Discomfort, Pain And Injury (DPI): Management, Factors, And Hazards

DPI stands for discomfort, pain and injury. Identification of things which can cause discomfort, pain and injury is the main purpose of DPI framework. Management of discomfort, pain and injury is vital while moving equipment and assisting other people in mobility. (ACC, 2010)

Psychosocial factors include the problems associated with the personal life and stress that arises inside and outside the workplace and the method you respond to those issues.

Workplace issues:

• Work loads
• Feeling unsupported by your managers

Non-work factors:

• Financial issues
• Health worries of your own or someone else

To Overcome this problem in my facility everyone who works there needs to visit psychologist once in a year to share their problems and they can also take leave to manage their stress level.

Individual

These factors are divided into further two types:

1. Factors that cannot be changed by the individuals which includes their gender, age and height.
2. Factors that can be changed which includes habits, diet, sleep and fitness. Some patients in the facility are at risk of falling.
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   For this reason, they place a special sticker on the door that says there is a risk of falling, but if it does, it can cause DPI. Staff should be extra careful when dealing with these patients

Work Organisation

It includes how the work is organised or accomplished covering all the aspects like length of work hours, relaxation breaks, crest and trough of work load and management structure. To get rid of this every facility should need to follow health and safety rules to maintain the workload on the employees.

Like for instance:

• Allowing the employees to take enough breaks
• Maximum shift of an individual is of 8 hours

Environmental Issues

This includes the work-environment which can affect on the safety of the workers. For example, an environment can be noisy, too hot or cold and is having too much lighting. In workplace sometimes, the floor may be wet and staff who works there don’t know about that they can slip there on the surface which can lead to DPI. Floor must be dry all the times cleaning staff need to be aware about this.

Load/forceful movements

How much strength is required to work?It covers the force required to use the manual handling techniques of object and people-pushing or pulling. The person who uses the moving equipment should be trained. If any new staff member uses the hoist but he or she don’t have knowledge which can cause injury to them which leads to DPI.

Task Invariability

Doing the same work again and again without any variations in the body is known as Task invariability. It includes the issues related to keep standing in one position and lack of variations in the body. So, there is a need to give time to time break to staff and the employees should be changed every week so that they will not be stuck on one thing.

Workplace Layout/awkward Posture

The positions in which a worker work in a workplace. To prevent DPI, the workplace manager clarifies the workers to avoid

• Bending
• Reaching
• Twisting

If anything occurs like this in our facility first it reported to supervisor and the proper treatment should need to be provided to worker and worker can also apply for rest leave if they don’t feel better.

First Component: Risk assessment – Risk assessment is vital to be done before assisting the people in mobility. Risk assessment means to analyse the hazards or risks that can cause injury to the client. LITEN-UP approach is used for a risk assessment in a facility. Hoisting a client: when client is hoisted there are some risk assessment measures that needs to be done by the caregiver like knowing the weight and height to use the hoist accordingly as it might cause injury to client or caregiver. Falls Risk: Residents who have falls risk means who can walk but there is a chance to fall needs to walk with walker all the times. So, caregiver should not have to leave the falls risk client alone during walk and there must be walker with them to prevent DPI.

Equipment - Before using the equipment in assisting clients in mobility, it is necessary to check the equipment to ensure that whether it is correctly working or not to avoid risks. Likewise, Before, using hoist it is necessary to check its battery otherwise it can stop in between and can harm the client as well.

Third Component: Training - Effective training is vital to prevent DPI. In workplace new caregivers are not allowed to directly use manual handling equipment without any training. Training for at least two weeks is a basic requirement for them to use an equipment. Even after having training they are being supervised by the supervisor for 1-2 months or they can use the equipment with their senior healthcare workers.

Working hours

Potential hazards

1. Working more than 8 hours can cause stress and anxiety. As an aftermath, caregivers started doing tasks with carelessness which can cause injuries to the patients.
2. When there is less staff in a workplace it can cause work load on one caregiver, so when they try to concentrate on multiple tasks, they are not even managed to do a single task properly due to overloading of work.

Work Environment

Potential hazards

1. Unavailability of separate place for placing manual handling equipment can also become a hazard in a workplace. As if equipment is not placed in a proper place can cause injuries to the employers as well as patients.
2. The facilities which are situated nearby roads can face the problem of loud noise due to traffic as it prevents the caregivers to focus on tasks and effects on resident’s sense of hearing. Loud noises can be a hurdle in the caregiver's work as they cannot concenrtate properly. People accessing services.

Potential Hazards

1. Language or cultural difference - If the client is unaware of the common language then it prevents them from having effective communication. Like: Some of the clients in the facility belongs to different culture and caregivers cannot understand their needs.
2. In the facilities the patients those are suffering from any illness like dementia, hearing or eyesight problems can affect their mobility and they might not able to cooperate with the staff. Like: if a patient suffers from last stage of dementia then he or she cannot tell the caregiver and client needs to go toilet it can cause harm to the patient. Carers and the use of moving and handling equipment

Potential Hazards

1. If any untrained caregiver is using manual handling equipment it can become a major hazard in a workplace. If the caregivers are not trained, then they cannot assist the client in mobility otherwise it can cause injuries to both clients as well as themselves. Likewise, untrained caregiver is not aware of the steps that needs to be followed while handling people.
2. Lack of manual handling equipment in a facility. For example: If there would be lack of hoists in the facility and when a caregiver is using the hoist and assisting the patient in transferring from bed to chair and at that time if the hoist’s battery gets dead or if there would be no enough battery then it would cause harm to the client.

I have participated in a training at my facility in which I learned about the manual handling techniques and equipment. I learned about the different equipment that are used by the caregivers in handling people. I learned how to use hoist that is how its battery is changed or how to control it with a remote. Moreover, I also come to know about the sliding sheets which are used by the caregivers in repositioning of clients on bed to prevent bedsores. In training it was also told by the trainer that it is necessary to warm up and stretch before starting work. This training assists a lot in moving and handling equipment. Having knowledge about all the equipment makes easier to use them in manual handling.

Responsibility 1: Back Care

The responsibilities for back care include: Doing exercise and stretch for 15 minutes before starting the work. It is necessary to pay attention to the posture. Lift properly. Don’t twist when lifting. If the equipment is hard to lift-up alone then ask for help. Modify the repetitive tasks.

Responsibility

Biomechanical principles

Applying safe biomechanical principles minimise the force on your joint. Have feet directing in the direction of movement helps to avoid twisting. Avoid stooping by bending your knees slightly at the bottom out.

Responsibility. Reporting any hazards or incidents

If any incident occurs in a facility it is very important to be document, it. Then it is required to report to the RN or supervisor about the incident and then give first aid to the client if any injury takes place. Fill the incident report form for documentation.

Moving and handling equipmentItem

1. Walker

It is a device used by the people those are not able to maintain balance.

2. Wheelchair

People those are unable to mobile due to any disability, injury or illness uses wheelchair for walking.

3. Hoist

Hoist is a device which allows the patient to be transferred from one place to another likewise bed to chair.

4. Sliding sheets

Sliding sheet is a sheet made up of low friction material and assists the client in repositioning in bed, sling attachment and lateral transfers.