Question

The RN observes a co-worker attempting to move an obese client from the bed to chair without assistance or the use of lifting equipment.

Initial Discussion Post:

Discuss how you would intervene in this situation.

What teaching and recommendations wold you provide to your co-worker?

Discuss the implications of musculoskeletal injuries on healthcare workers and healthcare facilities.

Answer 1

Ans) Intervention for shifting an obese person to chair:

Patient safety is the main concern when moving patients from bed.This transfer often requires the patient's help, so clear communication is essential & assistance of two people will be required.

- When patients are weak, brace your knees against theirs to keep their legs from buckling. Also, transfer toward patient's stronger side if possible.

Teaching & recommendation to the coworker:

1) Sit the patient up:

• Position and lock the wheelchair close to the bed. Remove the armrest nearest to the bed, and swing away both leg rests.
• Help the patient turn onto his or her side, facing the wheelchair.
• Put an arm under the patient's neck with your hand supporting the shoulder blade; put your other hand under the knees.
• Swing the patient's legs over the edge of the bed, helping the patient to sit up.

Step 2. Stand the patient up:

• Have the patient scoot to the edge of the bed.
• Put your arms around the patient's chest, and clasp your hands behind his or her back. Or, you may also use a transfer belt to provide a firm handhold.
• Supporting the leg farthest from the wheelchair between your legs, lean back, shift your weight, and lift.

Step 3. Pivot toward chair

• Have the patient pivot toward the chair, as you continue to clasp your hands around the patient.
• A helper can support the wheelchair or patient from behind.

Step 4. Sit the patient down

• As the patient bends toward you, bend your knees and lower the patient into the back of the wheelchair.
• A helper may position the patient's buttocks and support the chair.

Musculoskeletal disorders involve injuries to:
-muscles
-nerves
-tendons and ligaments
-joints
-cartilage

- These are the most prevalent, most expensive and most preventable workplace injuries in the US. It is the biggest healthcare injury and is common in other jobs.

- Exposure to these workplace risk factors puts workers at a higher level of MSD risk.

- It's common sense: high task repetition, forceful exertions and repetitive/sustained awkward postures fatigue the worker's body beyond their ability to recover, leading to a musculoskeletal imbalance and eventually an MSD.

Prevention of musculoskeletal injuries:

1. Improved Work Techniques. Figure out the best way to complete a job by keeping the goal of decreasing your risk factors in mind. ...
2. Proper Stretching. Suggest a work site stretch and flex program. ...
3. Personal Protective Equipment (PPE) ...
4. Better tools and resources. ...
5. Training

Treatment for Musculoskeletal injury:

1. Physical or occupational therapy.
2. Using a splint to immobilize the affected joint and allow healing.
3. Using heat or cold.
4. Reducing workload and increasing rest.
5. Reducing stress through relaxation and biofeedback techniques.
6. Acupuncture or acupressure.