workbook - careerforce home · do the learning activities included throughout this workbook. write...

Workbook

Support people to use assistive equipment and move in a health, disability or aged care context

US 27833

Level 3 Credits 5

Name:

Careerforce – Issue 1 0 – Sep 2013 US27833 Support people to use assistive equipment and move … 3

Contents

Before you start ...................................................................................................................................... 4

Supporting people to move .................................................................................................................. 7

Managing discomfort, pain and injury ................................................................................................ 8

Injury prevention ................................................................................................................................... 10

Back care ............................................................................................................................................... 11

Looking after yourself .......................................................................................................................... 12

General principles of moving ............................................................................................................. 13

Moving and handling programme ..................................................................................................... 18

Risk assessment .................................................................................................................................. 24

Assisting people ................................................................................................................................... 25

Assistive equipment ............................................................................................................................. 27

Using normal movement patterns .................................................................................................... 34

Caring for equipment ........................................................................................................................... 46


Before you start

Welcome to this workbook for unit standard 27833:

Support people to use assistive equipment and move in a health, disability or aged

care context.

For this unit standard you will have:

this workbook.

an assessment.

In this workbook you will learn more about:

general principles of moving people.

self-care and injury prevention.

reducing the risk of discomfort, pain and injury.

risk assessment and hazards.

techniques for supporting people to move using normal movement patterns.

supporting people to use assistive equipment.

How to use this workbook This is your workbook to keep. Make it your own by writing in it.

Use highlighters to identify important ideas.

Do the learning activities included throughout this workbook. Write your answers in

the spaces provided.

You might find it helpful to discuss your answers with colleagues or your supervisor.

Finish this workbook before you start on the assessment.


Workbook activities

Learning activity

You will come across learning activities as you work through this

workbook. These activities help you understand and apply the

information that you are learning.

When you see this symbol, you are asked to think about what you

know. This may include reviewing your knowledge or talking to a

colleague.

When you see this symbol, it gives you a hint, tip or definition.

The glossary and study hints book has study hints for

all trainees. It also explains key words and phrases

from the compulsory unit standards for Foundation

Skills and Core Competencies.

You can download it from www.careerforce.org.nz or

order it from http://shop.careerforce.org.nz


Check your knowledge…

Before you begin, think about using assistive equipment

Name two pieces of equipment you use to assist people to move.

1

2

What do you have to do before you use the equipment?

How do you look after yourself when assisting people to move?

How do you report any unsafe equipment or hazards?


Supporting people to move

In your role as a support worker you will support people to move themselves and support

them to use equipment to move.

You may use a handling belt, slide sheet or transfer board to help a person to move. You

may help a person transfer to and use their walking frame or wheelchair.

Assistive equipment allows a person to do something they need support to do or to assist

them to do something better. You as a support worker may use the assistive equipment to

assist the person. This can include shower and bath equipment and toileting aids.

There are many situations in which you will support a person to move. They include:

positioning, for example, repositioning a person in bed.

mobility, for example, transferring from bed to wheelchair.

bathing and showering, for example, getting into and out of a bath.

toileting, for example, transferring to a toilet from a wheelchair.

Helping people to move is called manual

handling work as it requires you to lift,

lower, push, pull, slide, carry or move, hold,

support or otherwise handle people.

Manual handling can lead to injuries and

you must look after yourself.

Under the Health and Safety in

Employment Act 1992:

it is the employer’s responsibility to

provide a safe working environment.

it is your responsibility to take all

practicable steps at work to ensure

your own safety and the safety of

others.

This workbook is based on the principles in

the Accident Compensation Commission

2012 publication Moving and handling

people: The New Zealand Guidelines.


Managing discomfort, pain and injury

A major injury prevention programme promoted within workplaces by ACC is:

Preventing and Managing Discomfort, Pain and Injury (DPI).

ACC’s approach encourages workplaces to focus on both prevention and management of

musculoskeletal conditions.

DPI can be prevented or managed if the pain and its contributory factors are addressed in

the early stages. Where feasible, people should be able to stay at work, providing changes

are made to address factors contributing to their conditions.

There are seven contributing factors that may lead to DPI. They all interact with each

other and all must be identified and addressed. Of these seven factors, there is no clear

distinction between work and non-work contributory factors.


Individual factors

These factors relate to things a person can’t change about the way they are, such as their

gender, age and height.

They also relate to things a person can change, such as their strength, physical fitness,

skills and training.

Psychosocial factors

These relate to the issues that may affect a person, and how the person deals with them,

both at work and outside of work.

These factors include the development of a culture of safety at work.

Workplace layout/awkward postures

This relates to the way the workplace is set up and the physical working positions that

workers adopt, which may be as a result of the facility design and available space.

Workplace layout should aim to minimise workers having to bend and reach.

Work organisation

This relates to how work is arranged and carried out. For moving and handling people this

includes adequate rest breaks, length of shift hours, management policies and support

and good training.

Task invariability

This relates to how much a task varies. Is it repetitive, or does it involve holding positions

for long periods of time? Is it boring or too challenging?

Load/forceful movements

These relate to what a person handles and the forces they have to apply to use them. This

also includes the use of specific client handling techniques and equipment.

Environmental issues

These relate to the conditions in which a person works, including room temperature, noise,

lighting, workplace size, resources and staff skill levels.


Injury prevention

Pain and injury are not necessarily related to each other. You can have pain without injury

and injury without pain.

To prevent and manage discomfort, pain and injury you need to focus on three kinds of

prevention – primary, secondary and tertiary.

Primary prevention

Stop discomfort, pain and injury from happening. For example, warm up and stretch your

muscles before you start work, take rest breaks, eat wisely and drink plenty of water.

The ACC website has Smart Tips sheets for health workers to prevent and manage DPI

which includes warm up and stretching. See www.acc.co.nz/preventing-injuries/at-work

Secondary prevention

If it happens, stop it from getting worse. Self-help and self-management are a vital part of

the process.

Report any DPI to your manager early. The aim is to reduce the chances of the support

worker being off work.

Tertiary prevention

If it does get worse, manage it for the best possible outcome. The goal is to get back to

work with the greatest level of health and function possible.

Effective primary prevention initiatives should be put in place to keep the worker safe at

work and to prevent re-injury.


Back care

Your back is not naturally designed to move equipment or people. However there are

tasks that we all do every day that involve moving. People may be heavy and they are

often hard to grip.

Back injury is one of the most common forms of workplace injury and a back injury can

stay with you for life. Poor manual handling practices can lead to musculoskeletal injuries,

including sprains and strains and overuse disorders.

Several research studies have identified that manual handling tasks are associated with

an increased risk of injuries, including an extensive study based on ACC claims in New

Zealand.

Between July 2007 and May 2009 ACC claims that involved 60 days or more off work, the

most frequent task leading to long term claims was lifting patients. Lifting patients involved

74% (129) of the 176 claims for injuries that occurred while moving and handling patients

within the New Zealand residential care (or retirement village) sector.

Of the lifting claims which had information about the task, 54% involved transferring

patients to or from equipment (bed, chair, wheelchair, toilet, commode), 25% involved

catching falling patients and 11% involved picking patients up from the floor.

54%

25%

11%

10%

Cause of injury

Transferring patients

Catching falling patients

Picking up patients off floor

Other


Looking after yourself

Our backs do a huge amount of work and you must take care of yourself and your back.

Warm up and stretch your muscles before you start work. See the ACC Smart Tips sheets

on www.acc.co.nz/preventing-injuries/at-work

Organise your environment in a way that will assist you when moving people. Arrange

things to minimize bending and reaching. Work at a comfortable height and raise or lower

equipment, such as beds where possible.

Minimise the people handling hazards that could cause harm to your back. If you do a lot

of moving and transferring, spread the tasks out and take frequent small breaks between

the tasks.

Things to consider:

make sure your grip is stable.

maintain a good posture and spinal alignment.

push rather than pull wherever possible.

utilise your body weight, using your whole body, not just your arms.

move your whole body when changing direction.

keep your line of vision clear.

If it feels heavy, it is heavy. A person weighing

50 kgs requires a 40 kg pulling force to

re-position them. A slide sheet reduces this to

12 kgs.

If it is difficult, find another way, for example:

use moving equipment.

get another person to assist you.

You need to be aware of the safety of yourself

and others at all times.

Under the Health and Safety in Employment

Act 1992:

it is the employer’s responsibility to

provide a safe working environment.

it is your responsibility to take all

practicable steps at work to ensure your

own safety and the safety of others.

http://www.acc.co.nz/preventing-injuries/at-work


General principles of moving

It is important to apply safe biomechanical principles of posture, position and technique so

you can provide the best support for the person whilst minimising the risk of harm to

yourself.


Biomechanical principles

Stand in a stable position.

Your feet should be

shoulder distance apart.

The circle gives you a safe

and stable base to work in.

Moving out of this circle

can put your safety at risk.

Avoid twisting.

Keep your feet pointing in

the direction of movement.

This is the step-stand

position.

Make sure your shoulders

and pelvis stay in line with

each other. This will avoid

twisting your back.

Bend your knees slightly.

Maintain your natural spinal

curve.

Avoid stooping by bending

slightly at the hips (bottom out).


Keep your elbows tucked in.

Keep the person close to your body.

Avoid reaching - the further away

from you the person is, the greater

the potential for harm.

Tighten your abdominal muscles

to help support your spine.

Keep your head raised.

Keep your chin tucked in.

Head, shoulders and hips should

all be facing the same direction.

Move smoothly throughout the

technique and avoid fixed holds.

Move upper and lower body as one unit

to avoid twisting at the waist.


Learning activity

You can help yourself prevent and manage discomfort, pain and injury.

Consider each of the seven contributory factors below and write down what you can

do for yourself. The first one has been done for you as an example. Hint: The ACC

website www.acc.co.nz has a useful list of possible solutions to manage DPI.

Individual factors

My contributory factors are that I am not feeling well at the moment due to

lack of sleep, eating poorly, not drinking enough water and not exercising

enough. I can take more control of my life. I will try to get rest when I can

and eat and drink properly. I am going to join a walking group to encourage

myself to exercise regularly.

Psychosocial factors

Workplace layout/awkward postures


Work organisation

Task invariability

Load/forceful movements

Environmental issues


Moving and handling programme

ACC research shows that training people in moving and handling techniques alone is

ineffective in reducing injuries. Only a moving and handling programme with multiple

components is effective in reducing back problems and other injuries.

Core programme components typically include:

a policy on moving and handling clients.

a training programme in moving and handling people.

risk assessment protocols, documentation and an incident reporting system.

the provision of moving and handling equipment.

facilities that are designed or modified for moving and handling people.

Your workplace will have a moving and handling programme and a risk assessment

process that needs to be done before moving and handling people. The purpose of risk

assessment is to identify and manage hazards to reduce the likelihood of incidents

occurring that could cause harm or injury for carers and clients.

A ‘risk’ refers to the possibility of an injury or other negative outcome occurring. A low risk

means a low likelihood of a negative outcome. A ‘hazard’ is a feature of a task or

environment that may lead to injury or harm to a carer or to a client.

Hazards

Hazard identification should be part of risk assessment to reduce the risk of injury to

carers. You must be aware of the hazards in your workplace so that the risks can be

managed by eliminating, isolating or minimising them.

Hazards related to people being supported

People who are difficult to move because of their size or condition.

A client’s ability to hear, see and understand, which may affect their mobility and

ability to cooperate.

Lack of understanding due to cognitive issues such as confusion and dementia, or

language and cultural differences.

Unpredictability of client when being moved.

Client anxiety and fear of moving or falling, which can limit cooperation.

Medical attachments to client, which may limit their ability to help.

Pain, which can affect a client’s ability to cooperate.


Hazards in the physical work environment

Slip, trip and fall hazards such as electrical cords, wires and wet or slippery floors.

Uneven work surfaces, such as steps.

Space limitations - small rooms with lots of equipment and clutter.

Inadequate space around beds and toilets for transfers.

Facility design inadequate for transfer tasks in the transfer area and for the

equipment required.

Inadequate lighting.

Hazards related to working hours and place

Staffing levels. Insufficient number of carers for moving and handling tasks for the

number of clients can result in increased work demands being placed on the existing

staff. For example, more transfer tasks (repetition) on each shift and long durations

can lead to fatigue and reduced work capacity, and to staff taking shortcuts and

following unsafe practices.

Extended workdays. More than eight hours work without a break increases the risk of

injury. This can occur when overtime becomes necessary because staff on the next

shift are suddenly not available, or staff are working regular 12 hour shifts.

Inadequate rest breaks. Not allowing enough time between people moving and

handling tasks can contribute to fatigue and overexertion. An example is busy work

schedules leading to missed breaks.

Working in isolation. For example when caring for a dependent person in their home,

a carer generally does not have the opportunity to call for assistance.

Hazards for carers using moving and handling techniques

Inadequate training. Carers are not trained in the task, or do not know how to use the

equipment properly.

Equipment not provided, not maintained adequately, not enough equipment, some

types of equipment not available, equipment outdated or obsolete.

Force - the amount of physical effort required to perform a task (such as pushing and

pulling) and to maintain control of equipment.

Repetition - performing the same movement or series of movements frequently

during the working day. Lack of variability can increase the load on body tissues and

muscles owing to a lack of changes in posture and the reduced chance of recovery.

Awkward positions that place stress on the body, such as leaning over a bed,

kneeling or twisting the trunk while moving a client, reaching away from the body or

over shoulder height for long periods and while exerting force.

Carer may be wearing inappropriate footwear and clothing.

Not having enough people to do the task.


Managing hazards

Take action to manage the hazard.

Can the hazard be eliminated?

If not, can it be isolated?

If it can’t be isolated, then it must be minimised.

Eliminating – getting rid of the hazard.

Isolating – protecting people from the hazard with barriers/signs.

Minimising – lessening the hazard.

Reporting hazards and incidents

Your organisation will have policies and procedures in place for reporting incidents,

accidents, hazards and unsafe equipment. You need to be aware of what you have to do.

Ask your supervisor to show you where the hazard identification forms are kept, and how

to fill them in.

When making a report, write the facts – what happened, where and when it happened,

who was involved. Do not include unrelated details.


Here is an example of a hazard identification and reporting form.

An injury, incident or

accident that happens in

the workplace must be

reported.

Here is an example of an

injury/accident/incident

report form.

You’ll find information on

equipment safety and

reporting forms for

equipment faults later

in this workbook.


Learning activity

For each of the four types of hazards describe two potential hazards

in your workplace. Describe what you would do to eliminate, isolate or

minimise them and how you would report them.

Hazards related to people being supported

1

2

Hazards in the physical work environment

1

2


Hazards related to working hours and place

1

2

Hazards for carers using moving and handling techniques

1

2


LITE =

Load

Individual

Task

Environment

Risk assessment

When assisting people to move, you must first do a risk assessment of the moving and

handling activity and any actual or potential risks. An example of a risk assessment tool

is LITE. The LITE principles can be applied to any moving task.

Applying the LITE principles will enable you to:

plan the task, check the environment, assess the risks

and identify hazards.

prepare for the task – minimise hazards, get any equipment,

prepare the people.

apply safe bio-mechanical principles of posture, position and

technique.

Load

Characteristics of the person being moved can affect the handling risk.

Consider age, gender, dependency, size, weight, diagnosis and disabilities, pain, fall risk,

ability to understand and cooperate, ability for independent movement, medical

attachments, moving and handling plan.

Individual

This relates to the capabilities and training of the support worker. For example their age,

fitness level, size, fatigue, knowledge and training.

Task

This relates to the nature of the task, ie what has to be done. It may require supporting a

person to sit up in bed or transfer to and use a mobility aid.

Consider the best handling method that will be needed, for example: lifting, pushing,

pulling, or carrying.

Environment

This relates to the work environment, the space available for moving and transferring, the

layout of the working area, the brightness of lighting and the type of flooring surface.

Before moving, check access ways are clear and that the destination is ready, for

example, the bathroom is unoccupied. Check for hazards, such as furniture in the way,

wet and/or slippery floors, uneven surfaces or steps, or tripping hazards like electrical

cords or loose mats. In a client’s home, additional tripping hazards may be children’s toys

and pets.


Assisting people

Make sure your clothing and footwear are appropriate for the task. Clothes should allow

free movement but have nothing loose that may get caught. Shoes should be non‑slip,

supportive and stable. If you have to remove your outside shoes in a client’s home, take

some clean house shoes with you. Tie up long hair and do not wear rings or bracelets.

Know your own capabilities and do not exceed them. Tell your manager if you need

training in the technique to be used. Talk to your manager or the moving and handling

adviser if you need advice on the techniques and equipment you should be using.

The person’s needs

You must follow the person’s service plan and/or moving and handling plan if they have

one. The plan will outline the support the person may need and how that support should

be given.

The equipment used is based on the individual’s needs and will be documented in their

plan. Make sure you know what equipment a person needs, what the equipment is used

for and how the equipment is to be used.

The length of time a person may use equipment can vary. For example, a person may

need a walker temporarily to regain mobility, while for another person they may always

need a walker to move around their home or go out.

Over time a person’s abilities and needs can change so the equipment they once used

may no longer be the best option for them. The equipment will be monitored to ensure it is

assisting the person and not restricting them.

The person’s plan will note any changes in the person’s ability and how they affect the use

of the equipment. If you become aware of any changes in the person’s abilities that are

not noted in the plan, you should inform your supervisor.

When you are supporting a person to move:

only do tasks that you are trained to do.

only use equipment you’ve been trained to use.

use the equipment correctly and safely.

do a risk assessment before you move the person.

follow the person’s moving and handling plan.

follow all your organisation’s policies and procedures.

follow the manufacturer’s user manuals and instructions.

evaluate the move once completed.

report faults promptly.


Preparing a person to move

Before a person is moved or assisted, you must explain to them what is going to happen

and how you are going to support them.

Think about the person and what might affect your ability to assist them safely.

Do they understand and will they cooperate?

Make sure their clothing and footwear is appropriate for moving.

Check if they have any medical attachments that need to be taken into account.

Remember to take any aids with them.

Before you move a person:

ask them how they feel today - they may want more or less support today than last

time you supported them.

tell them what you plan to do and what technique and equipment you will use.

show them the equipment if it is new to them and explain how it works.

explain to them what, if anything, is expected of them.

ask them if they have any questions, or would like a demonstration.

If more than one support worker is needed for moving or handling a person, it is important

to have a recognised leader. They will consult the person’s moving and handling plan,

check on the person’s capabilities, including mobility, cognitive ability and their need for

assistance.

The leader will coordinate the move and give instructions, like

“Ready.”

“Steady.”

Then an action word like stand, sit-up, move, roll, slide.

Get the person to rock gently forward on each word. If necessary, gently rock the person

backwards and forwards to build up momentum.

People must be treated at all times with dignity, respect and consideration for their

capabilities.

Make sure the person is comfortable during and after the move. Ask them for feedback.

This is a great way to learn about the effects of what you are doing and to get suggestions

for improvement in your moving technique. Always evaluate what you are doing and have

done.


Assistive equipment

Assistive equipment allows a person to do something they

need support to do or to assist them to do better something

that they can already do.

This can include shower and bath equipment and toileting

aids like raised toilet seats and a commode.

Furniture like handrails and grab handles and bars (also

known as monkey bars or bed poles) above the bed assist

the person with their positioning and mobility.

Canes, crutches and walkers also assist a person’s mobility.

Assistive equipment gives the person more control over tasks or activities, giving or

increasing independence and reducing the amount they need to rely on other people for

support.

It is helpful to know the normal sequence for an action, such as standing up or rolling over

in bed so that you can encourage the person to help. You can coach the person in their

movement, providing guidance.

Encourage normal actions and movement. Encouraging independent movement benefits

the person and makes the moving task safer. Help the person with any movements they

have difficulty with. Be adaptable when assisting them.

Where possible, promote independence. There is a continuum from dependent to

independent. You need to match the technique and/or level of assistance with the ability of

the person.

Dependent ________________________________________________Independent

mechanical 2 carers 1 carer assistive

assistance equipment


Mobility

Mobility is the ability to move or be moved freely and easily. It is a key aspect of a

person’s independence to be able to complete some tasks for themselves and to move

within their home and around their neighbourhood, such as to the shops or to the doctor.

A person may need your support with their mobility, for example:

to balance themselves and to stand.

to explain how to use their mobility aid.

to position their mobility aid where they can access and use it.

to transfer to their mobility aid, such as their walker or wheelchair.

Mobility aids include specialised assistive equipment that is used to help people:

to walk, especially to support speed and evenness of stride. For example, walking

frames and wheeled walkers.

to maintain an upright body posture, for example, walking sticks and canes.

to redistribute their weight when walking, from their legs to the arms of a walking

frame or cane as it is used for support.

to feel more confident, steady and balanced. For example, a walker or walking stick

may help the person feel as if they are less likely to fall.

Canes and walking sticks

A cane can help maintain mobility, as weight is transferred to the forearm.

A correct length cane will keep the person upright while providing support. A cane is

usually about half the person’s height. The top of the cane should reach the crease on the

underside of the person’s wrist. The elbow should be flexed at 15-20 degrees when

holding the cane while standing still.

The cane should be held using the hand that is on the same side as the stronger or good

leg. As we walk, we swing our hands as we move our legs. As we step out with our left

foot, we swing our right arm, and vice versa. Holding a cane in the hand opposite the

injury replicates the natural arm movement, allowing the hand and cane to absorb some of

the weight as the person walks forward with their bad leg.


Crutches

Crutches are needed if a person cannot put weight on a leg. Two crutches provide greater

stability than using one crutch.

Crutches are designed for either forearm or underarm use. The top of underarm crutches

should come to 2-3 cm below the armpit, and the crutches grip should be at the person’s

hip height.

To walk, the person should place the ‘feet’ of both crutches on the ground in front of them

by about 30cm, and lean forward slightly. Moving as though they are going to step on their

injured side, they need to shift their weight to the crutches and swing forward between the

crutches. They must come down on their uninjured leg, keeping their injured leg up, so

that no weight is placed on it.

To sit down, the person should hold both crutches in the hand on the good leg side, like a

long cane. Using the crutches for balance, the person should lower themselves down. To

stand up, the person should use the crutches for balance as they push themselves

upright.

Walkers

People who have difficulty balancing or are at risk of falling should use a walker. Walkers

may have no wheels, two wheels or four wheels. Walkers without wheels, which have to

be picked up and moved forward, are best if stability is a significant concern.

A two-wheeled walker is easy to push forward and is then safe from rolling as the person

steps forward. A four-wheeled walker moves easily and has brakes if stability is needed

only intermittently.

To fit a walker for height, get the person to step inside the walker. With their arms relaxed

at their side, the top of the walker should line up with the crease on the inside of the wrist.

With their hands on the grips, their elbows should be at an angle of 15 degrees. A well-

adjusted walker fits the person’s arms comfortably and reduces stress on their shoulders

and back as they use their walker.

If a walker is used for taking weight, the person pushes the walker forwards. Keeping the

walker still, the person places their first leg inside the walker, followed by the second leg,

keeping their back upright. They move the walker forward again and repeat the actions.

If the person uses the walker for balance, not for placing weight on it, then they can stand

inside it and walk as they normally would, guiding the walker in front of them.


Equipment used for positioning and mobility


Equipment for showering, bathing and toileting

The risk of falling while showering, especially on wet and/or slippery floors, can present

one of the greatest areas of concern for people. A person may need equipment to

support them.

The person may toilet independently with the use of assistive equipment, for example, a

raised toilet seat, or hand rails fixed to the wall that give extra support.


Learning activity

Name four items of assistive equipment and four items of moving

and handling equipment in your workplace and explain what they are

used for.

Equipment name What is the equipment used for?


Using normal movement patterns

In your role as a support worker you will assist people to move and to use assistive

equipment. Encourage normal actions and movement and coach the person in their

movement, providing guidance. These pictured techniques are from the ACC 2012

publication Moving and handling people: The New Zealand Guidelines. It is also online

and can be downloaded from the ACC website www.acc.co.nz

Handling belts

You may use a transfer or handling belt to assist a person to move to give you a secure

hold on the person. Make sure a layer of clothing is between the person’s skin and the belt

to avoid abrasion. Ensure the belt is securely fastened and cannot be easily undone

during use.

Handles on the belt are positioned so that the

support worker does not have to hold onto the

person’s clothing or directly onto their body.

Belts with padded handles are easier to grip

and increase security and control. Keep the

person as close as possible to you.

Support workers are advised not to place their full

hand through the handle of the belt as this will

prevent the release of their hold of the person in

the event of a sudden movement.

More than one caregiver may be needed. In most

cases the far handle should be used and with two

carers, the arms would be crossed.

Always transfer to the person’s strongest side. Use good bio-mechanical principles and a

rocking and pulling motion.

Handling belts should not be used for lifting people.

Handling belts can be used to provide support in walking. However, all manufacturers and

suppliers provide warnings regarding inappropriate use and advise carers to undertake a

specific risk assessment in respect of the weight bearing ability of the person and other

relevant factors.

http://www.acc.co.nz/


Repositioning a person

There are two basic techniques carers need to be familiar with.

Instruct the person to look

in the direction of the

move. This helps the

movement.

The lunge position is a

basic position for carers.

The lunge is not just a

position, but a movement.

You shift your whole body weight from one foot to another in the same plane. Using the

whole body increases strength and makes a move safer and easier.


Using a slide sheet

Always place a slide sheet underneath a bed sheet to protect the person’s skin.

Keep the edge of the slide sheet to the edge of the bed.

Roll the person on to their side.

Pull through the slide sheet, using the lunge position.


Sitting to standing

The chair height must allow the person to place their feet firmly on the ground, with their

hips and legs at right angles. The chair will ideally have arm rests, but if it doesn’t, the

person can push on the edge of the chair.

Use instructions, saying “ready, steady, stand” and get the person to rock gently forward

on each word. If necessary, gently rock the person backwards and forwards to build up

momentum.

Standing to sitting

Have the person stand with the back of their legs against the chair or bed.

Ask them to keep their head up, to lean forward slightly and put their hands on the chair

armrests or on the edge of the chair or bed. Tell them to slowly sit down with their bottom

as far back in the chair or on the bed as possible. The person then needs to straighten up,

with maybe a slight adjustment or repositioning for comfort.


Before repositioning a person in bed, make sure it is the correct height (if adjustable). The

mattress should be at your hip level, so your knuckles can rest on the bed.

If a person is going to stand up, lower the bed so that their feet will be on the floor when

they are sitting on the bed.


Sitting to sitting transfers


A small transfer board can be used to

bridge gaps between seats.

These boards can be straight or

curved. Curved transfer boards make

it easier to transfer around fixed

armrests.

If possible, have the surface to which

the person is being transferred slightly

lower. This makes it easier for the

person to move. You may also need to

use a slide sheet.


Moving in bed

A person can use an overhead pole or

monkey bar to move themselves in bed,

provided they have upper arm strength.

The person should firmly pull on the bar,

bend their knees and lift their buttocks

off the bed, while pushing their feet into

the bed. This moves their body up the

bed.


An excellent resource is the ACC videos on many of these procedures.

Go to www.acc.co.nz and search for the ‘moving and handling people’ videos.


Assisting a person who has fallen

When a person has fallen the first thing you need to do is check the area for anything that

may present a hazard. Ask the person if he or she is having any trouble breathing or if

anything hurts. In the majority of falls, the person will be able to respond to you.

If the person appears to be unwell or injured, you will need to call for medical assistance. If

you are unsure, follow the policies and procedures of your organisation which may include

contacting your supervisor.

Signs that a person may be injured

Signs that a person is injured or unwell and needs medical assistance urgently include:

severe pain.

difficulty breathing.

difficulty moving.

confusion/drowsiness.

severe bruising or bleeding.

vomiting.

seizure.

clear fluid or blood coming from the nose, ears or mouth.

unusual position or shape of limb.

unusual behaviour.

If the person is injured

If you suspect the person is injured or unwell, do not try to move them. Make them as

comfortable as possible, keep them warm, and stay with them to wait for medical

assistance to arrive.

Follow any instructions given by the emergency services. For example, you may be asked

to put pressure on a cut to stop severe bleeding.

If the person is not injured

A person who appears to be uninjured may be able to get up independently. You may be

able to coach a person into each step and assist with getting up, but do not try and lift the

person’s whole weight because you are very likely to injure your back by doing so.

Stop, at any point, if the person feels unable to move, dizzy or if pain levels increase.

Assist the person into a comfortable position and call for help.

The next page shows the sequence of steps for a person to get up from a fall.


A person who has fallen and is not injured may be able to get up independently by using

this method.

1 Roll on to side and then push up 2 Move into a position on hands

on one arm to a side sitting position. and knees and crawl to a chair.

3 Put closest hand on the chair 4 Lift your body by pushing with outside

and bring outside leg up. hand on knee and inside hand on chair.

5 Pivot body around to sit

on the chair.

Trying to catch a person who is

falling is very dangerous.

Someone who is 60 kg in weight

has the force of more than

480 kg by the time they reach the

floor, which is far too heavy to

catch safely.

Calculated by physiotherapist and ergonomist Dr Mike Fray


Caring for equipment

When using equipment it is important to ensure the device is used correctly and for what it

was originally designed. You should familiarise yourself with the manufacturer’s user

manuals and follow your organisation’s policies and procedures when using equipment.

This is to ensure the person’s safety and comfort and to prolong the life of the equipment.

The correct care for equipment is extremely important. If a device is damaged it may mean

the person is without it for a period of time while repairs are undertaken, or the person

maybe unsafe while using the equipment. This can have a dramatic impact on their

wellbeing as they may be unable to do certain tasks or activities that the device enables

them to do.

Visual checks

You should inspect all equipment before you use it. There should be no visible damage,

contamination, soiling or leakage and there should be no rough or sharp edges. Fabric

handling aids such as slide sheets and hoist slings should be inspected for tears, loose

stitching, soiling and dampness.

Where relevant, check the equipment has a current certificate of fitness. The designated

safe working load (SWL) is shown on the equipment and the weight of the person must

not exceed the SWL.

For electrical items, which can cause fires or electrical shocks if damaged, you should:

check the cord and plug for fraying and cracks.

keep the plug and cord away from heat sources.

check battery has enough charge and the location of a spare battery is known.

never use the equipment if your hands are wet or you are standing in water.

turn equipment off before unplugging it.

For equipment that is on wheels ensure that:

the brakes work and that you can lock and unlock them.

the wheels move freely and the tyres are not loose or flat.

the spokes are all intact and that none are damaged and broken.


Equipment safety and reporting faults

If equipment is damaged or faulty it may need to be replaced or returned to the

manufacturer. You should always report broken equipment to your supervisor.

You may need to place a ‘Do Not Use’ tag on the item. You’ll need to know where to put

the faulty equipment and you may need to fill out an equipment fault report.

Your organisation will have its own policies and procedures relating to reporting faulty

equipment. You should familiarise yourself with it, where equipment fault report forms are

kept and where faulty equipment is put.

You need to check your organisation’s policies and procedures to see what form is used.

Try filling the form out and show the form to your supervisor to ensure you can complete

the form according to requirements.

Here is a typical equipment fault report form.


Maintenance checks

Periodic maintenance checks should be carried out every few months. This is more

extensive than a visual check and equipment is cleaned and decontaminated in line with

infection control procedures.

Scheduled maintenance checks are in line with the manufacturer’s recommendations and

according to how often the equipment is used. Maintenance covers wear and tear,

defects, replacement of worn or damaged parts, and cleaning and decontamination.

For mechanical or electrical equipment, check battery capacity, lubrication and adjustment

if needed and renew the fitness certificate. The equipment service schedule should then

be updated.


My notes


Completion and assessment

Congratulations!

You have come to the end of the workbook. Please check over all the activities in this

workbook to make sure you have completed them.

Your assessment is next.

You need to complete the assessment successfully to be credited with this unit standard.

Acknowledgements

Careerforce thanks the people who have contributed to this workbook by:

researching and validating content.

providing advice and expertise.

testing the activities.

sharing personal experiences.

appearing in photographs.

The images contained in these workbooks are visual illustrations only and are not representative of

actual events or personal circumstances. Careerforce thanks ACC for permission to use images from

their 2012 publication Moving and handling people: The New Zealand Guidelines.

Creative Commons

This work is licenced under a Creative Commons Attribution-NonCommercial Licence.

You are free to copy, distribute and transmit the work and to adapt the work. You must

attribute Careerforce as the author. You may not use this work for commercial purposes.

For more information contact Careerforce www.careerforce.org.nz

workbook - careerforce home · do the learning activities included throughout this workbook. write...

Documents