Course name - Law and Management in Occupational Health and Safety
Patients in the Perioperative environment are often required to be repositioned on the operating table and most of these patients have had a regional or general anaesthetic, making it impossible for them (the patient) to assist staff in that repositioning. The added risk in any repositioning is loss or damage to the patients’ airway, and maintaining the patients’ musculoskeletal alignment, so as to not cause any damage to nerves, muscles, limbs, spine and or neck etc. The repositioning should be assessed to determine if it can be done manually or by some assistive devices. During the surgery it may be necessary to lift the patients’ legs, arms or head to prepare the area for sterile field draping, which may result in nursing or theatre support staff at risk of musculoskeletal injuries, and in situations where bariatric patients (over 100kgs) the manual handling staff may need limb holding devices. Prior to surgery, the anaesthetic nurse, anaesthetist, surgeon, theatre support technician or orderly should plan and collaborate regarding positioning, support and moving devices as well as the technique which will be utilised in the moving and repositioning of the patient – during and after the procedure when the patient will be transferred on to another bed for the post-operative recovery period. When transferring a patient from patient bed to operating table, it is important to have enough staff to assist with the transfer and to use the correctly placed support devices as well as using good body mechanics (ergonomic techniques). When patients are obese it may be necessary to use soft gel straps to support the patients legs so that they do not move off the operating table and cause debilitating and painful nerve damage. This project is to develop a Safety Management Plan to implement a safe practical way to identify, assess and control risks in the Perioperative environment (Operating Theatre) specifically relating to the lateral transfer and or movement of patients requiring surgery at this hospital facility.
Perioperative Manual Handling
Safety Management Plan
Perioperative Manual Handling
Safety Management Plan
Using the 5 step process in the Queensland Government risk assessment plan the following matrix is how the Perioperative unit could benefit from experienced, safety motivated and interested staff could act as agents for change and safety in a more deliberate and focussed way to reduce the hazard of musculoskeletal injuries to staff especially in the task of laterally transferring patients from the operating table to the postoperative bed. These patients are usually unconscious and unable to assist or communicate their needs and concerns at this time.
Perioperative Safety Management – Risk Identification and Controls
| Step 1
| Look at the Hazard * Musculoskeletal disorders in nursing staff and orderlies when undertaking a lateral or horizontal transfer of unconscious patient from operating table to post-operative bed
| How to look for HazardsKnowledge and Understanding Manual Handling Policies * Manual Tasks Involving the Handling of People Code of Practice 2001 * Workplace Health and Safety Act 1995 * Workplace Health and Safety Regulation 2008 * Manual Handling Training - especially regarding unconscious patients
| What to look for * Practices that are causing discomfort either for the member of staff or patient * Practices that are likely to cause nerve or musculoskeletal injuries – shoulder, fingers, wrist, forearm, back, neck, sciatic nerve, knees, ankles
| Step 2
| Decide who might be harmed and how * Nursing Staff * Orderlies * Anaesthetists * Surgeons/Assistants * Recovery Staff
| Assess the riskHow might someone be harmed * Injury to patient when moving the unconscious patient from operating bed to recovery bed with a supported airway * Lateral or sideways movement...
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