MANUALLY HANDLINGTHE PLUS-SIZE PERSON

SUPPLYING PLUS-SIZED MANNEQUINS

WE’RE BIG ON QUALITY TOO!

www.bariquins.com

MANUALLY HANDLING THE PLUS-SIZE PERSON

WHAT ARE THE DIFFICULTIES WHEN HANDLING THE PLUS-SIZE PERSON?

To overcome some of these difficulties it is important to have the correct systems in place, which include although not exclusive to:

• A competent trained workforce who have the skills, experience and knowledge to reduce the risks when handling the plus-size person.

• Processes and systems in place that are transparent and easy for staff to follow.

• An overarching strategy and supporting policy and risk management structure exploring current and future needs. With a governance process to ensure continual improvement.

• Access to a range of equipment that will accommodate different weights, sizes; including the varying shapes due to the distribution of the weight of the individual.

• Access to a range of furniture.

• Spatial risk factors require identifying in the short and long term, incorporating better building design and ensuring accessibility.

• Vehicle and transportation for internal and external transfers.

• Good communications that ensure collaboration across agencies.

• Correct management of pain, safety, dignity and comfort.

Manual Handling is a key part of daily and work life within many sectors, particularly the health and social care sector. Working with people is often more complex than working with an inanimate load; there are often additional factors identified within the TILE risk assessment that are not present when moving and handling an inanimate load.

Task - to safely move the person or casualty Individual Capability - skills, knowledge, experience and confidence of the handler Load - the person maybe in pain, confused, scared and unpredictable Environment - what are the variables that can make the task difficult

Mechanical devices are available to assist in moving a plus-size person (sometimes referred to as ‘bariatric’) and these should always be the first choice for a scenario where the person cannot assist themselves. However, these handling aids require the person to be manoeuvred into or on to them, so that they are comfortable and safely positioned. The risk of injury to health and social care staff and the person being handled can be high if the staff are not trained and they do not use the equipment correctly. There is evidence even after training that if not reinforced that the trainees can quickly forget what they have been taught (Webb and Harrison 2015).

Work-related musculoskeletal disorders (WRMSDs) are one of the commonest conditions resulting in ill health. WRMSDs accounted for 40% of all days lost due to workplace ill-health in 2014/2015 (HSE, 2015). The health and social care setting continues to have an elevated number of WRMSDs due to a focus on patient manual handling. The lower back/spine is reported by general practitioners as the most frequent site of injury (HSE, 2015).

Lower back pain is a socioeconomic problem, often associated with pain and disablement, resulting in organisations having to manage work place absenteeism with the healthcare and benefits costs being borne by the state. In 2011, the charity BackCare reported that NHS staff who injure their backs whilst carrying out work-related tasks costs the taxpayer £400million a year. Of course, all organisations will have to meet the costs of covering any staff shortages from what can be a long term condition.

The number of plus-size people is rising globally (The Lancet, 2013) and the past three decades have seen a steady rise. The training of employees across the many different sectors who handle plus-size people is a huge challenge.

As well as the healthcare sector, there are other types of services who do handle the plus-size person, they are;

Ambulance, fire and rescue, housing association, care homes, rescue staff, social care staff, police, and funeral undertakers

There will be many more too, such as hotel and cruise line staff, for example, who may have to handle the plus-size person with little notice.

The employees within all these services will require training to reduce the high risk activity involved in moving the plus-size person.

As well as the handler, the plus-size person is often at risk of being injured due to poor manual handling techniques. The plus-size person often feels vulnerable, not having control and is often unintentionally made aware of the lack of training and experience of the staff.

To reduce the risk of injury, legislation sets out the legal responsibilities of organisations. A systems approach should be in place that includes the provision of suitable equipment, risk assessments, supervision, instruction and training. This should be audited and reviewed on a regular basis or as things change.

It is the employer’s legal responsibility to ensure their staff have received suitable and sufficient training within their working environment. This may include the manual handling of a plus-size person. For example, employees requiring this type of training within the healthcare setting would include; occupational therapists, manual handling advisers and trainers, nurses, physiotherapists and allied health professionals, mortuary staff plus many more.

From a litigation viewpoint, the Corporate Manslaughter Act now places a greater responsibility on the managers and CEO’s of organisations to ensure the safety of their staff as well as the patients being handled. The manual handling of the plus-size person within the health and social care settings is now common place, and the provision of equipment is readily available on either a purchase or rental basis. The issue with having a wide enough range of equipment to accommodate the plus-size person is often the storage when not in use.

WE’RE BIG ON QUALITY TOO!

A SYSTEM OF TRAINING THAT IS EASY TO DUPLICATE AND IS NOT COST PROHIBITIVE

MANUALLY HANDLING THE PLUS-SIZE PERSONThe reasons for this difficulty is multi-fold; ranging from the physical safety of the handler and the real life model, to the embarrassment and dignity issues for both parties. The cost of a real life model repeatedly attending such training sessions can be prohibitive and unrealistic. Therefore, the provision of a training mannequin can be used in situations that are both hazardous and uncomfortable. To remove the factors associated with using an actual model, a training mannequin can be used. This will also allow the handlers to set the pace during instruction.

Options that have previously been available to manual handling trainers have been to:

• Use a real life model

• Use a training empathy suit

• Use a weighted mannequin

The use of a real life model, although great for authenticity, has its draw backs; the model may tire easily and get breathless or whilst those training wait their turn and take a break, the model rarely gets the chance for a pause. The risks to the model are often overlooked and may not have been risk assessed as being potentially harmful to them. This is another area that organisations need to be mindful of when risk assessing the training of their staff.

The empathy training suit, is a great way for people to experience being the larger person and feeling the restrictions that this places on the body during movement and general activities. However, as a manual handling training aid, they do have their limitations. Although they have the dimensions of a plus-size person, they do not possess the weight of one and therefore lack the realism during tuition.

As regards weighted mannequins, these can be extremely difficult to move around as they weigh 25 stones or more, therefore often requiring equipment to it. Alternatively, several already trained personnel would be needed to position the weighted mannequin in the training arena prior to instruction and then remove it after. This again requires careful planning and risk assessment. Lifting equipment will be required for transportation, especially when

moving from one area to another. The weighted mannequin also requires plenty of storage space when not in use.

Some mannequins are more manoeuvrable as they can be filled with water in the training area, thus providing the weight. However, a hosepipe leading through corridors from a tap to the training area is far from ideal for a lesson centred on workplace safety. Even if the tap has a good rate of water flow, filling the mannequin can be very time consuming. If the nearest water point has a low-flow tap or movement-activated tap fitted, this will increase the complexity of filling the mannequin. Furthermore, after the training session has been completed, the water has to be discharged from the mannequin. Unless the training takes place outside or undercover in an area where a drain is present, emptying the water could be a long and messy, if not destructive, process. Additionally, even in the UK, water can sometimes be a scarce resource.

A simple yet very practical solution, avoiding all of the above problems, is the Bariquin. This is a weighted dummy that is built in easily manageable sections and quick to put together, thereby reducing the risks associated with manually handling the traditional weighted dummy.

The benefits of a Bariquins mannequin for an organisation could potentially include many of the following:

• Transportation of this 25 stone mannequin (when not assembled) is no longer an issue and does not require the use of lifting equipment

• The Bariquin is simple to put together and then disassemble after use

• Unique assembly system allows for scenarios where the Bariquin has 1 or more half limbs or limbs removed to simulate the amputee patient

• The price of the Bariquin can soon be recouped compared to using a real life model in training sessions

• The embarrassment and reluctance of staff to manually handle a real life model will be significantly reduced

• Staff will be able to repeatedly practice as often as they are able to

• The session will not be affected by the real life model becoming tired or breathless

• Training will reduce the risk of litigation against your organisation

• More complex scenarios can be practised

• New techniques can be devised, designing out any risks involved

• Complicated removals can be practised before carrying out the actual movement of a real person in an evacuation or other scenario

• Emergency evacuation drills can be practised

• The mannequin can be stored discretely away

• Reduced time spent attending incidents due to better training

• Fewer staff members required to deal with incidents

• Revenue can be earned by providing training to others

• Reduction in staff sickness due to back injuries

• Less need for provision of cover for staff on sick leave

• Ad hoc training can be undertaken, when time allows, to develop staff skills and knowledge

WE’RE BIG ON QUALITY TOO!

ALL BARIQUINS FEATURE THE FOLLOWING ADVANTAGES:

• Designed and made in the UK

• 12 month guarantee against failure due to workmanship or materials

• Made from micrAgard PLUS material which is fully recyclable and free from the harmful substances used in PVC

• migrAgard is anti-micobial, fire retardant, fluid repellent, non-rot & UV stable

• Impact resistant, giving a better build quality and great aesthetics

• High quality durable fittings used for the most demanding of environments

• Easy to clean and washable with mild soap and water

• A set of clothing is available

• The superior appearance of the Bariquins will complement your organisation’s professional reputation

This booklet has been produced in consultation with

Deborah Harrison RGN, PG Dip PMH, PG Cert VR, PG Dip SM

Deborah is the Managing Director of A1 Risk Solutions Ltd

The organisation provides both face to face training and has a manual handling online

training and risk management resource www.a1risksolutions.co.uk. Contact us for your

manual handling requirements; training, risk assessments, accident investigations, audits,

return to work and Display Screen Equipment assessments.

Deborah has recently been appointed the Honorary Lecturer at the University of Salford

and the Research and Communication Officer of the National Back Exchange. She is also

a national and international speaker in the field of manual handling.

Suite 336, Stockport Business & Innovation Centre, Broadstone Mill, Broadstone Road

Reddish, Stockport, Greater Manchester SK5 7DL

WE’RE BIG ON QUALITY TOO!

Further Reading

HSE (2015) INJURY STATISTICS [ACCESSED 20/01/2016]

www.hse.gov.uk/Statistics/causinj

WEBB. J. AND HARRISON (2015) FRIEND OR FOE? CAN ONLINE TECHNOLOGY REDUCE THE RISKS IN HEALTH AND SOCIAL CARE? TACKLING CHALLENGES NATIONAL BACK EXCHANGE CONFERENCE 28TH SEPTEMBER HINCKLEY

THE LANCET (2014) GLOBAL, REGIONAL, AND NATIONAL PREVALENCE OF OVERWEIGHT AND OBESITY IN CHILDREN AND ADULTS DURING 1980–2013: A SYSTEMATIC ANALYSIS FOR THE GLOBAL BURDEN OF DISEASE STUDY 2013 [ACCESSED 20/01/2016]

www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60460-8/abstract

HSE (2007) RISK ASSESSMENT AND PROCESS PLANNING FOR BARIATRIC PATIENT HANDLING PATHWAYS [ACCESSED 19/12/2015]

www.hse.gov.uk/research/rrpdf/rr573.pdf

MUIR, M. AND RUSH, A. (2013) MOVING AND HANDLING OF PLUS-SIZE PEOPLE AN ILLUSTRATED GUIDE. THE NATIONAL BACK EXCHANGE

www.bariquins.com