyfloors,

uneven surfaces

No Yes

Moverequireshighforce,

holding,restraining

No Yes Inappropriatefurniture,such

aswindupbeds,nograbrails

inbathrooms

No Yes

Moverequiresreaching

awayfrombodyorover

shoulder height

No Yes Equipmentnot

easily moveable

No Yes

Total column score (Yes selected) Total column score (Yes selected)

*Highriskmovesinclude:repositioninginbed,

repositioninginachair,transferbetweenbed

andchair,transferbetweenchairandtoilet,

lateraltransferbedto stretcher.

Total risk score =

(outof15)

Scoresover6indicateneedtoreplan

movetocontrolorreduce risk

7/27/2019 Wpc 108935

30/30

Appendix 3.5 Example of a client assessment profile for

home caregivers

Client Assessment Profile

Thefollowingcriteriaaredesignedtoassistahomecaregiverwhoisintheprocess

ofmakingadecisionregardingaccesstoanappropriatehoist.Onceyouhave

consideredthesecriteria,werecommendyouconsultDistrictHealthBoardstaff,ACC

orstaffinotherorganisationswhoarefamiliarwithmovingandhandlingequipment

togetadviceonrecommendedmodelsofhoists,slings,bedsandaccessoriesto

meetyourspecificneeds.Occupationaltherapistsandphysiotherapistsmayalso

beabletoadviseonaccesstoMinistryofHealthandACCfundedmovingand

handling equipment.

Client dependencetheclientsrequiredlevelofassistanceisoneofthemost

importantcriteriawhendetermininghoisttypesandaccessories.Whenconsideringa

hoist,assesswhethertheclientisfullydependentorpartiallydependentonthecarer

forassistanceingettingintoandusingthehoist.

Client clinical conditiontheclientsclinicalandmentalconditioncanalsoaffect

hoistselection.Makeanoteofpainlevels,fracturesorjointlimitations,medication,

recentsurgery,musclespasms,sensitiveskin,abilitytocommunicate,agitation

and cooperativeness.Client strength and staminaboththeclientsupperandlowerbodystrength

mustbetakenintoconsiderationbeforemakingahoistrecommendation.Thismay

determinewhetherastandinghoist,ceilinghoist,gantryhoistoramobilefloorhoist

wouldbestsuityourneeds.

Weight bearinganotherimportantconsiderationistheclientsabilitytobeartheir

ownweightforaperiodoftimeandtoretaintheirbalance.

Physical characteristicsmakeanoteoftheclientssize,heightandweight.Weight

willhelptodeterminethetypeandmodelofhoist,whilesize/shapewillhelpto

determineslingsizeandtype.Ensureyouhavethecorrectsafeworkingloadhoistto

fityourclient.

Special circumstancesmakeanoteofanyotherfactors,suchasgeneral

practitionerortherapyrecommendations,surgicaldressings,attachedmedical

equipmentandanticipatedlengthofrecovery.NOTE:Iftheclientsconditionis

permanentorlongterm,youmaywishtoconsidergettingahoist.Contactan

occupationaltherapistorphysiotherapistforadviceortoaccessMinistryofHealthor

ACCfundedmovingandhandlingequipment.

Adaptedfrom:www.safeliftingportal.com/homecare/patientlift/assessmentinformation.php.

Documents

Wpc 108935