CHCWHS312A Follow WHS safety procedures for direct care work

Introduction

Most care worker jobs involve carrying out some type of manual task using the body to move or hold an object or person. Manual tasks cover a wide range of activities including stacking shelves, helping clients to move and entering data into a computer. Some manual tasks are hazardous and may cause musculoskeletal disorders. These are the most common workplace injuries across Australia. (www .safeworkaustralia.gov.au/sites/swa/about/publications/pages/hazardous -­‐ manual -­‐ tasks -­‐ cop)

What is a musculoskeletal disorder (MSD)?

A musculoskeletal disorder, as defined in the WHS Regulations, means an injury to, or a disease of, the musculoskeletal system, whether occurring suddenly or over time. It does not include an injury caused by crushing, entrapment (such as fractures and dislocations) or cutting resulting from the mechanical operation of plant.

MSDs may include conditions such as:

• sprains and strains of muscles, ligaments and tendons
• back injuries, including damage to the muscles, tendons, ligaments, spinal discs, nerves, joints and bones
• joint and bone injuries or degeneration, including injuries to the shoulder, elbow, wrist, hip, knee, ankle, hands and feet
• nerve injuries or compression (e.g. carpal tunnel syndrome)
• muscular and vascular disorders as a result of hand -­‐ arm vibration
• soft tissue hernias
• chronic pain.

MSDs occur in two ways:

• gradual wear and tear to joints, ligaments, muscles and inter -­‐ vertebral discs caused by repeated or continuous use of the same body parts, including static body positions
• sudden damage caused by strenuous activity, or unexpected movements such as when loads being handled move or change position suddenly.

A hazardous manual task

as defined in the WHS Regulations, means a task that requires a person to lift, lower, push, pull, carry or otherwise move, hold or restrain any person, animal or thing involving one or more of the following:

• repetitive or sustained force
• high or sudden force
• repetitive movement
• sustained or awkward posture
• exposure to vibration.

These factors (known as characteristics of a hazardous manual task) directly stress the body and can lead to injury

Responsibilities of employers

A person conducting a business or undertaking has the primary duty to ensure, so far as is reasonably practicable, that workers and other persons are not exposed to health and safety risks arising from the business or undertaking

A person conducting a business or undertaking must manage risks to health and safety relating to a musculoskeletal disorder associated with a hazardous manual task.

Responsibilities of Workers

Workers have a duty to take reasonable care for their own health and safety and that they do not adversely affect the health and safety of other persons. Workers must comply with any reasonable instruction and cooperate with any reasonable policy or procedure relating to health and safety at the workplace.

Employers must

• identify manual tasks that are hazardous
• assess the risks of MSDs associated with the hazardous manual task
• implement suitable risk control measures
• review the effectiveness of control measures

Consultation with workers and their health and safety representatives is necessary at each step of the risk management process. Workers know the equipment and activities that contribute to their discomfort and may have practical suggestions for solutions.

It is important to consult workers as early as possible when planning to:

• introduce new tasks or change existing tasks
• select new equipment
• refurbish, renovate or redesign existing workplaces
• carry out work in new environments.

Workers should be encouraged to report problems with manual tasks and signs of discomfort immediately so that risks can be managed before an injury occurs.

IDENTIFYING HAZARDOUS MANUAL TASKS

The first step in managing risks from carrying out manual tasks is to identify those tasks that have the potential to cause MSDs. Hazards that arise from manual tasks generally involve interaction between a worker and:

• the work tasks and how they are performed
• the tools, equipment and objects handled
• the physical work environment.

How to identify hazardous manual tasks

Consult workers
Review available information
Look for trends
Observe manual tasks

Hazardous manual tasks can also be identified by looking at how people actually work and focusing on their postures and movements. A manual task is hazardous if it involves any of the following characteristics:

• repetitive or sustained force
• high or sudden force
• repetitive movement
• sustained and/or awkward posture

A risk assessment involves examining the characteristics of the hazardous manual task in more detail to assess whether the forces, movements and postures are undertaken in such a way that they give rise to the risk of MSDs.

When should a risk assessment be conducted?

You should carry out a risk assessment for any manual tasks that you have identified as being hazardous, unless the risk is well -­‐ known and you know how to control it

A risk assessment can help you determine:

• which postures, movements and forces of the task pose a risk
• where during the task they pose a risk
• why they are occurring
• what needs to be fixed

CONSIDER

Systems of work, or the way work is organized. This can influence the physical and mental demands that a manual task places on a worker.

The sources of risk include:

• time constraints
• pace and flow of work across the working day or shift
• ability for workers to influence workload or work methods and changes in the workplace
• the level of resources and guidance
• consultation processes
• work roles and performance requirements or processes for dealing with conflicts
• staffing levels, skill mix and shift arrangements.

Workers will also have different physical and psychological characteristics and these individual factors may increase the risk, for example:

Skills and experience – being inexperienced in a job may increase the risk

Physical characteristics – an overload situa tion may result from a mismatch between the worker and the task

Unaccustomed work – workers who are new, have transferred from another job or are returning from extended leave and whose muscles are not conditioned to the work.

Managing risks Hierarchy of Controls	Example
Level 1 Elimination	The client stands up and walks to the dining room with supervision only.
Level 2 Substitution	Replace manual wind up beds with electric beds
Engineering	Use mechanical lifting aids Provide workstations that are height adjustable
Level 3 Administrative	Rotate workers between different tasks Train workers to use control measures Persona l protective equipment Specific procedures followed.

HANDLING PEOPLE

No worker should fully lift a person (other than a small infant) without assistance from, mechanical aids, assistive devices or another worker. All people handling activities are a po tential source of injury and the risks associated with this hazardous manual task must be eliminated or minimised so far as is reasonably practicable. With people handling, the health and safety of the person being handled needs to be Considered, as well as the health and safety of the worker(s). The physical condition of the person being handled; their ability to understand, communicate and their behaviour, will affect how the people handling activity is undertaken and the risks involved. When people are being handled, controls may include a mobility risk assessment; optimizing the person’s ability to assist and the use of appropriate mechanical and/or assistive devices.

Examples are

• The use of a shower trolley to bathe a patient
• Mechanical hoists (full sling lifter or stand up lifter) for transfers
• Use of 2 workers when using a hoist
• Adequate time provision for the task allowed in the work routine
• Where the use of a hoist requires two or more people provide adequate supervision and resources to elimina te the risk of workers being under time pressure and attempting the task on their own
• Planning how to handle a person attached to medical or other equipment
• Ensuring the location and storage of mechanical aids and assistive devices allows easy access
• Providing training for the safe use of mechanical aids and assistive devices

TRAINING

Training in the type of control measures implemented should be provided during induction into a new job and as part of an on -­‐ going manual task risk control program . Training should be provided to:

• workers required to carry out, supervise or manage hazardous manual tasks
• any health and safety representatives.

The training should include information on:

• manual task risk management, including the characteristics of hazardous manual tasks
• specific manual task risks and the measures in place to control them
• how to perform manual tasks safely, including the use of mechanical aids, tools, equipment and safe work procedures
• how to report a problem or maintenance issues.

The training program should be reviewed regularly and also when there is change to work processes, plant or equipment, implementation of new control measures, relevant legislation or other issues that may impact on the way the task is performed. Records of induction a nd training should be kept. The records can include information such as the date of the session, the topics dealt with, and the name and signature of the trainer and each of the workers who attended the session.

Using administrative control measures

Administrative control measures do not address the risk factors or source of the risk – they only attempt to reduce risk by reducing exposure to those risk factors.

JOB ROTATION

The risk of MSDs may be minimised by rotating staff between different tasks to in crease task variety.

REST BREAKS

Regular rest breaks provide opportunities for workers to prevent the build -­‐ up of, or recover from the effects of, fatigue in muscles and mental fatigue.

TEAM HANDLING

Team handling is manual handling of a load by two or m ore workers. Team handling brings its own risks and requires coordination. It should only be used as an interim control measure.

REVIEWING CONTROL MEASURES

The best time to eliminate or minimise the risk of MSDs is in the design and planning stage – wh en hazards and risks can be ‘designed out’ before they are introduced into a workplace. Nursing homes that carry out a high level of manual tasks will have particular design requirements to

Where possible, place items used in manual tasks so they are:

• in front of the worker
• between waist and shoulder height
• close to the midline of workers and orientated towards the worker
• on the worker’s preferred side
• positioned within comfortable reaching distance
• positioned to avoid double handling and to avoid moving loads manually over long distances.

Handling loads

Examples of control measures that should be considered when handling loads include:

• purchasing products in smaller loads for manual handling or larger loads to be shifted mechanically
• reducing the size or capacity of containers

Maintenance

Tools and equipment should be well maintained by carrying out regular inspections and servicing in accordance with the manufacturer’s specifications.

Using mechanical aids

Mechanical equipment may eliminate or reduce the need for workers to lift, carry or support items or people. A wide range of mechanical aids is available.

Aids should be

• designed to suit the load and the work being done
• as light as their function will allow
• adjustable to accommodate a range of users
• easy to use
• suited to the environment in which the task is performed
• located close to the work area so they are readily available but do not cause an obstruction
• supported by a maintenance program to ensure they are safe and that the required effort to use them is kept at the lowest possible level
• introduced with suitable instruction and training in their use.

Pushing and pulling loads

Pushing loads is preferable to pulling because it involves less work by the muscles of the lower back, allows maxi mum use of body weight, less awkward postures and generally allows workers to adopt a forward facing posture, providing better vision in the direction of travel.

Reduce the effort required to start the load in motion by:

• using slide sheets to reduce friction when moving patients
• positioning trolleys with wheels in the direction of travel
• using large power muscles of the legs and whole body momentum to initiate the push or pull of a load.

Regulation 38: A person conducting a business or undertaking must rev iew and as necessary revise risk control measures:

• when the control measure does not minimise the risk so far as is reasonably practicable
• before a change at the workplace that is likely to give rise to a new or different health and safety risk that the co ntrol measure may not effectively control
• if a new hazard or risk is identified
• if the results of consultation indicate that a review is necessary
• if a health and safety representative requests a review.

A review should be conducted using the same method used when the hazardous task is first identified.

Care workers need to follow the work instructions of the organization when performing hazardous manual tasks.

RISK MANAGEMENT PROCESS (from code of practice appendix A)

What is the manual task?

(Are workers) Using the body to lift, lower, push, pull, carry or otherwise move, hold or restrain any person, animal or thing.

Is the manual task hazardous?

(Is) Application of force – repetitive, sustained, high, sudden

(Is) Posture – sustained, awkward

(Is) Movement – repetitive

(Is) Vibration – present

What is the risk of MSD?

How often and how long are specific postures, movement or forces performed or held?

What is the duration of the task?

Does the task involve high or sudden force?

Does the task involve vibration?

WHAT IS THE SOURCE OF RISK?

Work area design and layout

Systems of work

Nature, size, weight and number of persons, animals or things handled

Work environment

Control the risk

Is the task necessary?

Can the source of risk (work area layout, envir onment, etc) be changed?

Can mechanical aids be used to perform the task?

What training is needed to support the control measures?

Review the risk

DISCOMFORT SURVEY

A discomfort survey can help identify hazardous manual tasks. Early reporting of symptoms c an lead to risk controls being put in place before injury occurs.

The survey sheet below will help you identify and record instances where workers experience discomfort that:

persists, or

re-occurs the next day, or

persists after rostered days off.

Encour age workers to report pain or discomfort at work or at any other time. Follow up the reasons for the problem.

Even if only one worker reports problems, assess the presence of a risk factor.

Name (optional)
Date
Job work location
Tasks involved
Time on this job: Less than 3mths Supervisor	3mths to 1 yr	1 to 5 yrs
1.Do you suffer from swelling, numbness, tingling, ‘pins and needles’ stiffness, aches and pains in any part of the body? Indicate in the diagrams where the problem occurs
2. Rate the level of discomfort/pain on a scale of 1 to 5 1. _________ 2. _________ 3. _________ 4. _________ 5. _________ Just noticeable Moderate Unbearable
3. What do you think caused the problem?

A number of tools are available from Safe Work SA to help assess and manage risk. They are found in the appendices of the code of practice. They have bee n copied below. The training package stipulates that you should be able to use these tools.

APPENDIX D –RISK ASSESSMENT WORKSHEET

Location of task:
Management rep:
Description of hazardous manual task:
Health and Safety rep:
Date of assessment:
Others (
workers, consultants):
Reason for identification
Existing task    
Change in task, object or tool    
Report of musculoskeletal disorder(MSD)    
New task    
New information 

STEP 1 – Does the task involve repetitive or sustained movements, postures or forces? As a guide;

repetitive means the movement or force is performed more than twice a minute and sustained means the posture or force is held for more than 30 seconds at a time.

Postures and Movements	place a tick in the ‘yes’ column each time you observe repetitive movement or sustained posture	yes	This action happens when...	because... (describe why) This is the source of the risk	If any boxes are ticked, what are possible controls to reduce the risk
BACK
Bending or twisting e.g. more than 20 degrees	Forwards
	Sideways
	Twisting
Bending e.g. more than 5 degrees	Backwards
NECK OR HEAD
Bending or twisting e.g. more than 20 degrees	Forwards
	Sideways
	twisting
Bending e.g. more than 5 degrees	Backwards
Arms and hands
	Above shoulder height
	Reaching more than 30 cm (forward or side)
	Reaching back
	Bending wrist
	Twisting, turning, wringing, picking or grabbing actions
Legs
	Squatting, crawling, kneeling, lying, semi-lying, jumping
	On one leg
Very fast movements
	Lifting or lowering
	Using one side of the body or one hand
	Exerting force on one side
	Pushing, pulling or dragging
	Fast actions
	Fingers close together or wide apart
	Uneven, fast or jerky movements
	Holding supporting or, restraining

STEP 2

Does the task in step 1 involve a long duration?

DURATION	YES	COMMENTS
More than 2 hours over an entire shift
Continually for more than 30 min at a time

If you ticked yes the task is a hazard and must be controlled.

STEP 3– DOES THE TASK INVOLVE HIGH OR SUDDEN FORCE?

FORCES (Tick yes if the task involves any of the following high or sudden forces, even if the force is applied only once)

	Yes	This action happens when...	This action happens because... (describe why) This is the source of the risk	If any boxes are ticked, what are possible controls to reduce the risk
Lifting, lowering or carrying heavy loads
Throwing or catching
Hitting or kicking or jumping
Applying a sudden or unexpected force including: handling a live person or animal or applying uneven, fast or jerky forces during lifting, carrying, pushing or pulling or Pushing or pulling objects thatare hard move or stop eg a trolley
Exerting force while in an bent, twisted or awkward posture including: supporting items with hands are above shoulder height or moving items when legs are in an awkward posture, working with fingers pinched together or held wide apart Using a finger grip or pinch grip or an open handed grip
Exerting a force with the non-preferred hand
Needing to use two hands to operate a tool designed for one hand
The task can only be done for short periods of time
Two or more people need to be assigned to handle a heavy, awkward or bulky load
Workers report pain or significant discomfort during or after the task
Stronger workers assigned to do the task
Employees say the task is physically very strenuous or difficult to do
Workers think the task should be done by more than one person, or seek help to do the task as it requires high force

STEP 4- IS THERE HAND, ARM OR WHOLE BODY VIBRATION?
Tick yes if any of the following environmental factors are present in the task.
Driving for long periods
Driving on rough roads
Frequent use of hand powered tools or use for long periods
Using high grip forces or awkward postures when using power tools
Use of machines or tools where the manufacturer’s handbook warns of Vibration
Workers being jolted or continuously shaken
Use of a vehicle or tool not suitable for the environment or task

STEP 5 – IS THERE A RISK?
Did you answer yes in step 1 and step 2?
The task is a risk. Risk control is required.
Did you answer yes in step 3?
The task is a risk. Risk control is required.
Did you answer yes in step 4?
This task requires further investigation
To aid prioritisation of timing and resourcing risk controls you may also need to consider:
Number of ticks or risk factors
Additional factors such as injuries associated with the task.
These items capture degree and likelihood of harm. You will also need to consider the availability and suitability of risk controls for the task.

Activity 1

(1) What are the 5 steps that should be taken when making an assessment of risk.

(2) Say why the tasks below can be regarded as hazardous manual tasks.

Brushing a client’s hair.
Replacing soap in a dispenser
Pushing a wheelchair
Using a sling lifter
Changing an incontinence pad
Lifting a linen bag.

(3) How can you reduce the risk of MSD for yourself in each of the above tasks?

http://www.safeworkaustralia.gov.au/sites/swa/about/publications/pages/hazardous-manual-tasks-cop

*Note : these tools are the same as those in the SA code of practice

Activity 2

RECORD FOR DEMONSTRATION AND PRACTICE OF MANUAL HANDLING SKILLS

Student to complete

Skills	Attended demonstration or viewed on youtube	Practiced in skills lab	Date
Assisting client into bed out of bed
Use of slide sheet for rolling a client in bed moving client up or down bed
Assist client to stand from a chair Prompt 1x assist 2x assist
Walk with client 1x assist 1x assist with frame
Use of full assist lifter
Assisting client up from floor after a fall Client assisted Lifter used

Assessment; Answer the following questions

1. You are required to shower 6 residents. Identify hazards (at least 5) which you should be aware of when performing this work. Why are they hazards?
2. How can care workers reduce the need to use lifting equipment for residents in Aged care facilities?
3. What practical training in hazardous manual tasks should you receive when you first get a job in Aged Care.
4. Where can you find out how to safely perform hazardous manual tasks in your organization?