PRESENTATION

ON
ERGONOMIC S
AND
ERGONOMIC S
SOLUTION

Bernardino Ramazzini wrote an article in 1713 that
identified problems in different workers .

In Clerks they developed problems from constant
sitting, Cobblers & tailors were called chair-workers
because they sit at their work all day and they became
bent, hump-backed, and held their heads down like
people looking for something on the ground.
Cont

Porters-whose work is loading and unloading
merchandise from the cargo ships. All porters in time
became round shouldered because the dorsal vertebral
are constantly bent forward and become set in that
position.
In nursing it is a well known fact all over the world
that working in a nursing environment is the second
most dangerous job in the health sector. The nursing
profession is always at risk of injuries.



Employees in nursing and personal care facilities suffer
over 200,000 work-related injuries and illnesses a year
Many of these are serious injuries leading to permanent
disabilities and more than half require time away from
work.
Work injuries cost employers an estimated of over $1
billion dollars a year
Back pain affects up to 38 percent of nurses
About 12 percent of nurses leave the profession annually
because of back injuries
An unknown number of nurses acquire nosocomial
infection including HIV from nursing settings.

Ergonomics is designing a job to fit the worker so the
work is safer and more efficient. Implementing
ergonomic solutions can make employees more
comfortable and increase productivity.

Designing jobs, equipment, and work tasks to fit
human physical characteristics and energy limitations
Make the work fit the person, not the person fit the
work

Ergonomics is important because when youre doing a
job and your body is stressed by an awkward posture,
extreme temperature, or repeated movement your
musculoskeletal system is affected.


Increased savings

Increased morale

Increased productivity .

Reduced absenteeism





Personnel Factors:
Staff shortage
Poor patient handling techniques
Repetitive tasks
Lack of equipment training
Lack of time
Patient Related Factors:
Decreased consciousness
Decreased strength and ability to cooperate
Patient size and weight


Cont
Environmental Factors:
Confined space of patient room and bathroom
Wet and slippery floors
Multiple monitors, IV poles, equipment, etc. in
rooms
Equipment Factors:
Lack of proper equipment (lateral transfer
equipment, bariatric equipment)
Broken and poorly maintained equipment

Repetitive motion
Static pressure
Poor posture
Awkward position
Lifting
Twisting
Lighting
Vibrations
Pressure
Air quality
Uncomfortable
temperature







Examples of WMSDs

Sprain Overstretching or overexertion of a ligament
that results in a tear or rupture of the ligament
Strain Overstretching or overexertion of a muscle or
tendon
Tendonitis Inflammation of the tendon inside the
sheath
Carpal Tunnel Syndrome Compression of the
median nerve as it passes through the carpal tunnel in
the heel of the hand

White Finger Medical term is Reynauds
Phenomenon constriction of the blood vessels
in the hands and fingers (Caused by operating
vibrating machinery especially in cold, damp
weather)


Laborers and material movers
Truck drivers
Salesperson
Registered nurses
Cleaners
Stock clerks
Construction laborers
Maintenance and repair workers


Ergonomic stressors that nurses face in
hospitals/nursing homes

Force - the amount of physical effort required to
perform a task
Repetition - performing the same motion or series of
motions continually or frequently.
Awkward postures - assuming positions that place
stress on the body.
Vibration - rapid oscillation (swing to and fro) of the
body or part of the body.

Contact stress - pressing the body or part of the body
against a hard or sharp edge, such as using the hand
as a hammer.
Majority of needle-sticks occur when health care
workers: Dispose of needles, Administer injections,
Draw blood Recap needles, Handle trash and dirty
linens.
Patient Aggression and Workplace Violence.

Decreased range of motion
Loss of function
Deformity
Cramping
Loss of color
Decreased grip strength
Loss of balance
Swelling
Redness


Ergonomic process
Manual lifting of Patients minimized in all cases
and eliminated when feasible.
Employers implement an effective ergonomics process
that:
provides management support;
involves employees;
identifies problems;
implements solutions;
addresses reports of injuries;
provides training; and evaluate ergonomics efforts.
Controlling ergonomic stressors

To adequately identify and control ergonomic
stressors and minimize the severity of workplace
injuries, nurses and all people who work in hospitals
and nursing homes, should receive training .

Ergonomic Training Goals

Teach employees to recognize the signs and symptoms
of MSDs so that they can report them early and
respond to them appropriately

Identify those jobs or tasks that have ergonomic
stressors capable of causing MSDs

Know how to control ergonomic stressors.

Success of the ergonomics program depends to a great
extent on the effectiveness of ergonomics training.


Ergonomic hazards are prevented primarily by the
effective design of a job or job-site and the tools or
equipment used in that job.

Based on information gathered in the work-site analysis,
procedures can be established to correct or control
ergonomic hazards using either engineering controls or
work practice controls. Thoughtful arrangements reduce
stress and eliminate many potential injuries and disorders
associated with the overuse of muscles, with bad posture,
and with repetitive motion


.
Some jobs expose workers to excessive vibration and
noise, eyestrain, repetitive motion, and heavy lifting.

Machines, tools, and the work environment may be
poorly designed, placing stress on workers' tendons,
muscles, and nerves and in addition, workplace
temperature extremes may aggravate or increase
stress.

Work Practice Controls

Key elements of a good work practice program include
instruction in proper work techniques, employee training and
conditioning, regular monitoring, feedback, adjustments,
modification, and maintenance.

After workers are trained in a particular work activity, such
as proper lifting, they should be monitored to ensure that they
continue to use the proper techniques.

Improper practices should be corrected to prevent injury.


90-degree" posture:

Sit upright with your elbows, hips and knees bent at
right angles and your feet flat on the floor or on a
footrest
This position is biomechanically correct, but it can
fatigue your back muscles over time
Fatigue can lead to slouching, even on a chair with
lumbar support.




Lean back 10
o
- 20
o
into the chair's backrest and put
your feet out in front of you to open up the angle at
your hips and knees
This helps relax your back muscles and promotes blood
circulation
Leaning back too far however, can result in an
awkward neck posture when trying to keep your head
upright.


Standing posture

Standing provides the biggest change in posture, and
is a good alternative to prolonged sitting, which can
aggravate low back injuries.

It can be fatiguing, however, so have a counter-height
chair available at standing workstations, or use a
height adjustable sit/stand workstation

Also, prop one foot up on a low footrest occasionally
to help shift your weight



Lift assist device to eliminate heavy,
awkward lifts in nursing homes and home
health care



Ergonomic chairs
Adjustable back height
Adjustable arm rest


Height and distance to prevent eye strain

Ergonomic aids

Use foot rail, foot stool, or standing stool for standing
workers.
Adjust tilt and curvature of keyboard to match natural
hand position.
Place most used task materials within nearest reach zone
Prioritize materials according to reach zones
Improve housekeeping
Eliminate clutter
Organize storage areas to minimize hazardous lifting
Avoid leaving items on the floor.

Cont..
Minimize static lifting.
Organize work and work area to avoid awkward
postures
Request help with heavy, bulky, or awkward lifting
tasks.
Remove obstructions to passageways and storage access.
Provide regular equipment checks and maintenance.
Repair or replace damaged equipment.
Assure work processes are the least strenuous and
stressful.
Assure the most natural body positions are being used

Take and properly use rest breaks
Reduce exposure to strenuous and stressful tasks.
Do not rest wrists on sharp or hard edges.
Place mouse within easy reach .
Blow dust from mouse ball cavity and wash ball with
mild soap and water.
Top of the screen should be no higher than eye level .
Locate screen to minimize glare.
Use screen hoods or glare guards to minimize glare
Cont..
Keep screen clean and free from dust.
Reduce excessive light, especially for computer work.
Do not cradle the phone on the shoulder.
Organize work and area to minimize bending and squatting.
Plan work to break up extended periods of repetitive motion
tasks.
Limit excessive exposure duration to vibrations. Use proper
personal protective equipment in extreme temperatures
Report hazards and hazardous situations to your supervisor
Eliminate ALL fall hazards.
Take health and safety seriously, both on the job and at home
Know safe processes and procedures
Be a health and safety role model for others to follow


Prevent Back Injuries

Avoid lifting and bending whenever you can.
Place objects up off the floor.
Raise/lower shelves.
Use carts .
Use cranes, lift tables and other lift-assist devices
whenever you can.
Test the weight of an object before lifting by picking up a
corner.
Get help if its too heavy for you to lift it alone.


Risk reduction techniques

Job rotation
Cross train workers so they can rotate jobs throughout
the day.
Change tasks often within your own job
(Example: type for an hour and then file for an hour).
Job hazard analysis
Break each job up into smaller or different tasks.
Determine the risk factors for each task.
Determine how each task affects risk factors for the
total job.
Select appropriate tools
By attaching a handle extension, bending can be
eliminated from many jobs.
Participatory ergonomics
Enlist workers to brainstorm better ways to do their
work.
Have trained workers teach new staff.



Educate staff on the risk factors for musculoskeletal
disorders, and how ergonomics can make their work
easier, more efficient, and safer.

Train staff to identify job tasks that may present a
risk and determine better ways to complete those
tasks
Exercise regularly, every other day Warm up slowly .
A walk is a good Way to warm up.
Inhale deeply before each repetition of an exercise and
exhale when performing each repetition.
These are exercises or stretches that can be performed
at your workstation, home, just about anywhere.

Exercises to Help Your Back

Wall slides to strengthen your muscles .
Stand with your back against a wall, feet shoulder-
width apart. Slide down into a crouch with Knees bent
to 90 degrees.
Count to 5 and slide back up the wall - Repeat 5 times.




Leg rises to strengthen back and hip muscles
Lie on back, arms at your sides Lift one leg off the
floor and hold for count of ten Do the same with the
other leg Repeat 5 times with each leg If this is too
difficult keep one knee bent and the foot flat on
the floor while raising the other leg.

Leg rises while seated

Sit upright, legs straight and extended at an angle to
floor.
Lift one leg waist high .Slowly return to floor. Do the
same with the other leg. Repeat 5 times with each leg
Cont
Blinking and yawning both produce tears to help
moisten and lubricate the eyes. Focus on a distance
object across the room or even outside the window.


While seated, brace elbows on the edge of the desk.
Let weight fall forward.
Cup hands over eyes and close eyes.
Inhale slowly through nose & hold for 4 seconds.
Continue deep breathing for 15-30 seconds.






Close eyes and slowly & gently move eyes up to the
ceiling, then slowly down to the floor
Repeat 3 times
Close eyes and slowly & gently move eyes to the left,
then slowly to the right
Repeat 3 times


Neck stretch

Tilt ear towards shoulder
Reach up and touch top of head with palm to hold in
tilted position
Hold 5-10 seconds. Repeat 2-3 times (come out of
stretch slowly)
Reverse side and repeat



Place arms behind head being careful not to
press hand into head.
Relax shoulders, and squeeze shoulder blades
together while keeping
shoulders back and down Hold 5-10 seconds.
Repeat 2-3 times.


Shoulder Shrug

Sitting up straight, slowly bring shoulders up toward
your ears.
Hold positions 5-10 seconds
Then bring the shoulders down and hold
Repeat 2-3 times


Chair Rotation Stretch

Sit in chair and place feet flat on floor
Reach across your body and grab the back of the chair
Pull gently to increase stretch in mid back
Hold 5-10 seconds. Repeat 5 times
Repeat on other side

Hold hands behind back and grasp hands together.
Pull shoulder blades back and down.
Hold 5 seconds. Repeat 5 times.


Foot Rotations

While sitting upright, slowly rotate each foot from
the ankles 3 times in one direction
Then rotate 3 in the opposite direction



Wrist Flexed & Extended

Hold arm straight at waist height
With fingers of other hand, gently press down above
the knuckles, bending wrist down. (DO NOT hold at
the fingers to push down.)
Hold 5-10 seconds and repeat 2-3 times
For extending, hold onto palm of hand and stretch
wrist back. (DO NOT pull on fingers.)
Hold 5-10 seconds and repeat 2-3 times.

Cont.

Finger Massage

VERY gently, massage the fingers of each hand
individually.
Move toward the nail gently.
Massage the space between your fingers to widen and
relax


Finger Squeeze

Squeeze a foam block OR the edge of your desk firmly
with all fingers
Hold for 3 seconds
Relax your grip


Summary

The nursing community has many hidden occupational
hazards.
The leading causes of employee injury claims in the
nursing profession include:
Muscular-skeletal disorders (back or shoulder pain)
Exposures to blood-borne pathogens
Injuries that are the result of workplace violence or
patient aggression
By reducing the risk of ergonomic stressors, it will
facilitate retention of nurses


Conclusion
Ergonomics is the field of study that seeks to
fit the job to the person, rather than the
person to the job. This is achieved through
the evaluation and design of workplaces,
environments, job tasks, equipment, and
processes in relationship to human
capabilities and interactions in the
workplace