Our stories: Ergonomics in Long-Term Care

How is this sector unique?

In most other workplaces, priority is placed on product quality, production, and worker health and safety. In long-term care, however, the priority is resident care and well-being, above all else. The term “resident care” includes assistance with hygiene and meals, lifts and transfers.

Work in long-term care is cyclic from day to day, in the sense that workers perform the same type of tasks each day. However, tasks can vary considerably from one day to the next. For example, the residents’ ability to self-assist with transfers, or to eat on their own depends on their physical capabilities, which may vary from day to day. Their capabilities dictate the type and amount of support the worker must provide.

What approaches have worked best for you?

Aaron, who has recently been working on a long-term care projects, says, “Due to the variability in the tasks performed, I find it important to observe work in the natural flow. This allows me, as an ergonomist, to see how tasks overlap with one another when providing care.”

Workers in long-term care work as a cohesive team to provide the highest quality of care to patients. This means that the breakdown of who does what can be difficult to understand. Sitting down with stakeholders at the beginning of a project to discuss the duties performed, and how often each occurs, helps to frame the project.

What are the biggest ergo challenges in this sector?

To complete an assessment in this industry, family members and residents, in addition to the workers, must be willing to allow the ergonomist to observe the process. Due to the sensitive nature of the work being performed in this sector, we must be compassionate, and we are grateful when residents, their family, and workers support the initiative.

Resident handling continues to present the most significant MSD hazard in this sector. Most long-term care facilities have controls and procedures in place to ensure worker safety. However, instances of high efforts in awkward body positions can still occur. The resident’s size and ability to self-assist can present challenges for care workers. When assessing these jobs, we try to look at a “typical” scenario, and a “worst” case scenario.

Unlike working in a factory that makes parts or food, long-term care workers work with people.  They may encounter emotionally sensitive environments. As ergonomists, we need to be sensitive, and flexible to adjust to various situations.

What advice would you give to someone who is responsible for MSD prevention in this sector?

Making the right equipment readily available is the first step, of course. Mechanical assistance has come a long way since our first healthcare projects in the 90’s. (Ha! Carrie remembers being told that, “A ‘zero-lift’ policy is unachievable”, and that, “We will never lift people using mechanical assistance.”) There are so many amazing new devices for lifting, transferring, and assisting, and more are being developed every day. Authorities including the US OSHA now say that “Mechanical lifts are safer for both patients and healthcare workers.”

Once you are confident that the equipment is available and works well, the next step is to ensure that everyone has training and is confident in using the equipment, and other “ergonomic” work strategies. Some of our clients do a pretty amazing job of this! We’re working on some “microlearning” modules (practical ergo training in 5-minute formats) to help, as well.

Finally, don’t forget that long-term care includes many employees who are not involved with direct resident care, and these can also involve heavy, awkward, or repetitive demands. Housekeepers, kitchen staff, maintenance staff, and laundry all perform tasks that may present MSD hazards, and these groups are easily overlooked in a sector that focuses so acutely on resident care and wellbeing.

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