ISO Technical Report Summary

The International Organization for Standardization (ISO) is made up of 163 national standards institutes worldwide that contribute towards the publication of International Standards.

In 2012, ISO published a technical report titled “ISO/TR 12296:2012 Ergonomics – Manual handling of people in the healthcare sector.”  This technical report was written to provide information and guidance for those working in the healthcare sector, with its main focus on providing an overview of evidence based practice methods used to assess and manage risks associated with manual handling of people.

The technical report recommendations are separated into the following areas of concern:

  • Risk assessment and management
  • Work organisation
  • Aids and equipment
  • Care environment
  • Education and training
  • Evaluation of interventions

The full technical report is available for purchase at the ISO website and a full edited summary of the report is available on the ArjoHuntleigh website.



When assessing the risks associated with manual handling of people, it is necessary to understand that these risks can come from a variety of sources, including the number of staff available to provide care, their experience and training and the nature of the people being handled.

Risk assessment is the common strategy used to prevent injury to caregivers and patients.  It involves a systematic approach to hazard identification and risk reduction and evaluation.  The report specifically discusses different methods used to quantify risk, including Dortmund Approach, MAPO index, PTAI and Care Thermometer.


Organisations need to develop and implement appropriate patient handling policies and procedures in order to promote a culture of safety.  Specifically, there needs to be clear commitment and accountability from management staff, including financial commitment, and the provision of appropriate staff to manage the specific patient handling requirements.  This may mean providing mentors, peer support and ensuring adequate staff to patient ratios.


Appropriate equipment needs to be available for safe patient handling to take place.  This both improves care and reduces associated handling risks.  Aids and equipment may include: beds, slings and hoists, slide sheets and wheelchairs.

Tools for selection of aids and assistance requirements are discussed, as are ways to determine adequate equipment requirements for facilities.


The environment in which care is given can impact significantly on manual handling risks.  Lack of space could mean that equipment cannot be used or postures are poor.  In addition, the report discusses risks associated with flooring, slopes and steps in care environments.


Training of staff in safer manual handling must be part of the overall risk management approach.  For training to be effective, the following points were considered best practice:

  • Training of all care staff, including management
  • Availability of equipment during training
  • Peer support on the floor to reinforce good practice
  • Training must include theory and practical components with clear competencies to be assessed that meet the learning needs of the staff
  • Sufficient time must be allocated to allow staff to practice during training
  • Timing of training for new and old staff


When evaluating how effective risk management strategies have been, the report discusses measuring staff competency and compliance (can they do their job and will they follow policy), physical and subjective outcomes for the patient being handled and also discusses comparing and evaluating different management strategies using the Fray and Highett Intervention Evaluation Tool.

Key things to take away from the report:

The culture of manual handling of patients needs to change for the better.  This can only be achieved if everyone involved works together and follows the recommendations.



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