1. Understand anatomy and physiology in relation to moving and positioning individuals 2. Understand current legislation and agreed ways of working when moving and positioning individuals 3. Be able to minimise risk before moving and positioning individuals 4. Be able to prepare individuals before moving and positioning 5. Be able to move and position an individual 6. Know when to seek advice from and/or involve others when moving and positioning an individual
Outline the anatomy and physiology of the human body in relation to the importance of correct moving and positioning of individuals
The study of the human body is divided into two sections called anatomy and physiology. Anatomy is the study of the structure or parts that make up the body, whilst the physiology is concerned with their function of cells, tissues and organs of the living organism. The anatomy and physiology of the human body explains that muscles are attached to the skeleton. They work like hinges or levers to pull or move particular joints when a muscle contracts, pulling the joint in the direction it is designed to move. Parts of muscles move antagonistically, that is, when one contracts, its opposite member relaxes to allow movement. Muscles can become slack, making movement slower and more difficult because increasing age and less use of the muscles.
The brain give command in order for the muscles to move. Single nerve cells in the spinal column called motor neurons form a long very thin extension of the single cell, called an axon. When an impulse travels down the axon to the muscle, a chemical is released at its ending. Muscles are made of long fibres connected to each other lengthways by a ratchet mechanism that allows the two parts of an extension ladder to slide past each other, overlapping each other more, so that the muscles get shorter and fatter. When the impulses from the nerves stop, the muscle fibres slide back to their original position. In relation to the importance of correct moving and positioning activities, it makes the muscles not to be fractured. Correct moving and handling or positioning will make the muscles not to strain or sprain.
The individual and carers will not experience pains and discomfort. For example, the elbow and knee joints have limited movement; trying to extend these joints beyond their range can cause painful damage to the joint. Also need to understand that elderly people are not as supple as younger people and even if they do not suffer movement restriction through a medical condition. They bruise easier too and so great care has to be taken when handling, moving and positioning them especially when assisting them to sit up or when using the hoist strap. Failure to follow the care plan and any presenting conditions can lead to causing the individual injury, pain and discomfort. It may also lead to legal action being raised.
Describe the impact of specific conditions on the correct movement and positioning of an individual
There are a number of conditions that can impact on moving and positioning of individuals, these include arthritis, Parkinson’s disease, cerebral palsy, stroke and amputation of limbs. Below are some of the problems that may occur with such conditions. Arthritis – Arthritis suffers will often have stiff and painful joints and frequently a limited range of movement within the affected area. Parkinson’s disease – Parkinson’s suffers may have limb rigidity and slower reaction times. Cerebral palsy – Cerebral palsy suffers may have contracted muscles and/or joints that may lead to rigid limbs.
Stroke – Stroke can lead to a permanent weakening down one side of the body, for instance one arm or leg stronger than the other. This needs to be taken into account when weight bearing or moving as to avoid putting unnecessary pressure on the weak side. Amputees – Loss of a limb, be it either upper or lower can affect people ability to move independently so care must be taken to when moving people with amputated limbs. Support worker communication is very important in order to correctly moving and positioning the service user with any of the above condition.
Describe how current legislation and agreed ways of working affect working practices related to moving and positioning individuals
Legislation that is relevant includes the Management of Health and Safety at Work Regulations which introduced the requirement for risk assessment, risks when moving and positioning individuals must be assessed, acted on and reviewed. Also all staff must be trained in moving and positioning individuals. The Lifting Operations and Lifting Equipment Regulations (LOLER) introduced the requirement for employers to provide lifting equipment that is safe to use and maintained and staff must also be provided with training. The Manual handling Operations Regulations for employer states that they must carry out risk assessments for all moves and reduce the risk of injuries from happening and avoid dangerous moving and handling.
The employees’ responsibilities include using all equipment as trained to do so, follow all health and safety working practices and avoid putting themselves or other staff, Individuals or visitors at risk, reporting any hazards or risks to their employer. Agreed ways of working mean that employers must have workplace policies and procedures for moving and handling; these must be explained to staff and staff provided with training and supervision. It is also important that all employees, read these procedures, if they do not understand ask, that they attend training, are supported with understanding all individuals’ needs, the moves needed and all equipment being used.
Describe what health and safety factors need to be taken into account when moving and positioning individuals and any equipment used to do this
I would only move a person if I have been trained to do so. I would check the persons care plan to see if the person has any preferences or needs before performing the move. I would wear appropriate foot wear when I move a person to avoid risk of being harmed e.g. when using a hoist I must not wear open shoes or saddles. I also do a manual risk assessment before performing any move. I do not use any equipment that I have not been trained to use and I check I have room to carry out the move.
Equipment needs to be checked that it is working correctly e.g. hoist is charged/equipment is clean and not damaged. Infection control is important and wearing PPE. I would ask the persons agreement before the move and make sure I’m using correct equipment e.g. the correct sling for the person and that it is safe to use and clean. When finished with sling I would store it safely away to avoid accidents or it being used on someone else.
Identify any immediate risks to the individual
Risks can occur every day which is why it is important to always check to identify the risks straight away and try to correct it weather it is the wires are hanging down on the bed which could be a risk if the hoist gets trapped on them, or even if the sling you are using has a tear in the seam. No matter how small the risk is if you don’t correct it straight away it could lead to a massive risk. You should also have a risk assessment in place which may need to be changed.
Describe actions to take in relation to identified risks
When I come across risks before moving and positioning an individual my actions will depend on what they are. If there are risks in the environment from hazards that I can move like an item on the floor then I will do so with the individual’s agreement but if there is a risk in terms of the equipment I’m using if it is faulty or from the individual it may be that I think they are unwell or a I see a change in their behaviour then I would not carry out the move but first would report the risks to my line manager and seek advice. The equipment if faulty is removed from the immediate area and an out of order sign placed on it until it is replaced to make others aware that it is not working or safe to use. If procedures are not followed correctly then there is a greater risk to everyone involved client, care staff and family. Injuries can result due to poor practise by not following the care plan or using lifting equipment incorrectly. Clients can be traumatised by poor and lose confidence in their own abilities and the abilities of the care team.
Describe what action should be taken if the individual’s wishes conflict with their plan of care in relation to health and safety and their risk assessment
Sometimes workplace policies and procedures in relation to moving and handling may conﬂict with someone’s wishes. For example, some workplaces have adopted ‘no-lifting’ policies which mean that hoists are used for all people – but what if a person does not want to be hoisted? If dealt with incorrectly, this could leave people feeling unvalued, humiliated, distressed and degraded. You could also ﬁnd yourself in trouble, because the reason’s basic human rights may have been violated.
In order to prevent the conflicts it is my responsibilities to explain their service user what their care plan and risk assessment says, the risks involved and my responsibilities and duty is to only follow the care plan. If the individual still insisted then I would explain that I would need to report this to my line manager. I must also record the risks, the date I identified these and the actions I take.
The main reason for allowing the service user to take risk sometimes a person condition can changes and their mobility can improve as well as deteriorate. As the conflicts will be reported to the manager and the service user is notified by me (support worker) of the risks associated with their action. If the person wants to do more for themselves, I should encourage this, but also be aware of their limitations – are they trying to do too much too soon? If the person refuses to be moved or turned, I should encourage them to move as much as possible by themselves.
Describe the aids and equipment that may be used for moving and positioning
There are different aids and equipment that you can use to move and handle service user in moving and positioning. Hoists and slings these are used to move individuals who cannot move themselves from one position to another and the slings come in different sizes and types depending on the height and weight of the individual. Slide boards are used for people who are quite independent and who just need a little support with moving for example from their bed to a chair or from a chair back to their bed. Lifting handles are used with some individuals to can help them to sit up in bed independently; they hold onto to these to move themselves.
Handling belts are used when an individual might be a little unsteady when getting up and so by holding onto the handles on the belt you can help steady the person so that they don’t fall over. There also grab handles placed in individuals ‘bathrooms for individuals to be independent when standing up, walking frames with and without wheels can also help individuals move themselves independently.
Describe when advice and/or assistance should be sought to move or handle an individual safely
There should be suﬃcient information provided in a person’s moving and risk assessment and mobility support plan regarding the number of people required to safely move or handle somebody safely, along with the equipment that is needed and the best techniques to use. However, there may be occasions when further advice and/or assistance will be required, such as when: When the manoeuvre is difficult and risky to the health and safety of both the individual and the carer as this is against the law and can cause injury When the wrong equipment is available
When the equipment is faulty again against the law and can cause injuries When the individual’s care plan indicates that two carers have to assist with a specific manoeuvre and no-one is available When the carer is not sure how to complete the tasks or use the equipment When the individual asks you to carry out the manoeuvre that is outside of the care plan and that may harm them or the carer as we are not allowed to go outside the care plan this will be unsafe for the carers and individual I have not received training for moving and handling equipment.
When there is an emergency
Describe what sources of information are available about moving and positioning individuals
There are lots of different sources of information; in my workplace the moving and handling procedures and guidelines about the correct practices to follow, individuals’ risk assessment and care plans about their needs and practices agreed to follow – the individuals and their families can also help with what they find useful. I can also ask my colleagues and manager for information and advice. Sometimes we can also ask other health care professionals such as physiotherapists and moving and handling specialist specific questions or advice about issues – training courses and information leaflets are also useful.
Courtney from Study Moose
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