Back Safety and Ergonomics

As a healthcare and hospital worker, you spend much of the day lifting and moving items or people. It is not an easy job! Using the right movements can help protect your back and prevent an injury.

Back pain is a familiar complaint and is common among health care workers who lift heavy objects and move patients. Back pain IS avoidable and doesn’t have to be “part of the job!”

Improper lifting often leads to unnecessary stress on the back muscles which can cause an injury. Once the back is injured, re-injury is much more likely to occur. Protecting your back means working SMARTER and not HARDER. Learning to move people and objects efficiently reduces the risk of injury.

Understanding Your Back Understanding the anatomy of the back can help keep the spine’s three natural curves balanced.

Poor posture can create problems by destroying the balance of the spine’s natural curves. The strain on the muscles adds stress to the spine which endangers the discs. Over time, the disc can rupture. A disc rupture causes more problems as nerves are irritated.

Poor body mechanics is the uncoordinated movement that eliminates the balance of the natural curves of the spine. This can happen when you hold loads away from your body. Another way it can happen is when you keep your feet planted while turning on your upper body. Keeping the legs straight also increases the strain on your back.

Good body mechanics keeps your spine balanced during movement—even during the heavy lifting of patients! Holding loads close to your body can minimize the effects of their weight. If you keep your knees slightly bent, you’ll put the stress on your legs and not on your back. Move your torso and one unit—never twist.

Assistive Devices can be used to lessen the strain of lifting and moving patients and objects. Draw sheets make it easier to pull a patient up in bed or over to the side. Be sure to raise the bed to a comfortable level before pulling on the lift sheet. Ideally, two people should pull the patient up in the bed using a draw sheet.

An over-bed trapeze allows the patient to assist when they are moved in the bed. Adjust the length of the chain to allow the patient’s elbows to be slightly bent when they are grasping the trapeze.

Slide boards are used to help transfer a patient from one surface to another. Slide boards help to reduce the friction of moving a patient from the bed to a stretcher, for example. If no slide board is available, plastic bags can be used instead.

When helping patients move, it is helpful to use a gait belt. Gait belts are made from heavy canvas and have a sturdy buckle. Place the belt snugly around the patient’s waist and grasp the belt when you are assisting the patient—this helps your back and decreases the chance of injury to the patient.

When pulling a patient up in bed, there are certain ‘tricks’ that will help. The larger the patient, the more difficult it is to pull them up in the bed. The first thing you should do when you are planning to pull a patient up in bed is to get a co-worker to help!

Use a draw sheet under the patient, as this helps to reduce friction. Place the bed at a comfortable height. Both you and your co-worker should bend your knees and push with your feet. Lean in the direction you want to move the patient. On the count of “3” (so you’re both pulling at the same time) lift and pull the patient to the head of the bed. (Be careful not to bump their head on the headboard!) It may take more than two people to pull large patients up in the bed.

When transferring the patient from a bed to a stretcher, the best thing to do is make sure the patient is on a lift sheet. Position the bed slightly higher than the stretcher and make sure the brakes on both the bed and stretcher are locked. The “puller”—the person pulling toward the patient toward them should be the stronger of the two. Pull the patient to the edge of the bed. Next, place the patient’s legs on the stretcher. Have the “pusher” kneel on the bed and grasp the lift sheet. Again, on the count of 3, both the “puller” and the “pusher” work in unison to slide the patient onto the stretcher.

When transferring a patient from the bed to the wheelchair, it is important to move the patient in a series of “steps”. First, explain to the patient what you are planning to do. Have the wheelchair close to the bed, but not in your way. Turn the patient onto their side and help them to sit on the edge of the bed. Place a gait belt on the patient after they have scooted to the edge of the bed. Grasp the gait belt in the middle of the patient’s back to help minimize pulling on the patient. If no gait belt is present, you can put your arms around the patient’s chest and clasp your hands together behind their back. Bend your knees and on the count of 3, lift. Have the patient pivot toward the chair as you continue to keep your hands grasped behind the patient’s back. Bend your knees and lower the patient into the wheelchair.

When a patient is going to fall, the instinctive reaction is to try and catch them. This is not only difficult but also dangerous. Once the patient has started to fall, it is almost impossible to stop it. In trying to stop a fall, you can be injured yourself. Instead of attempting to catch the patient, try to guide them to the floor. Once the patient is on the ground, get help in order to move the patient back to bed or onto a stretcher.

People who have fallen are often feeling dizzy or are faint. Check them for injuries before trying to move them. If the patient has been injured, tend to the injury before you try to move them. If there has not been any injury, get ready to safely move the patient. GET HELP. You may need assistance of four (or more) people to safely move the patient.

Roll the patient onto a blanket or lift sheet. Have two (or more) people on each side of the patient. Each person should knell on one knee and get a secure hold on the blanket. On the count of 3, lift the patient and stand up, moving the patient onto the bed or stretcher.

There are several things you can do to prevent back injuries. By using the correct lifting techniques, equipment and body movements, you can minimize the risk of back injury, but that will only go so far in preventing back injuries.

Back exercises will help build strength and flexibility. Doing partial sit-ups is one of the best exercises for your back. Stretching helps loosen your back and shoulder muscles which improves the flexibility of the muscles.

If you have

injured your back on the job, you need to tell your department supervisor immediately. If your supervisor isn't present, contact the department head or nursing supervisor. The employee should fill out an accident report.

The accident report must be sent to the Employee Health Department within 24 hours. Employee Health reviews each report and will record the incident (if necessary) in the OSHA 300 log.

Depending on your condition, you may be referred to the Emergency Department or you may go to the Marietta Occupational Health Partners. Employee Health will follow up with you via phone to check on your condition and progress.

The following form is the Employee Accident Report form. This form can be obtained from your manager or the nursing supervisor.

For free interactive training on back safety from OSHA, please visit the website:

Ergonomics is the science of fitting jobs to the people who work in them. The goal of an ergonomics program is to reduce work-related musculoskeletal disorders (MSD’s) which workers develop when a major part of their jobs involve reaching, bending over, performing heavy lifting, using continuous force, working with equipment that vibrates or performing repetitive motions.

Workers suffering from MSD’s may experience less strength for gripping, less range of motion, loss of muscle function and the inability to carry out everyday tasks.

MSD’s are injuries that affect muscles, nerves, tendons, ligaments, joints or spinal discs. Your healthcare practitioner might tell you that you have one of the following common MSD’s:

If you have signs or symptoms of MSD’s please report them. If the signs and symptoms are reported and treated early, you may be able to maintain normal function and avoid long-term effects. You may report the MSD on an accident report form and forward a copy to the Employee Health Department, the original to Human Resources and a copy to your manager..

Repetition—Repeatedly performing the same motions places stress on the muscles and tendons involved in the movement. The severity of the risk depends on how often the action is repeated, the speed of the movement, the number of muscles involved and the amount of force required for the task.

Forceful exertions—Force is the amount of physical effort required to perform a task (such as heavy lifting) or to maintain control of equipment or tools. The amount of force depends on the type of grip, the weight of an object, the posture of the body, the type of activity and the duration of the task.

Awkward postures—Posture is the position your body is in and the affects of the muscle groups that are involved with the awkward position. Awkward postures include repeated or prolonged reaching, twisting, bending, kneeling, squatting, working overhead with your hands or arms, or holding a fixed position.

Contact stress—Pressing the body against a hard or sharp edge can result in placing too much pressure on nerves, tendons and blood vessels. For example, using the palm of your hand as a hammer can increase your risk of suffering an MSD.

Vibration—Operating tools that vibrate such as sanders, grinders, chippers, routers, drills and other saws can lead to nerve damage.

Prevention is the key to reducing MSD’s, which means organizing your workspace to reduce the risk factors. It is also important to use proper body mechanics and protective equipment when possible.

Carpal tunnel syndrome	Sciatica	Hand-arm vibration syndrome
Trigger-finger	Rotator cuff injury	DeQuervain’s disease
Tendonitits	Raynaud’s phenomenon	Carpet layer’s knee
Herniated disc	Low back pain	Tension neck syndrome