Managing the Manual Handling Risk

Ruth Robotham MSc, CMIOSH, RN, RNT

Chartered Safety and Health Practitioner& Back Care Advisor

Sussex Safety Ltd

Objectives

• Why do we need policies and protocols?

• What are the consequences of failing to manage risks

• Outline a simple management system for reducing manual handling risks, with ways of improving safety

What’s Changed in the Last 5 Years?

Financial constraints: – 12 hour shifts – Moving staff between specialties– Difficulty releasing staff for training, or reduced time

Corporate Manslaughter Act 2007

Fatality caused by a ‘gross breach’ of a duty of care.

The way that the defendant organisation’s activities were managed by its ‘senior managers’ was a ‘substantial’ element in the breach.

Where the prosecution can show the gross breach falls ‘far below’ what can reasonably be expected, juries are likely to convict.

A Positive Safety Culture is vital.Compliance with Guidance will be scrutinised.

Health and Safety (Offences) Act 2008Health and Safety (Offences) Act 2008

For any serious breach of health and safety legislation

Magistrates CourtFines: Up to £20,000 per breachImprisonment: 6 months

Crown CourtFines: UnlimitedImprisonment: Up to 2 years

Fee for Intervention (FFI)

Health & Safety (Fees) Regs 2012Duty on the HSE to recover its costs for carrying out its regulatory function from those found to be in material breach of health & safety law.

£124 per hour – based on time spent by HSE identifying the breach, investigating & taking enforcement action.

Lofstedt Health and Safety Review 2011

Aim: to reduce burden of red tapeFindings: Largely fit for purpose & Cost effective

• Consolidate legislation• ACoP simplify & review (53) eg LOLER• Review absolute liability / SFAIRP• Redirect enforcement to high risk businesses

If the Organisation has breached health and safety law

Enforcing Agency needs to ProveA statutory duty was owed and the law was broken

Organisation Needs to Prove (Guilty until proved innocent)Everything had been done to reduce significant foreseeable risks

Criminal Prosecution

HSE Safety Management System (HSG65)(POPIMAR)

HSE Safety Management System (HSG65)(POPIMAR)

Setting Policies

Organising for Health and Safety

Auditing Planning and Implementing

Measuring Performance

Reviewing Performance

Setting Policies

Manual Handling Policy• Based on your Health & Safety Policy• Include therapeutic and bariatric risks, if relevant• Keep it simple and realistic and achievable• State how you will monitor that it happens

Organising for Health & Safety

Strategies• How do you Control what happens • How do you get Co-operation to ensure safety• How do you ensure Communication with all staff• How do ensure staff Competence

If you can say you achieve these, there is likely to be a good safety culture

Planning and Implementation Planning and Implementation

A planned and systematic approach to risk reduction

Generic Risk Assessments for significant risks eg turning any patient in bed

4 C’s - eg policies & procedures individual patient handling assessments, mechanical handling devices, small handling aids, footwear and clothing, at risk staff, health monitoring, information, training and supervision, reporting ill-health and injuries, etc

Hierarchy of Control MeasuresHierarchy of Control Measures

• Avoid or Eliminate the hazard - Always the first choice (Redesign to avoid the handling task)

• Use mechanical handling devices -electric profiling beds and trolleys, hoists, mechanical transfer devices, where possible

• Procedural controls – Safe working procedures, handling aids, control of agency staff

• Behavioural controls – Information, instruction, training, supervision, PPE (safety shoes)

Action Plan Implementation

• Ensure the generic risk assessment is discussed at the right level

• Write a convincing business case for what you realistically need

• If it is a significant risk, ask for it to be put on the Risk Register

• Keep risk assessments under review

Role of Senior Management

• To consider the nature and extent of the risks facing the organisation – on the risk register

• To decide whether those risks are considered as ‘acceptable’

• To assess the likelihood of the risks materialising• To assess their ability to reduce the incidence and

impact of the risks• To put suitable and sufficient measures in place to

control the risks

Improving Patient SafetyImproving Patient Safety

• Write an individual patient handling assessment.• They should be seen as helpful, multi-disciplinary

documents – They should reflect the goals set for patients,

especially in longer term patients/residents– They should say what the patient/resident is able to

do for themselves– Consider using pictures to demonstrate how to

position patients, but maintaining their confidentiality. eg CVA patients.

• Staff must report ill-health and injuries to patients due to manual handling eg frozen shoulder, skin damage from positioning slings, etc. (safeguarding issues)

HSE Safety Management System (HSG65)(POPIMAR)

HSE Safety Management System (HSG65)(POPIMAR)

Setting Policies

Organising for Health and Safety

Auditing Planning and Implementing

Measuring Performance

Reviewing Performance

Measuring PerformanceMeasuring Performance

Pro-Active MonitoringTo check if the Manual handling policy is being followed• Are the risks controlled by the measures in place• Is the standard of patient handling good• Is patient independence being promoted and goals being achieved

ie spot observations; or working with staff; checking risk assessments; key performance indicators; is equipment available; evaluate the impact of introducing new equipment, etc

Date Task carried out

Health effects / Symptoms

Possible solution and effect

4/4/06 eg Using my computer

I get a pain in the right side of my neck after 15 minutes.

Removed arms off my chair so I can get closer to my desk, with a right angle at my elbow. Pain now less

Name ………………………… Role …………………………… Identify the tasks you carry out each day, eg carry out a leg ulcer dressing; input data on the computer; catheterisation; carry out venipuncture; driving the car, carrying equipment. Things you do outside of work can also be included. Discuss work issues with your manager, or get advice from the manual handling advisor or Occupational Health, to work out what you can do to reduce your symptoms.

Your signature ……………………………. Date ………………… Line manager’s signature ……………………. Date……………….

Reflective Health Diary

Measuring Performance

Reactive monitoring system• Manual handling accidents and incidents • Sickness absence -musculo-skeletal disorders • Patient injuries due to handling

Nationally 2011/1217% fall in reported MSD caused or made worse by work

HSE Safety Management System

AuditCollecting information on the efficiency, effectiveness and reliability of the total systemeg Benchmarking against standards• HOP6• NBE Standards in Manual Handling• NBE Moving and Handling Strategy

Review Performance

Learn from experience, improve performance,respond to change, share best practice.Update your policy, if necessary

I would recommend BCA /MHA consider completing a risk management course - IOSH Managing Safely for Healthcare Professionals

Conclusion

1. POPIMAR approach to health and safety is a tried and tested system to manage risks

and costs

2. The threats are now greater, so robust systems are needed

3. If everyone knows the goals they are aiming for, then handling practice should improve, and patient’s independence may increase.