Steria Strains Safe Patient Handling and Mbility Prgram Guide Sectin 2 Identifying Hazards and Assessing Risk Sectin 2.1- Identifying Pririty Areas A prvincial strategy fr healthcare wrkplace musculskeletal injury preventin.
Sectin 2.1 Identifying Pririty Areas Page 1 f 7 Table f Cntents Sectin 2.1 Identifying Pririty Areas...2 Intrductin...2 Table 2.1.1 Examples f Leading and Lagging Indictrs...3 Health Care Wrker Reprts...5 Incidents and Near-Miss Reprts...5 Existing Hazard Identificatin Reprts/Risk Assessments...5 Table 2.1.2 Hazards Specific t the Health Care Industry...5 Steria Strains - A prvincial strategy fr healthcare wrkplace musculskeletal injury preventin
Sectin 2.1 Identifying Pririty Areas Page 2 f 7 Sectin 2.1 Identifying Pririty Areas Intrductin This sectin includes varius tls and methds fr site crdinatrs, patient safety divisins, senir management, and OH&S departments that will assist in identifying pririty areas/units and their activities. Implementing rganizatins may already have a priritizatin prcess in place. Here yu ll find suggestins t cnsider when reviewing thse prcesses. Hwever, the prcesses fr selecting pririty areas shuld change as the safe patient handling and mbility prgram matures frm initial implementatin t prgram maintenance. This shuld reflect a mve t frmalize prcesses and prgress frm a reliance n lagging indicatrs t leading indicatrs. Suggested steps t identifying pririty areas: Step/Activity Tls 1. Clarify priritizatin prcess Tls that may be created during early adptin and referenced in the 2. Identify/select key indicatrs final prgram draft: 3. Review lagging indicatrs 4. Review leading indicatrs 5. Analyze data and create a list f pririty areas Sample Reprt Card Sample Scring Matrix fr Analyzing Data Step 1 Clarify the Priritizatin Prcess It is imprtant t make the priritizatin prcess explicit s it can be cmmunicated t the rganizatin. This will assist in nging cmmunicatins and managing expectatins as the prgram is implemented acrss the rganizatin. The prcess shuld cntain the fllwing infrmatin: Wh will participate (e.g., OH&S, executive spnsr, Multi-Stakehlder Safe Patient Handling and Mbility Prgram Crdinating Cmmittee/Crdinatr) What rle the participants will have (e.g., cllecting/presenting data, reviewing and decisin-making, prviding expert pinin) Hw decisins will be made (via executive decisin, cmmittee, cnsensus, etc.) Hw the data will be analyzed/reviewed (e.g., scring matrix) Steria Strains - A prvincial strategy fr healthcare wrkplace musculskeletal injury preventin
Sectin 2.1 Identifying Pririty Areas Page 3 f 7 Step 2 - Identify/Select Key Indicatrs An essential step when priritizing areas in any facility is t understand the risk t wrkers and any hazards that might lead t an injury fr each lcatin in the facility. Knwledge f current cnditins will help ensure resurces are allcated strategically and ffer the mst significant return n investment. This step invlves identifying what indicatrs t review when creating the pririty list. Initially lagging indicatrs, shwn in Table 2.1.1, will be an rganizatin s primary fcal pint when it cmes t identifying existing hazards related t patient handling and priritizing areas fr change. As the rganizatin matures, leading indicatrs will becme the primary data surce fr identifying pririty areas. Table 2.1.1 Examples f Leading and Lagging Indictrs Leading Indictrs Lagging Indictrs Near-Miss Reprts Previus Injury Statistics Staff-Perceptin Reprts Insurance Premiums Hazard Identificatin Reprts Past-Incident Reprts Risk Assessment Sickness/Absence Refer t Sectin 1.4 Prgram Evaluatin and Measurement Framewrk fr examples f mre tls and indicatrs. Step 3 - Review Lagging Indicatrs Baseline injury data that is cllected and reviewed shuld fcus n injuries related t patient handling and mbility. Data shuld at minimum capture: A descriptin f the incident including the patient-care activity perfrmed at the time f the injury (bathing, repsitining, transfer frm bed t chair, etc.) The cause f the injury (pull, push, reach, struck, etc.), the type f injury (sprain/strain, cntusin, etc.) The time f the incident The unit/lcatin where the incident ccurred The bdy part(s) affected Days f wrk lst Mdified duty days required Steria Strains - A prvincial strategy fr healthcare wrkplace musculskeletal injury preventin
Sectin 2.1 Identifying Pririty Areas Page 4 f 7 Other injury-data surces include: Direct wrkers cmpensatin csts: medical csts earning-replacement benefits treatment csts Indirect csts assciated with: transitinal duties accmmdatins replacement wrkers decreases in prductivity and mrale Typically, data frm the last twelve mnths is cllected then analyzed s that trends can be identified; hwever, multiple years f data will prvide a histrical view t better evaluate trends ver time, s it is imprtant t evaluate as many years as pssible. Analyses shuld first be perfrmed by units and then aggregated acrss units t prvide an verall assessment f the facility(s). Unit analysis will minimally address the incidence, severity (defined as lst and mdified-duty days), primary task(s) invlved in the injuries, and the primary cause(s) f injuries n the unit. Thse units with a high incidence and severity f injuries are classified as high-risk units. While every unit in an ergnmic assessment/imprvement initiative will eventually be included, priritizing time and resurces is frequently necessary. High-risk units will have the greatest incidence f patient-handling injuries, the mst wrkdays lst, and the highest cncentratin f staff n mdified duties. Keep in mind that there are likely t be variatins by unit as well as by shift. Step 4 Review Leading Indicatrs Many rganizatins may nt have access t all leading indicatrs until later in their implementatin prcess. The indicatrs used in the priritizatin prcess shuld be reviewed regularly t reflect this evlutin. Leading indicatrs described in this step are health care wrker reprts, incidents and nearmiss reprts, existing-hazard identificatin reprts and risk assessments. Steria Strains - A prvincial strategy fr healthcare wrkplace musculskeletal injury preventin
Sectin 2.1 Identifying Pririty Areas Page 5 f 7 Health Care Wrker Reprts It is imprtant t identify and assess staff perceptins f high-risk tasks. The highest-risk tasks are likely t vary between patient care units, depending n patient characteristics, availability f equipment, physical layut, and wrk rganizatin. Fr example, sme studies have indicated that bathing, tileting tasks, and transfers frm beds t chairs are high-risk tasks fr health care wrkers. Other units may priritize lateral transfers frm bed t stretcher r turning patients frm side t side in bed. Health care wrker pinin regarding factrs cntributing t injuries can be cllected thrugh the use f staff surveys. A simple pen-ended survey asking smething like: What is cntributing t the injuries ccurring n yur unit? may bring up significant issues such as lack f equipment, equipment maintenance and repair, strage, staffing, r prblems with mdified-duty assignments. Interviews may als bring up pertinent issues that cannt be gleaned frm injury data. Ideally, management interviews will take place during a walk-thrugh f the unit. Jb bservatins and brainstrming sessins with health care wrkers can als be used t identify and priritize high-risk tasks and units. Incidents and Near-Miss Reprts Learning pprtunities fr preventing prblems is the purpse f any incident and near-miss investigatin. It is the supervisr/manager s jb t determine the crrective actins that will prevent reccurrence f a near-miss, illness, r injury. The purpse is nt t find fault r blame, but rather t identify the basic, rt causes s that cntrls can be put in place t prevent further ccurrences. Infrmatin frm the investigatin shuld be dcumented in an incident/near-miss reprts. Statistics received frm these reprts are als useful in identifying higher-risk tasks and prblem areas, and can aid in setting pririties, develping annual preventin plans, and identifying training initiatives. Existing Hazard Identificatin Reprts/Risk Assessments Existing hazard identificatin reprts/risk assessments can be used t priritize which areas f the facility shuld be targeted fr enhanced cntrls. Typical hazards that will be identified in these reprts wuld include activities fund in Table 2.1.2. Table 2.1.2 Hazards Specific t the Health Care Industry Hazards might include: 1) Reaching and lifting with lads far frm the bdy 2) Lifting heavy lads 3) Twisting while lifting 4) Experiencing unexpected changes in lad demand during the lift 5) Reaching t lw r t high t begin a lift 6) Mving/carrying a lad a significant distance 7) Identifying envirnmental hazards such as cluttered patient-care areas, cnfined space in bathrms, r brken equipment Steria Strains - A prvincial strategy fr healthcare wrkplace musculskeletal injury preventin
Sectin 2.1 Identifying Pririty Areas Page 6 f 7 Step 5 Analyze Data and Create a Priritized List f High-risk Units Hw an rganizatin priritizes its varius areas will depend n its prgram maturity. As the safe patient handling and mbility prgram matures, the imprtance f lagging indicatrs shuld shift t leading indicatrs. Develping a prcess that accunts fr all indicatrs enables rganizatins t custmize pririties based n updated infrmatin surces (See Figure 2.1.1). Staff Reprts Incidents and Near Miss Reprts Injury Stats Pririty List Existing Hazard Identificatin Reprts New Hazard Identificatin Reprts Figure 2.1.1 Once the data is reviewed and analyzed, a list f units shuld be prepared based n pririty. The next step is then perfrming unit-based assessments t identify the hazards present and assess the risk these hazards pse. Steria Strains - A prvincial strategy fr healthcare wrkplace musculskeletal injury preventin
Sectin 2.1 Identifying Pririty Areas Page 7 f 7 Step 6 Cnsider Organizatinal and Envirnmental Factrs t Cnfirm Pririty List Initially, rganizatins shuld select a number f units that can realistically be assessed and slutins implemented based n the available human and capital resurces. Other rganizatinal and envirnmental factrs such as (cmmitment, readiness, cmpeting pririties, existing equipment and human resurce distributin, etc) shuld be cnsidered when cnfirming the list f pririty units/areas. Fr planning purpses, it may be helpful t use a grss budget-estimatin prcess based n experience in jurisdictins within Nva Sctia and PEI. Estimated Cst/Unit = (# beds) x ($3000 ±15%) This estimate includes cst f equipment and training, but nt maintenance f equipment. Als, there is an assumptin that n majr structural issues are present within the facility that wuld require significant renvatins and/r upgrades. Tls that may be created during early adptin and referenced in the final prgram draft Sample Reprt Card Sample Scring Matrix fr Analyzing Data Steria Strains - A prvincial strategy fr healthcare wrkplace musculskeletal injury preventin