1.1 Anatomy: The physical structure of the body.
Physiology: The normal functions of the body.
When moving and positioning an individual it is important to ensure they are not moved more than their body is capable of, as muscles can only move bones at the joint as far as the joint allows. It is also important to move and handle correctly to ensure nerve fibres are not damaged as they are delicate structures and also important as they send impulses to muscles which enables the muscles to contract and relax. When an individual is moved and positioned it is important this happens smoothly. Sudden movements or pulling in any direction of an individual’s limbs or body can cause pulled muscles or tear tendons which can cause a lot of pain.
1.2 Working with individuals with different conditions affects the way in which we move and handle them correctly. Dementia
People suffering with dementia who is confused might not understand what we are saying and when we are supporting them to move so we have to show the individual by our actions and take time to do this. Arthritis
Individuals with arthritis have to be supported to move gently as they may be in a lot of pain and positioning or moving may be uncomfortable. Stroke
An individual that has had a stroke might have one arm or leg stronger than the other so this needs to be taken into account when weight bearing or moving so as to avoid putting pressure on the weak side. Parkinson’s disease
People suffering from Parkinson’s may suffer limb rigidity that can affect normal moving and positioning. So when moving an individual it is important not to force the rigid limb further than it is able to, as this could cause pain or discomfort as well as damage the joint. It is also important to give an individual with Parkinson’s time to move and not to rush them as they have slower reaction times. They may not be able to say that they are in pain so it is important to read their body language and look for non-verbal signs. Cerebral Palsy
People who suffer from cerebral palsy may have contracted muscles or joints causing a fixed rigid limb. As care staff we need to be aware of the needs of people who suffer from cerebral palsy and ensure that effective communication skills are used when assisting people to move or reposition. 2.1Every time we as care workers move or support moving somebody we are manual handling that person. Unsafe moving and handling can result in an injury to ourselves or the individual. To reduce the risk of injury to care workers and people being supported, legislation is in place to protect people. The Health and Safety at work Act 1974 makes it a legal requirement for employers to ensure the health, safety and welfare of all their employees. Employees have a duty to take reasonable care or health, safety and welfare of themselves and others. The Manual Handling Operations Regulations 1992 (amended 2002) impose duties on employers, self-employed people and employees. They state employers must avoid all hazardous manual handling in the workplace.
If you are assisting an individual to move it is joint responsibility of yourself and your employer to make ensure your own and the person being assisted safety. The HSE provides guidance about the weights that can be safely lifted but these are based on objects rather than people that can object, protest and fidget. Working within these guidelines will cut the risk of injury. Our own workplace also has policies and procedure’s which affect the way in which we move and handle people, in each person’s care plan and daily record file it shows how many carers an individual needs to move them correctly and safely as well as listing what equipment needs to be used for example stand aid or hoist. It is your responsibility to read these workplace policies and procedures and to ensure you follow them. 2.2Health and safety factors that need to be taken into account before attempting to move or position can include: The activity – What activity you are assisting with, how far do you need to go, who else can help you, how long it will take.
The environment – Enough room to complete the activity, check floor surfaces are level, dry and free from obstacles. The person you are assisting – What they can do for themselves that you have asked their permission for the move and taken into account their preferences, needs and wishes, you are using the correct equipment for the individual which has been checked before use. Yourself and others – Have you received moving and handling training for the activity you need to carry out, wearing suitable clothing to perform the activity (clothing needs to allow for free movement) wearing supportive and well-fitting footwear.
It is important for infection control to wash hands before and after the activity and that you are wearing the correct PPE as per company policy. Equipment to be used – Before using any equipment it is vital you check the equipment is available, clean, in good condition, in good working order, the right piece of equipment for the activity you need to carry out as well as the right piece of equipment for the individual, the correct number of people are there to use the equipment and that you do not use any equipment you have not been trained to use. 5.3Aids and equipment that may be used for moving and positioning include:
Hoists, there are two main types ceiling hoists which are fixed to the ceiling and run along a track, they take up less room then a portable hoist and can be fitted to the ceiling in a person’s home. Portable hoists take up more room then a ceiling hoist and may not be possible to have in a person’s home, but they can be moved from room to room in a residential home / hospital. Both types of hoist require the individual being moved to be placed in a sling. Slings are colour coded by weight ranges so you need to know the weight of the individual to ensure the correct sling is used.
Slide Sheets, are made from thin pieces of friction free material which slide over each other. It requires two people at opposite sides of the bed to be used. It is placed under the individual across the bed to roll the individual from side to side e.g. for washing or dressing or can be placed long ways to move the individual up the bed. It is important not to share slide sheets with other individuals for cross infection reasons.
Stand Aids, can be used when an individual is able to weight bear but needs assistance to stand to be moved from chair to wheel chair etc. A sling is used around the individuals’ body and hooked onto the stand aid. The individual stands on the bottom part of the stand aid and slowly pulls themselves up as the stand aid assists them. Grab Handles, placed in individuals’ bathrooms for individuals to be independent when standing up. Walking Frames with and without wheels can also help individuals move themselves independently. 6.1Advice or assistance should be sought to move or handle an individual if: A person’s condition has changed, their condition may have deteriorated and they may not be able to give consent for the activity or they may not be able to assist in the move whereas before they could. Their condition could also improve and they need less assistance so this needs to be taken into account. There is an emergency you may need to summon help to complete the manoeuvre safely and provide immediate care for the individual.
Lack of equipment or damaged equipment, damaged or faulty equipment can cause injury or harm and needs to be withdrawn from use following the workplace procedures until it is replaced or repaired. You may need to seek advice from a senior colleague if there is no replacement equipment for the manoeuvre or may need the manoeuvre to re assessed. A change in your own health such as back problems, muscle sprains or pregnancy need to be told to your employer so that moving and handling risk assessments can be reviewed. You will also need to seek advice if you have not received training for moving and handling equipment. It is your employer’s responsibility to ensure moving and training is available for employees. It is your own responsibility to attend training provided by your employer. Working without the correct training puts yourself and the individual at risk of harm or injury. 6.2Sources of information about moving and positioning individuals can be found from:
Matron, Nurse in charge or other colleagues
My organisations policy for moving and handling, this policy may include
How to perform moving and handling risk assessmentsStaff training requirementsWhat to do if you cannot gain consentWhere equipment is purchased and servicing requirementsWhat to do in an emergencyHow to record adverse reactionsHow to record staff injuries Other sources of information can be found from the HSE which provides a wide range of resources including downloadable and printable materials. Moving and handling training advisors are another good source of knowledge and will be able to support with moving and handling questions. Legislation which may include information to do with moving and handling: Health and Safety At Work Act 1974 Lifting Operations and Lifting Equipment Regulations (1992) (LOLER) Manual Handling Operations Regulations 1992 (amended 2002) Mental Capacity Act 2005