How does your organisation’s resident handling measure up?

In late 2013, Worksafe Victoria released the Aged Care Facility Resident Handling Assessment tool.  This tool was designed to be used specifically by Residential Care facilities to determine how well they are meeting safe patient handling work practices, to identify gaps in their work processes, and to measure continuous improvement.  It is a self-audit system, allowing for comparison within the same workplace over time or even between facilities operating within the same organisation.

The assessment tool outlines a seven part checklist including:
Section 1. Resident handling aids and equipment

Section 2. Resident factors

Section 3. Worker factors

Section 4. Building and work environment

Section 5. Work organisation

Section 6. Workplace culture

Section 7. Evaluation of resident handling system effectiveness.

Each of these sections contains a number of sub-sections, each with their own criteria.  In order for organisations to score themselves, they must be able to meet and provide evidence for meeting the requirements of each sub-section within a level.  Dependent on their outcomes, an organisation may meet Minimal Standards (Level 1), Improved Standards (Level 2) or Best Practice Level (Level 3).

To access the full assessment tool, click here.

In addition to the provision and maintenance of suitable equipment and appropriate assessment of resident mobility status, there are a number of areas to consider when looking at Manual handling training, risk management and cultural change within the workplace.

The first of these relates to Section 3.1 – Safe Resident handling and equipment use.  At a minimum level, all workers caring for residents (including permanent, casual and agency staff) should be provided with face-to-face manual handling training, initially at their induction and then with regular refresher programs.   This training needs to be provided by a trainer and assessor specifically skilled in the area, with online systems not considered an adequate replacement.  To achieve improved levels, competency assessments should be undertaken, and best practice requires competency outcomes to be documented at least annually and peer support/buddy systems to be in place to promote and reinforce safe work practices on the floor.

When looking at other factors relating to the worker, Section 3.2 – Worker handling capacity and needs – specifically has a risk management focus.  This section takes into account the need to allow workers opportunities to vary their handling load in the care environment.  At a minimum level, worker to resident ratios must be based on actual resident care needs and not be budget driven.  Improved and Best practice levels encourage consultation with staff to identify special needs and to develop management systems for resident handling issues, pairing of compatible workers to optimise resident handling and increase safety and encouragement of staff by the organisation to be fit for work.

Safety with relation to handling of residents also extends to buildings and work environments.  Issues of space, facility design and layout, flooring and equipment storage all play a critical role.  In addition, Section 4.4 – Facilities for residents with special needs – relates to the risks associated with special needs clients, such as those with bariatric conditions or cognitive and/or behavioural conditions.  A key factor in managing special needs clients is the commitment of organisations not to admit these types of residents until specific risk management processes are in place to adequately deal with any increased risks to staff.

Cultural change in the work environment cannot happen unless there is first a commitment from management.  Section 5.1 – Management commitment and resource allocation – discusses management’s responsibilities with relation to policy development and allocation of resources to reduce manual handling risks.  At a minimum, this may include allocating sufficient budget for necessary equipment purchases and maintenance, staffing, and training programs on an annual basis.  In addition, management must be committed to consulting with workers and having a risk management system in place, which includes, at its core, incident reporting and investigation.

Management must also be committed to specifically looking after their agency and casual staff, as these types of workers are more likely to sustain an injury at work (Refer Section 5.3 – Short term workers).  At a minimum, these workers must have adequate induction and training programs organised by the organisation, and ideally only be used for work that they specifically have experience in (for example, care of a bariatric client).  At an improved level, management is responsible for organising work systems where these casual staff are buddied with more experienced staff with the specific skills, and best practice organisations would have a bank of experienced casual staff to assist.

Finally, cultural change can only occur when work practices are monitored, and workers are empowered and encouraged to comply with good work practices and report poor practice.  A safety culture really relies on a top-down approach.  The more people within organisations that are on-board with safety, the more successful the programs.

It’s time we took a serious look at our manual handling practices as an industry.  It’s time we all aim for best practice, not just doing the bare minimum!  Everyone from the senior management, to the workers, to the residents and their families will benefit!

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