Table Of ContentErgonomics & Human Factors M Patient Handling in
e
n
o
“… provides an extensive and comprehensive description of the evidence-based n
MAPO INDEX that will allow not only trained ergonomists and biomechanists the i • B
ability to conduct a thorough patient handling risk assessment but many and varied at the Healthcare Sector
t
e
healthcare professionals as well. … the level of detail found in the text facilitates v
i •
intervention implementation and maintenance successes.” C
a
—Mary W. Matz MSPH, CPE, CSPHP, Patient Care Ergonomic Solutions, LLC ir
o
li A Guide for Risk Management with MAPO Methodology
“The main strength of this book is its comprehensiveness in addressing the
P (Movement and Assistance of Hospital Patients)
important problem of injuries suffered by healthcare workers due to manual patient
a
handling. … much more than a list of recommendations for safe patient handling t
i
but instead presents a system that any healthcare facility or institution can use to e
systematically assess their facilities and practices for patient handling and design n
t
improved systems for such activity.”
H
—Robert R. Fox Ph.D., CPE, Chair, US TAG to ISO TC159/SC3 Anthropometry
and Biomechanics a
n
d
Hospital staff and caregivers are regularly exposed to biomechanical overload
l
risk, particularly at spine and shoulder level—a risk factor that will continue to rise i
n
with the progressive aging of the population. Patient Handling in the Healthcare g
Sector: A Guide for Risk Management with MAPO Methodology (Movement
i
and Assistance of Hospital Patients) details the analysis of patient handling risk n
using the MAPO method in different areas of healthcare and helps you develop
t
h
strategies to mitigate them.
e
Focusing on the organization of work, this approach gives you the tools to: H
e
• Rapidly analyze the problem
a
• Rapidly identify solutions l
t
• Effectively monitor the results of preventive actions h
c
a
One of the special features of this approach is that it employs tools that allow you
r
to allocate financial resources to estimate what investments are needed to achieve e
specific results. This means taking the decision-making process out of the hands S
of ergonomics experts and putting it into those of healthcare facility administrators. e
c
t
o
K22094 r
6000 Broken Sound Parkway, NW
Suite 300, Boca Raton, FL 33487 ISBN: 978-1-4822-1718-6 Olga Menoni • Natale Battevi • Silvia Cairoli
711 Third Avenue 90000
an informa business New York, NY 10017
2 Park Square, Milton Park
www.crcpress.com Abingdon, Oxon OX14 4RN, UK
9 781482 217186
w w w. c r c p r e s s . c o m
K22094 cvr mech.indd 1 7/30/14 12:10 PM
Patient Handling in
the Healthcare Sector
A Guide for Risk Management with
MAPO Methodology (Movement and
Assistance of Hospital Patients)
Patient Handling in
the Healthcare Sector
A Guide for Risk Management with
MAPO Methodology (Movement and
Assistance of Hospital Patients)
Olga Menoni • Natale Battevi • Silvia Cairoli
Parts of this book were previously published in Italian: The MAPO Method for the Analysis and Prevention of Risk
from Handling Patients; published by FrancoAngeli s.r.l., Milano, Italy.
CRC Press
Taylor & Francis Group
6000 Broken Sound Parkway NW, Suite 300
Boca Raton, FL 33487-2742
© 2015 by Taylor & Francis Group, LLC
CRC Press is an imprint of Taylor & Francis Group, an Informa business
No claim to original U.S. Government works
Version Date: 20140617
International Standard Book Number-13: 978-1-4822-1719-3 (eBook - PDF)
This book contains information obtained from authentic and highly regarded sources. Reasonable efforts have been
made to publish reliable data and information, but the author and publisher cannot assume responsibility for the
validity of all materials or the consequences of their use. The authors and publishers have attempted to trace the
copyright holders of all material reproduced in this publication and apologize to copyright holders if permission to
publish in this form has not been obtained. If any copyright material has not been acknowledged please write and let
us know so we may rectify in any future reprint.
Except as permitted under U.S. Copyright Law, no part of this book may be reprinted, reproduced, transmitted,
or utilized in any form by any electronic, mechanical, or other means, now known or hereafter invented, includ-
ing photocopying, microfilming, and recording, or in any information storage or retrieval system, without written
permission from the publishers.
For permission to photocopy or use material electronically from this work, please access www.copyright.com
(http://www.copyright.com/) or contact the Copyright Clearance Center, Inc. (CCC), 222 Rosewood Drive, Danvers,
MA 01923, 978-750-8400. CCC is a not-for-profit organization that provides licenses and registration for a variety
of users. For organizations that have been granted a photocopy license by the CCC, a separate system of payment
has been arranged.
Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for
identification and explanation without intent to infringe.
Visit the Taylor & Francis Web site at
http://www.taylorandfrancis.com
and the CRC Press Web site at
http://www.crcpress.com
Contents
Preface.......................................................................................................................ix
Acknowledgments .....................................................................................................xi
The Authors ...........................................................................................................xiii
Chapter 2 A Review of Work- Related MSDs in Caregivers .................................5
2.1 Introduction ...............................................................................5
2.2 Definitions .................................................................................6
2.3 A Brief Overview of the Pathogenesis ......................................7
2.3.1 Risk Factors ..................................................................8
2.4 Magnitude of the Problem .......................................................10
2.5 Epidemiological Studies on Clinical Effects among
Healthcare Workers Assigned to Manual Patient-
Handling Tasks ........................................................................11
2.5.1 The International Experience .....................................11
2.5.2 The Italian Experience ...............................................12
2.6 Conclusions ..............................................................................14
Chapter 3 Manual Handling in the Healthcare Sector: The International
Approach to Risk Assessment ............................................................15
3.1 Introduction .............................................................................15
3.2 Risk Assessment Methods in the International Literature ......16
3.3 Guidelines for the Prevention of Risk due to Patient
Handling ..................................................................................16
3.4 ISO- CEN 12296 Technical Report ..........................................18
Chapter 4 Manual Patient- Handling Risks: Occupational Biomechanics
(Biomechanical Hazards of Manual Patient Handling) .....................25
4.1 Introduction .............................................................................25
4.2 The Study of Occupational Biomechanics ..............................25
4.3 Occupational Biomechanics Studies in Manual Patient
Handling ..................................................................................28
Chapter 5 Methods and Criteria for Analyzing Manual Patient Handling
by Healthcare Workers .......................................................................33
5.1 Introduction .............................................................................33
5.2 Organizational Analysis ..........................................................35
v
vi Contents
5.2.1 Patient- Handling Operators ........................................35
5.2.2 Description and Number of Dependent Patients ........36
5.2.3 Description of Operator Training ...............................39
5.2.4 Definition of Patient- Handling Tasks .........................40
5.3 Analysis of Patient- Handling Devices .....................................43
5.3.1 Description of Wheelchairs ........................................44
5.4 Environmental Assessment .....................................................46
5.4.1 Bathrooms ..................................................................46
5.4.2 Bathrooms and Toilets ................................................47
5.4.3 Patient Rooms .............................................................47
5.4.4 Description of Patient Beds ........................................49
5.5 Criteria for Defining the Specific MAPO Index of Wards ......50
5.5.1 Value of the Lifting Devices Factor (LF) ...................51
5.5.2 Value of the Minor Aids Factor (AF) .........................52
5.5.3 Value of the Wheelchair Factor (WF) ........................52
5.5.4 Value of the Environmental Factor (EF) ....................53
5.5.5 Value of the Training Factor (TF) ..............................53
5.6 Characteristics of Italian Extended Care Facilities .................54
5.7 MAPO Risk Estimation and Screening ..................................55
5.8 Ward Characteristics with Respect to Different Shift
Schedules .................................................................................56
6.1 Introduction .............................................................................71
6.2 Results and Description of Exposure Levels in Study Wards ...73
6.3 Relationship between MAPO Exposure Index and Acute
Low- Back Pain in the Previous 12 Months .............................77
6.4 MAPO Screening Method: Validation Study ..........................79
6.4.1 Results and Description of Exposure Levels in
Study Wards ...............................................................81
6.4.2 Relationship between the MAPO Screening
Index and Acute Low- Back Pain during the
Previous 12 Months ....................................................81
6.5 Reference Values .....................................................................83
Chapter 7 Analysis of Patient- Handling Tasks in Operating Rooms ..................85
7.1 Introduction .............................................................................85
7.2 Data Collection Protocol .........................................................85
7.2.1 Operators Involved in Patient- Handling Activities ....86
7.2.2 Description and Number of Surgical Procedures ......87
7.2.3 Description and Quantification of Handling
Maneuvers ..................................................................88
7.2.3.1 Example of Description and
Quantification of Disabled- Patient-
Handling Tasks ...........................................88
Contents vii
7.2.4 Description of Operator Training ...............................89
7.3 On- Site Inspection ...................................................................90
7.3.1 Analysis of Patient- Handling Devices .......................90
7.3.2 Adequacy of the Environment....................................91
7.3.3 Example of On- Site Inspection: Description
of Equipment and Environment/ Furnishings .............92
7.4 Estimated Risk Exposure in Surgical Unit and Summary
of Risk Factors .........................................................................92
7.4.1 Equipment Factor .......................................................94
7.4.2 Stretcher Factor, Environment Factor ........................94
7.4.3 Training Factor ...........................................................95
Chapter 8 Analysis of Outpatient Services and Day Hospital ..........................101
8.1 Introduction ...........................................................................101
8.2 Data Collection Sheet: Organizational Aspects ....................101
8.2.1 Quantification of the Average Number of NC and
PC Patients ...............................................................103
8.2.2 Description and Quantification of Disabled
Patient- Handling Tasks ............................................103
8.2.2.1 Example of Quantification of Lifting
Maneuvers .................................................104
8.3 Description of Patient- Handling Assistive Devices ..............106
8.4 Adequacy of Environment and Furnishings ..........................107
8.5 Assessment of MPH Risk Exposure in Outpatient
Services: Summary and Criteria for Estimating Exposure ...108
Chapter 9 Emergency Department: Setting Up Preventive Strategies for
Manual Patient Handling .................................................................117
9.1 Presentation ...........................................................................117
9.2 Information Gathering: The Data Collection Sheet ..............118
9.2.1 Organizational Aspects ............................................118
9.2.2 On- Site Inspection: Description of Patient-
Handling Equipment ................................................119
9.2.3 On- Site Inspection: Assessment of Space and
Furnishings ...............................................................120
9.3 Risk Exposure Assessment: Final Overview .........................121
Chapter 10 Procedures and Tools for Choosing Adequate Equipment ..............127
10.1 Introduction ...........................................................................127
10.2 Approaches to Choosing Adequate Lifting Aids ..................129
10.3 Approaches to Choosing Height- Adjustable Stretchers.........131
10.4 Approaches to Choosing Patient Beds...................................132
viii Contents
10.5 Approaches to Choosing Minor Aids ....................................132
10.6 Approaches to Choosing Wheelchairs ..................................134
10.7 Approaches to Choosing Patient Washing Aids ....................134
Chapter 11 Definition and Management of Preventive Planning .......................145
11.1 Introduction ...........................................................................145
11.2 Approaches to Staff Training ................................................146
11.3 Testing the Effectiveness of Preventive Strategies ................147
11.3.1 Mapping Risk in a Hospital: Examples
of Procedures and Applications ...............................148
11.4 Other Effectiveness- Testing Tools .........................................149
Chapter 12 Examples of Manual Patient- Handling Risk Assessment
in Various Wards ..............................................................................155
References .............................................................................................................189
