Long Term Care Worker
Protection Program
This training and related materials are provided under Susan Harwood
Program Grant Number SH-22247-11-60-F-48 from the Occupational
Safety and Health Administration U.S. Department of Labor. It does not
necessarily reflect the views or policies of the U.S. Department of Labor
nor does mention of trade names commercial products, or organizations
imply endorsement by the U.S. Government.
Minimizing Hazards in the Workplace
June 21, 2012
www.ltcworkersafety.com
Content Expert
 Kathy Wismer, RN, COHN-S
Employee Health,
Texas Health Presbyterian Hospital Plano
Kathy graduated from Texas Women’s University with a
BSN in 1995; has worked at THR for 16 years, moved
into Occupational Health in 2007. Currently certified
in Occupational Health, and is passionate about
performing ergonomic evaluations for staff.
The CDC (Center for Disease Control) describes
ergonomics as the scientific study of people at
work.
OSHA (Occupational Safety and Health
Administration) describes ergonomics is the
science of fitting workplace conditions and job
demands to the capabilities of the working
population.
Per the CDC the goal of
ergonomics is to reduce stress and
eliminate injuries and disorders
associated with the overuse of
muscles, bad posture and repeated
tasks.
• Engineering Controls
• Administrative Controls
• Personal Protective Equipment
Preferred way to reduce hazards
• Equipment Design
• Ventilation
• Lighting
• Sufficient space for movement
• Training
• Monitoring
• Scheduled Breaks
• Work Hours
The least effective way of
control.
• Respirators
• Ear Plugs
• Safety Goggles/Masks
• Gowns/Scrubs
To yourself as well as
other
• Nerves
• Muscles
• Tendons
• Joints
• Cartilage
• Spinal discs
Examples are:
• Tendinitis
• Carpal Tunnel Syndrome
• Back injury
• Disorders associated with repetitive trauma
According to OSHA ergonomic risk factors occurs in jobs
that require:
• Repetitive, forceful or prolonged exertions of the hands.
• Frequent or heavy lifting.
• Pushing/ pulling.
• Carrying heavy objects.
• Working in prolonged awkward positions.
• Vibration and cold may add to risk.
Jobs that present multiply risk factors will have higher
probability of causing musculoskeletal problems.
Level of risk depends on the intensity, frequency and
duration of activities
• Mental
• Physical
• Use of Ergonomics
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Awareness
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Position
Surroundings
Knowledge
Use of equipment
Stress
Concentration
• Use of proper body mechanics
• Overall physical wellness
• Proper sleep/rest
• Hydration
• Nutrition
General environment: Adequate lighting and comfortable
temperatures and humidity.
Workstations and chairs that are adjustable
Layout of the work that reduces reaching and twisting
Postures that promotes neutral positions. Reduce
repetition/vary task.
Forces: Reduce the size and weight of held objects.
Eliminate vibration if possible.
Mechanical stresses: Eliminate sharp edges.
Lifting: reduce frictions and provide assistance devices.
Work organization: Adequate staffing. Alternate physical
and mental demanding task.
Patient Lifting
Computerized Charting
• Repetition
• Awkward positions
• Done using great deal of force
• Lifting heavy objects
• Combination of the above factors
OSHA recommends minimizing
lifting of patients/residents in all
cases and eliminate lifting when
possible.
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Never transfer Patients when off balanced.
Lift close to the body
Use lift teams or mechanical devises
Limit the number of lifts per worker per day
(More than 20 increases injury.)
Limit heavy lifting (alone/patient cannot
support own weight)
Training in mechanical devises.
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Lifting equipment (e.g. sling type full lifts,
sliding boards/hover mats, Lean stand assist).
Shower chairs.
Toilet seat risers.
Height adjustable electric beds.
Trapeze lifts.
Wheelchairs.
• Repetition.
• Awkward positioning.
• Improper lighting/glare.
• Layout of work is awkward and out of reach.
• Chairs that are ill fitting/not adjustable.
• Cramped workspace.
• Lack of keyboard trays and wrist rest.
• Improper spacing between monitor and worker’s eyes.
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Keyboards should have keyboard trays with padded
wrist rest.
Monitor should be eye level with user.
Monitor should be at least 16 to 22 inches away from
user’s eyes to reduce eye strain.
Head held in neutral position to reduce neck stain.
Gaze should avert from computer screen every hour for
a few seconds of blinking to reduce eye stain.
Adequate lighting . Reduce any glare on monitor screen.
There should be at least 2 inches of space between the
keyboard tray and the user’s thighs.
• Seat pans that fit the user.
• Lumbar support.
• Height adjustable. The user’s knees should
be at 90 degrees to thighs. Feet should be
flat on the floor or a foot rest should be
available.
• Chair arms should be both adjustable and
have padding.
• The chair base has 5 wheel support.
Reduces the risk of repetitive stress injuries.
Take a micro break of a few seconds every hour.
• Keep hydrated .
• Change positions .
• Get up/stretch/reposition.
• Take bathroom breaks when needed.
• Do a few seconds of ergonomic exercise.
Do not perform any hand /wrist stretches if you have
numbness in your hand. Consult with your doctor if you
have been diagnosed with any musculoskeletal disorder/
injuries before doing any exercises. Stop if any pain
occurs while performing any movement.
Place palms together.
Raise elbows.
Roll shoulders back.
Upper arm at side, keep elbow bent, palm up.
Using fingers, apply pressure slowly to bend back
palm.
Stop pressure when you feel a gentle pull.
Repeat on other hand.
Position 1
Wrist neutral, fingers & thumb flexed
Position 2
Wrist neutral, fingers & thumb extended
Position 3
Wrist, fingers & thumb extended back
Position 4
Same as Position 3 with fingers & thumb spread apart
Position 5
Wrist in neutral, fingers & thumb same as Position 4
Position 6
Gently stretch thumb.
Focus on an object 20 feet a way. (repeat 3 times)
Place cupped hand over eyes.(hold for up to one
minute)
Rotate eyes: Look up, right, down and left (X 3)
Look up, left, down and right (X 3)
• Set up your home computer using ergonomics.
• Practice the same micro breaks techniques at home as
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well at work.
Vary your positions and you tasks. Stretch.
Practice proper body mechanics when doing household
chores.
Exercise for at least 30 minutes most days of the week;
incorporate both aerobic and strengthening exercises.
Decrease stress by enjoying a hobby or socializing with
family and friends.
Jeffress, C. (2000, October). Beacon Biodynamics and Ergonomics
Symposium. OSHA Archive, retrieved from
http://www.osha.gov/pls/oshaweb/owadisp.show document?p
id=346&p table=speeches
Salazar, M. (2006). Core Curriculum for Occupational Environmental
Health Nursing (3rd ed.). Seattle, Washington: Mosby Inc.
Guidelines for Nursing Homes: Ergonomic for the Prevention of
Musculoskeletal Disorders, OSHA 3182-3R, 2009.