Risk assessment – identifying the best options

Carole Johnson

Freelance Manual Handling Adviser

Evidence

• Well designed meta analysis of >1 randomised control study

• Randomised control study• Well designed control study without

randomisation• Well designed non experimental control studies

(correlational and case studies)• Expert committee report, consensus conference,

clinical experience of respected authorities

Scottish Intercollegiate Guidelines Network

Aim

To inspire us to make our manual handling decisions making more measurable.

Evidence

• What were you doing 15 years ago?

• What decisions were you making?

• Where did you get your evidence from?

Decision Making

• The Question

• The Evidence

• Assessing the Evidence

• Have I missed anything?

• Making the Decision

• Evaluation

DIY Assessment Template

Encouraging Good Practice

The Tools • Effort (Handler)• Risk Matrix (person)• Risk Matrix (handler)• Body map• Considerations• Alternatives

The Tools – Child Ability (FIM)

The Tools – Skill (Drefus)

The Tools – Comfort

The Tools – Effort

The Tools – Risk Matrix

The Tools – Body Map

Case Study - Empowering Staff

• Andrew• Child size E• FIM (for personal care transfers) 1• Anti-spasm sling supplied by OT but

previously used ‘walking harness’ type sling

• Single (angled) overhead hoist with delayed start/stop and tensioner

• New staff

Andrew

• Task – transfer from wheelchair to height adjustable change bed

• Previous manual handling risk assessment completed, no problems reported by staff

• Andrew distressed in new class – now taking 5 staff to transfer, leaving only one person in the class

Assessment Nr 2:3rd September 2012

Assessment Nr 1:20th April 2012

Drivers - pain

Drivers – number of staff

Drivers - time

Drivers – Effort

Issues

The Date….

Issues

Issues

Julie

Julie, age 5 recent diagnosis (within last 18 months) of a muscular dystrophy

Underweight (16 kg)

94 cm

Shuffles around home on her bottom

Head and trunk control if remains in the mid line.

The Question

How will Julie transfer from the floor to her wheelchair?

‘Evidence’

• Manual Handling of Children (NBE 2011)

• The HOP’s (BackCare 2005, 2011)

• Local Policies

• Manual Handling Adviser

• Colleagues

Collecting your own evidence

• Comparison of options

Comparison

• Repeated 20 + times per day

• Needs to encourage independence

Comparison

Time (secs)

Effort

(Borg)

Skill

(Dreyfus)

Nr Handlers

Comfort (1 – 10)

Risk

(Matrix)

Indepen-dence

Scoop <60 16 Ab 1 6 No

Top & tail

<60 14 Ab 2 4 No

Lift Sling

> 120 10 C 2 7 No

ELK > 120 9 C 2 8 Yes

Stand Up

60 - 120 8 C 1 10 Yes

Hoist >120 16 C 2 7 No

Comparison

Time (secs)

Effort

(Borg)

Skill

(Dreyfus)

Nr Handlers

Comfort (1 – 10)

Risk

(Matrix)

Indepen-dence

Scoop <60 16 Ab 1 6 No

Top & tail

<60 14 Ab 2 4 No

Lift Sling

> 120 10 C 2 7 No

ELK > 120 9 C 2 8 Yes

Stand Up

60 - 120 8 C 1 10 Yes

Hoist >120 16 C 2 7 No

Comparison

Time (secs)

Effort

(Borg)

Skill

(Dreyfus)

Nr Handlers

Comfort (1 – 10)

Risk

(Matrix)

Indepen-dence

Scoop <60 16 Ab 1 6 No

Top & tail

<60 14 Ab 2 4 No

Lift Sling

> 120 10 C 2 7 No

ELK > 120 9 C 2 8 Yes

Stand Up

60 - 120 8 C 1 10 Yes

Hoist >120 16 C 2 7 No

Comparison

Time (secs)

Effort

(Borg)

Skill

(Dreyfus)

Nr Handlers

Comfort (1 – 10)

Risk

(Matrix)

Indepen-dence

Scoop <60 16 Ab 1 6 No

Top & tail

<60 14 Ab 2 4 No

Lift Sling

> 120 10 C 2 7 No

ELK > 120 9 C 2 8 Yes

Stand Up

60 - 120 8 C 1 10 Yes

Hoist >120 16 C 2 7 No

References

Manual Handling of Children, NBE 2011 Handling of People, (5th Edition) BackCare 2005

Handling of People, (6th Edition) BackCare 2011 Handle with Care, Scottish Commission for Children and Young People

2008

Moving And Handling SEN Magazine July 2009

Back Care - Looking after the Workforce PIR Magazine April 2011