HealthStream Regulatory Script
Ergonomics
Version: May 2008
Lesson 1:
Lesson 2:
Lesson 3:
Lesson 4:
Introduction
Basics of Ergonomics
Musculoskeletal Disorders
Healthy Habits
1
Lesson 1: Introduction
1001
Introduction
Welcome to the introductory lesson on ergonomics.
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As your partner, HealthStream strives to provide its customers with excellence
in regulatory learning solutions. As new guidelines are continually issued by
regulatory agencies, we work to update courses, as needed, in a timely
manner. Since responsibility for complying with new guidelines remains with
your organization, HealthStream encourages you to routinely check all relevant
regulatory agencies directly for the latest updates for clinical/organizational
guidelines.
If you have concerns about any aspect of the safety or quality of patient care in
your organization, be aware that you may report these concerns directly to The
Joint Commission.
Page 1 of 4
1002
Course Rationale
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This course will teach you how to avoid work-related
repetitive stress injury [glossary] to your:
• Wrists
• Arms
• Back
• Other at-risk areas of your body
You will learn:
• Risk factors for injury
• How good ergonomics can protect against injury
Page 2 of 4
1003
Course Goals
After completing this course, you should be able to:
• Define “ergonomics”
• Recognize how ergonomics protects against workrelated injury
• Identify common types of musculoskeletal disorders
(MSDs), including causes, symptoms, and risk factors
• Recognize strategies for preventing MSDs
• List healthy habits for preventing work-related injury
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Page 3 of 4
1004
Course Outline
This introductory lesson gave the course rationale and
goals.
Lesson 2 explains the basics of ergonomics.
Lesson 3 discusses musculoskeletal disorders (MSDs).
This includes a description of MSDs, risk factors, and
preventive strategies.
Finally, lesson 4 describes healthy habits that can help
keep you safe from injury at work.
FLASH ANIMATION: Course Map
Lesson 1: Introduction
Lesson 2: Basics of Ergonomics
• Definition
• Importance
Lesson 3: Musculoskeletal disorders
• Definition
• Common types
• Risk factors
• Symptoms
• Preventive Strategies
Lesson 4: Healthy Habits
Page 4 of 4
Lesson 2: Basics of Ergonomics
2001
Introduction & Objectives
Welcome to the lesson on the basics of ergonomics.
FLASH ANIMATION: Lesson Map
After completing this lesson, you should be able to:
• Define “ergonomics”
• Recognize the role of ergonomics in preventing
work-related injury
Lesson 2: Basics of Ergonomics
• Definition
• Importance
Page 1 of 7
2002
Ergonomics
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The term “ergonomics” comes from two Greek words:
• Ergon, meaning work
• Nomos, meaning natural laws
Ergonomics means designing work equipment and tasks
to fit the “natural laws” of the human body.
Page 2 of 7
2003
Ergonomics in the Workplace: Examples
Ergonomics should be used throughout the workplace.
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Ergonomic principles should be used to design:
• Workstations
• Controls
• Displays
• Safety devices
• Tools
• Lighting
• Common tasks
Page 3 of 7
2004
Importance of Ergonomics: Injury
Why is ergonomics so important?
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The body is stressed by awkward and difficult positions
and movements.
Over time, this stress can lead to injury.
This is especially true if:
• Awkward or difficult positions are held for long
periods of time
• Awkward or difficult movements are repeated
many times
Page 4 of 7
2005
Importance of Ergonomics: Preventing Injury
Ergonomics helps prevent work-related injury by helping
people avoid awkward and difficult positions and
movements.
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By preventing work-related injury, an ergonomic work
environment can lead to:
• A decrease in lost work days
• An increase in productivity
• Lower worker’s compensation costs
• Improved job satisfaction among employees
Page 5 of 7
2006
Review
Ergonomics means:
a. Work-related injuries
b. Fitting the human body to the needs of the job
c. Fitting the job to the natural laws of the human
body
d. None of the above
MULTIPLE CHOICE INTERACTION
[CORRECT ANSWER: C]
[RESPONSE FOR CHOICE A: Incorrect. The correct
answer is C.]
[RESPONSE FOR CHOICE B: Incorrect. The correct
answer is C.]
[RESPONSE FOR CHOICE C: Correct.]
[RESPONSE FOR CHOICE D: Incorrect. The correct
answer is C.]
Page 6 of 7
2007
Summary
You have completed the lesson on the basics of
ergonomics.
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Remember:
• Ergonomics means designing work environments
to fit the human body.
• Awkward positions and repeated movements can
lead to injury.
• Ergonomics can help prevent injury by preventing
awkward and difficult positions and movements.
Page 7 of 7
Lesson 3: Musculoskeletal Disorders
3001
Introduction & Objectives
Welcome to the lesson on musculoskeletal disorders
(MSDs).
FLASH ANIMATION: Lesson Map
After completing this lesson, you should be able to:
• Define “musculoskeletal disorder”
• Identify the types of workers at risk for MSDs
• Recognize symptoms and risk factors for MSDs
• List strategies for preventing MSDs, including
general ergonomic best practices
Lesson 3: Musculoskeletal disorders
• Definition
• Common types
• Risk factors
• Symptoms
• Preventive Strategies
Page 1 of 18
3002
Musculoskeletal Disorders due to Repetitive Stress
The most common type of work-related injury is the
repetitive stress injury (RSI).
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RSIs also are known as musculoskeletal disorders
(MSDs).
MSDs happen when there is ongoing wear and tear on
the body.
This wear and tear can damage:
• Muscles
• Tendons
• Ligaments
• Cartilage
• Nerves
• Blood vessels
Page 2 of 18
3003
MSDs: Severity
MSDs vary in severity.
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In some people, MSDs cause pain and problems every
day.
Others have pain and problems only once in a while.
Page 3 of 18
3004
MSDs: Who Is at Risk?
All workers are at some risk of developing musculoskeletal
disorders due to repetitive stress.
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However, the risk is higher among certain types of workers.
For example, clerical workers are more likely to develop:
• Injuries related to repetitive motion of the hands,
wrists, and arms
• Eyestrain and headache
• Back pain
Clinical and environmental workers are at high risk for
back injury.
Page 4 of 18
3005
MSDs in Clerical Workers: Hand, Wrist, & Arm Injury: Causes
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Many clerical workers spend at least part of each workday
performing repetitive tasks with their hands, for example:
• Typing
• Filing
Over time, this can result in injury to the:
• Hand
• Wrist
• Arm
Page 5 of 18
3006
MSDs in Clerical Workers: Hand, Wrist, & Arm Injury: Common Types
Three common hand and arm injuries seen in clerical
workers are:
• Carpal tunnel syndrome
• DeQuervain’s tenosynovitis
• Bursitis
Click on the name of each MSD to learn more.
CLICK TO REVEAL
Carpal tunnel syndrome
Carpal tunnel syndrome (or CTS) happens when a nerve
becomes pinched at the wrist. Painful, burning numbness
in the palm of the hand is a common symptom.
Numbness generally awakens the patient at night or
happens with repetitive use of the hand. Pain may radiate
up the arm toward the shoulder. Loss of strength in the
hand also is a common symptom.
DeQuervain’s tenosynovitis
Tendons are the rope-like structures that connect
muscles to bone. The synovial sheath is the protective
lining around tendons. Tenosynovitis is inflammation of
tendons and the surrounding synovial sheath.
DeQuervain’s or stenosing tenosynovitis affects the
tendons on the thumb side of the wrist. Symptoms
include aching, tenderness, swelling, and shooting pain.
Bursitis
Bursae are small, fluid-filled sacs that allow bones to
glide smoothly against moving structures such as
muscles and tendons. Bursitis is the inflammation of a
bursa. Symptoms of bursitis include pain and stiffness
aggravated by movement. Pain may be prominent at
night. Almost any bursa in the body can be affected, but
those located around a joint are affected most often.
Page 6 of 18
3007
MSDs in Clerical Workers: Hand, Wrist, and Arm Injury: Prevention
To help prevent MSDs in the hand, wrist, and arm:
• Avoid awkward wrist positions
• Reduce repetitive hand movements
• Minimize the use of vibrating tools
• Redesign tools and workstations to maintain a
neutral hand position
• Add variety to tasks
• Take frequent breaks
• Use wrist supports
• Adjust desk height
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Page 7 of 18
3008
MSDs in Clerical Workers: Back Pain: Causes
Causes of back pain in clerical workers include:
• Sitting with poor posture
• Sitting in poorly designed chairs
• Sitting in chairs that are not adjusted properly
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Sitting is a static posture that can stress the back, neck,
arms, and legs. This puts pressure on the back muscles
and the spine.
People who sit for long periods also may have swelling or
tension in muscles of the buttocks. This puts pressure on
the sciatic nerve, causing pain.
Page 8 of 18
3009
MSDs in Clerical Workers: Back Pain: Prevention
To help prevent back pain as a result of prolonged sitting:
• Use an ergonomically designed chair
• Place your chair at the proper height. Your feet
should rest flat on the floor or on a support.
• Distribute your body weight evenly on both hips.
• Bend your knees at a right angle. Keep your knees
even with or slightly higher than your hips.
• Sit with your back straight and shoulders back.
• Avoid sitting in the same position for more than 30
minutes at a time.
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Page 9 of 18
3010
MSDs in Clerical Workers: Eye Problems: Types
Computer use has not been shown to cause permanent
injury to the eyes.
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However, computer users often have temporary
problems with eyestrain and headaches.
Other eye problems can include:
• Double or blurred vision
• Burning or dry feeling in the eyes
• Eye fatigue
• Loss of focus
Page 10 of 18
3011
MSDs in Clerical Workers: Eye Problems: Prevention
To help prevent computer-related eye problems:
• Have your eyes checked by an eye doctor regularly
• Rest your eyes for at least 20 seconds every 30
minutes
• Clean your monitor screen regularly
• Keep your monitor 18 to 24 inches from your face
• Adjust lighting to reduce glare on your screen
• Use an anti-glare screen if necessary
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Page 11 of 18
3012
MSDs in Clinical & Environmental Workers: Back Injury: Introduction
Clinical staff and environmental workers often do a lot of
lifting.
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This puts them at high risk for back injury.
Page 12 of 18
3013
MSDs in Clinical & Environmental Workers: Back Injury: Risk Factors
For clinical workers, a significant risk factor for back
injury is not using the right device to assist with patient
lifts and transfers.
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Other risk factors for back injury when lifting are:
• Poor posture
• Poor physical condition
• Improper body mechanics
• Lifts that take a lot of force
Page 13 of 18
3014
MSDs in Clinical & Environmental Workers: Back Injury: Prevention
To help prevent back injury related to lifting and
transferring patients:
• Always use the proper device (e.g., gait belt,
transfer board, etc.) for the transfer
• Always use enough staff members to do the
transfer safely
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Other ways to prevent back injury when lifting include:
• Maintain proper body alignment
• Lift with the knees, keeping the back straight
• Wear slip-resistant shoes
• Keep lifted loads close to the body
• Take breaks and stretch often
Page 14 of 18
3015
General Tips for Preventing MSDs: Ergonomic Best Practices
Regardless of the type of work you do, use the following
best practices to help prevent MSDs:
• Avoid fixed or awkward postures
• Avoid manual lifting whenever possible (i.e., use carts
and lifting devices instead)
• Avoid highly repetitive tasks
• Avoid using a lot of force
• Provide support for your limbs
• Use the ergonomic tools supplied by your facility
(e.g., wrist supports for keyboards)
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Page 15 of 18
3016
General Tips for Preventing MSDs: Regular Exercise
Regular exercise can help prevent injury and illness of all
types.
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Always consult your physician before starting an exercise
program.
Page 16 of 18
3017
Review
Roll over the parts of Jane’s body where repetitive motion
injuries are most likely to occur.
FLASH INTERACTION: 3017.SWF
Page 17 of 18
3018
Summary
You have completed the lesson on musculoskeletal
disorders.
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Remember:
• All workers are at risk for work-related MSDs.
• The risk of MSDs is greater among certain
workers. These include clerical workers, clinical
staff, and environmental personnel.
• Use ergonomic best practices and other
appropriate strategies to help prevent MSDs.
Page 18 of 18
Lesson 4: Healthy Habits
4001
Introduction & Objectives
Welcome to the lesson on healthy habits.
FLASH ANIMATION: Lesson Map
After you have completed this lesson, you will be able to:
• List eight healthy habits that can help reduce
the risk of injury in the workplace
Lesson 4: Healthy Habits
Page 1 of 11
4002
Healthy Habit 1
Follow your facility’s policies and procedures.
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Take the time to review information on safe work
practices.
If you have any questions or need explanation, see your
supervisor.
Page 2 of 11
4003
Healthy Habit 2
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Know your equipment.
You should know about each item of equipment that you
use.
Know the answers to these questions:
• How does the equipment work?
• Can I adjust the equipment to better fit me?
.
Page 3 of 11
4004
Healthy Habit 3
Keep your tools close.
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Keep the tools you use often right in front of you.
This can help reduce:
• Twisting motions
• Stress to the arms, shoulders, and back
• Awkward stretching and bending while searching
for items
Page 4 of 11
4005
Healthy Habit 4
Maintain neutral positions.
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Neutral positions are the natural postures of the body.
Neutral positions are especially important when
performing repetitive tasks.
Page 5 of 11
4006
Healthy Habit 5
Take advantage of supportive equipment.
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Your facility supplies special equipment and tools to help:
• Provide support for repetitive work
• Reduce the risk of MSDs
Common examples of supportive equipment include:
• Keyboard wrist supports
• Gait belts for lifting
• Document holders and stands for visual comfort
• Ergonomically designed chairs for back support
Page 6 of 11
4007
Healthy Habit 6
Respond to your aches and pains.
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Aches and pains are the early signs of injury.
Ignoring pain may result in a more serious injury that is:
• Harder to treat
• Slower to heal
Pay serious attention to any persistent:
• Soreness
• Weakness
• Numbness
• Tingling
If you experience any of these signs or symptoms,
contact your physician to check out the problem as soon
as possible.
Page 7 of 11
4008
Healthy Habit 7
Modify high-risk work habits.
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High-risk behaviors increase the chance of injury.
Examples are:
• Sitting or standing in one position for too long
• Incorrect hand or wrist position when typing
• Leaning on the elbows and wrists
• Holding the head down and forward
• Slouching when sitting (i.e., poor posture)
Work on correcting these bad habits.
Page 8 of 11
4009
Healthy Habit 8
Review hobbies and chores at home.
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Bad habits at home often carry over to work, and vice
versa.
Page 9 of 11
4010
Review
Arrange items on the desk to avoid the stress of
reaching, twisting, and stretching.
• Pen
• Telephone
• Stamp
• Envelope
• Plant
• Family photograph
• Mouse
FLASH INTERACTION: 4010.SWF
Click on each item and drag it to the appropriate work
surface.
Page 10 of 11
4011
Summary
You have completed the lesson on healthy habits.
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Remember:
• Follow your facility’s policies and procedures
• Know your equipment
• Keep your tools close by
• Maintain neutral positions
• Take advantage of supportive equipment
• Respond to aches and pains
• Modify high-risk work habits
• Practice good habits at home
Page 11 of 11
Course Glossary
#
Term
carpal tunnel syndrome
cartilage
ligament
muscle
musculoskeletal disorder
nerves
OSHA (Occupational Safety
and Health Administration)
repetitive stress injury
sciatica
tendon
Definition
painful and sometimes disabling condition involving compression of the median
nerve as it passes through the carpal tunnel, a rigid compartment formed by the
carpal bones of the hand at the base of the palm
tough, elastic, fibrous connective tissue found in various parts of the body, such
as the joints, outer ear, and larynx
sheet or band of tough, fibrous tissue connecting bones or cartilages at a joint or
supporting an organ
tissue composed of fibers capable of contracting to effect bodily movement
any disease, injury, or significant impairment to muscles, bones, joints, or
supporting connective tissues
any of the cordlike bundles of fibers made up of neurons through which sensory
stimuli and motor impulses pass
federal agency responsible for national regulations that ensure a safe workplace
type of injury sustained over time due to repeating the same task or movement
over and over again; also referred to as musculoskeletal disorder
pain along the sciatic nerve, usually caused by a herniated disk of the lumbar
region of the spine
band of tough, inelastic, fibrous tissue connecting a muscle with its bony
attachment
Pre-Assessment
1. The best definition for ergonomics is:
a. Following "natural laws" in assigning work to employees
b. Defining "natural laws" according to the needs of a project
c. Considering the "natural laws" of the human body in designing work equipment
d. Obeying the "natural laws" of momentum and leverage in performing work-related tasks
Correct: Considering the "natural laws" of the human body in designing work equipment
Rationale: Ergonomics is the practice of designing work equipment and tasks to suit the "natural laws" of the human body.
2. Awkward and difficult positions and movements are a risk factor for injury. The risk is increased if these positions and movements:
a.
b.
c.
d.
Are repeated many times
Are not part of a person's everyday work
Are performed using ergonomic equipment
Are within a person's ordinary range of motion
Correct: Are repeated many times
Rationale: Repetitive movement is a risk factor for injury.
3. Another name for a musculoskeletal disorder (MSD) is:
a. Multiple sclerosis (MS)
b. Muscular dystrophy (MD)
c. Repetitive stress injury (RSI)
d. Posttraumatic stress disorder (PTSD)
Correct: Repetitive stress injury (RSI)
Rationale: MSDs often result from repeated movements that cause wear and tear on the body. Therefore, MSDs are also called
repetitive stress injuries.
4. With regard to severity, musculoskeletal disorders (MSDs):
a. Range in severity
b. Always cause pain and problems every day
c. Only cause pain and problems once in a while
d. Are never severe enough to require a change of jobs
Correct: Range in severity
Rationale: MSDs range in severity. They can be very severe. Therefore, it is important to respond promptly to symptoms.
5. In the healthcare setting, workers at greatest risk for musculoskeletal disorders (MSDs) affecting the wrist are:
a. Volunteers
b. Clinical workers
c. Clerical workers
d. Environmental workers
Correct: Clerical workers
Rationale: As a group, clerical workers are at greatest risk for wrist injury. This is due to repetitive tasks such as typing and filing.
6. Activities that DECREASE risk of musculoskeletal disorders (MSDs) for clerical workers are:
a. Avoiding a wide variety of tasks
b. Working on a single task without breaks
c. Spending a lot of time on typing and filing tasks
d. Maintaining a neutral hand position during tasks
Correct: Maintaining a neutral hand position during tasks
Rationale: Neutral body positions decrease the risk of MSDs.
7. Which of the following is an ergonomic best practice to prevent back pain and injury from prolonged sitting?
a. Keep the shoulders over the hips.
b. Shift body weight from hip to hip every ten to 15 minutes.
c. Place feet flat on the floor so that the knees are lower than the hips.
d. Round the shoulders forward to press the low back into the chair's back support.
Correct: Keep the shoulders over the hips.
Rationale: To help prevent back pain from prolonged sitting, maintain good posture. Keep the back straight and the shoulders over
the hips.
8. Computer users can develop eyestrain and headaches. To help avoid these problems, keep your computer monitor:
a. 12 to 18 inches from your face
b. 18 to 24 inches from your face
c. No less than 24 inches from your face
d. No more than 12 inches from your face
Correct: 18 to 24 inches from your face
Rationale: To avoid eyestrain and headaches from computer use, keep your computer monitor 18 to 24 inches from your face.
9. Clinical and environmental workers are at risk for back pain and injury primarily because they:
a. Do a lot of lifting
b. Sit for long periods
c. Perform a variety of different tasks
d. Maintain neutral back positions during most of their tasks
Correct: Do a lot of lifting
Rationale: Repetitive lifting puts clinical and environmental workers at risk for back pain and injury.
10. Which of the following is a healthy habit that can help reduce the risk of injury in the workplace?
a. Respond promptly to aches and pains
b. Keep tools at a distance from your workspace
c. Hold the head down and forward when working at a desk
d. Maintain joints in highly flexed positions whenever possible
Correct: Respond promptly to aches and pains
Rationale: Always respond promptly to aches and pains. This can help ensure that temporary pain does not develop into a chronic
injury.
Final Exam
1. When work equipment and tasks are designed ergonomically, they take into account:
a. The "natural laws" of the human body
b. The laws related to worker's compensation
c. The "economic laws" of supply and demand
d. The "unwritten laws" of employee satisfaction
Correct: The "natural laws" of the human body
Rationale: Ergonomics is the practice of designing work equipment and tasks to suit the human body.
2. An ergonomic work environment can help prevent work-related injury by:
a. Fitting the human body to the needs of the job
b. Helping workers repeat movements more rapidly
c. Helping workers avoid awkward and difficult movements
d. Fitting the human body to the constraints of small spaces
Correct: Helping workers avoid awkward and difficult movements
Rationale: Awkward and difficult movements are a risk factor for injury. An ergonomic work environment can help workers avoid
these types of movements.
3. Musculoskeletal disorders (MSDs) happen when:
a. A person is born with a genetic disease.
b. A person fractures a bone due to sudden trauma.
c. A person has brittle bones, which are at risk for damage from impact.
d. A person repeats certain movements, which cause wear and tear on the body.
Correct: A person repeats certain movements, which cause wear and tear on the body.
Rationale: MSDs result from repetitive stress on the body.
4. Choose the true statement regarding healthcare workers and risk of musculoskeletal disorders (MSDs):
a. Clerical workers have the least risk of eyestrain.
b. Clinical workers are at increased risk for back injury.
c. Environmental workers have the highest risk of all MSDs.
d. Clinical and environmental workers have the highest risk of wrist injury.
Correct: Clinical workers are at increased risk for back injury.
Rationale: Both clinical and environmental workers have an elevated risk for back injury. This is primarily because these types of
workers do a lot of lifting.
5. A practice that INCREASES risk of musculoskeletal disorders (MSDs) for clerical workers is:
a. Using ergonomic seating
b. Doing a variety of different tasks
c. Spending a lot of time on typing and filing tasks
d. Maintaining a neutral hand position during tasks
Correct: Spending a lot of time on typing and filing tasks
Rationale: Repetitive typing and filing is a risk factor for injury for clerical workers.
6. Clerical workers are at risk for back pain and injury primarily because they:
a. Sit for long periods
b. Do a lot of typing and filing
c. Perform a variety of different tasks
d. Maintain neutral back positions during most of their tasks
Correct: Sit for long periods
Rationale: Sitting for long periods is a risk factor for back pain and injury for clerical workers.
7. Which of the following practices is most likely to contribute to back pain from prolonged sitting?
a. Distribute body weight evenly over both hips.
b. Keep the back straight and the shoulders over the hips.
c. Place feet flat on the floor so that the knees are level with or slightly higher than the hips.
d. After establishing the position of the knees, hips, and shoulders, maintain this fixed position until the work is finished.
Correct: After establishing the position of the knees, hips, and shoulders, maintain this fixed position until the work is finished.
Rationale: Maintaining the same seated position for long periods is a risk factor for injury. To help prevent pain and injury, get up and
stretch periodically.
8. Computer users can develop eyestrain and headaches. To help avoid these problems, a recommended practice is to rest your
eyes for at least:
a. 10 seconds every 10 minutes
b. 20 seconds every 30 minutes
c. 30 seconds every 40 minutes
d. 60 seconds every 60 minutes
Correct: 20 seconds every 30 minutes
Rationale: To help avoid eyestrain and headaches, computer users should rest their eyes for at least 20 seconds every 30 minutes.
9. To help prevent back injury related to lifting and moving patients, the single most important practice is:
a. Use the proper device for the transfer
b. Hold the patient at a distance from the body
c. Allow the back to round during the lifting motion
d. Lift primarily using the muscles of the arms and shoulders
Correct: Use the proper device for the transfer
Rationale: A significant risk factor for injury during patient transfers is not using the proper device. Always use the proper device for
transfers.
10. Which of the following is a healthy habit that can help reduce the risk of injury in the workplace?
a. Keep tools at a distance from your workspace
b. Hold the head down and forward when working at a desk
c. Know your equipment and facility policies and procedures
d. Maintain joints in highly flexed positions whenever possible
Correct: Know your equipment and facility policies and procedures
Rationale: To avoid injury in the workplace, know your equipment. Also be sure you know facility policies and procedures for the work
that you do.