1.1. outline the anatomy and physiology of the human body in relation to the importance of correct moving and positioning of individuals
The human body is a delicate system and can be damaged easily with incorrect moving and handling. The musculoskeletal system is what keeps our bodies together and allows us to move. The human body is made from our bones which have joints that allow us to move a given range of motion, these joints are held tighter by our muscles, tendons and ligaments. For us to be able to move our muscles must contract (shorten), when doing so they pull on the tendons and bones to which they are attached allowing for movement. If you move an individual suddenly or move a joint beyond its range of motion, you risk damaging an individual by either pulling their muscles, tearing their tendons or ligaments and possibly dislocating their joints. If you are incorrectly moving an individual for example by dragging them under the armpits up the bed, you can cause damage by over stretching the joints and in turn straining the ligaments. If you want to roll an individual over by pulling at their arms or hands you can cause an individual’s bones to fracture. If you are using the incorrect equipment such as the wrong size sling for an individual, the individual could fall from the hoist and end up with various broken bones and bruising. If you do position an individual effectively or move an individual often enough you could cause damage to nerve fibres, which send impulses to enable the muscles to relax and contract or cause the individual to develop pressure sores.
1.2. describe the impact of specific conditions on the correct movement and positioning of an individual
Any individual who has a hearing or sight impairment may need extra support when moving, you may need to make physical gestures or to spend a bit more time explaining to the individual where it is they are going to keep them calm when moving. An individual with dementia may have little understanding of what you are saying they may need you to repeat what you are saying or you to show them what you are going to do before you do it. An individual who has had a stroke or has any sort of muscular atrophy may have limbs that are weaker than others, which must be considered when weight bearing and moving an individual to avoid putting too much pressure on the weaker parts of the body. These individuals are also more at risk of nerve damage and pressure sores as they don’t have a sensation in the damaged parts of their bodies and so therefore can’t feel whether they are doing damage to these areas by sitting on them or getting them trapped somewhere. An individual with arthritis will need extra care, attention and to only be moved as much as their joints will allow to reduce the chance of discomfort and pain for the individual.
2.1. describe how current legislation and agreed ways of working affect working practises related to moving and positioning individuals
The current legislation related to moving and handling includes the Management of Health and Safety at Work Regulations, The Lifting Operations and Lifting Equipment Regulations and The Manual Handling Operations. These legislations mean that all staff must be trained in the moving and positioning of individuals. The correct lifting equipment that is safe to use and maintained must also be provided by the employer, and staff need to have training to use it. There must also be risk assessments in place, to assess the risks for moving individuals, which must be followed and reviewed accordingly. Staff must also not put themselves or others at risk and report any hazards or risks that they see. Agreed ways of working also means that there should be polices and procedures in place regarding moving and handling. Staff must also have the correct training, supervision, a clear understanding of individual’s needs/equipment being used and have read and understood all policies and procedures within the workplace.
2.2. Describe what health and safety factors need to be taken into account when moving and positioning individuals and any equipment used to do this
When moving individuals, I must consider health and safety factors such as adhering to all policies and procedures within my workplace, making sure that risk assessments are in place for the moving of each individual and that I am following the correct procedures written within them. It is my responsibility to look after the individual, myself and others when adhering to my health and safety obligations. I must ensure that when I am transferring an individual I have considered whether the individual is safe to move, if not I must not make the move, ensuring that I have given them the correct reassurance and that the individuals arms are safe during the manoeuvre. I must ensure that the individual is in the correct sling and hoist, stated for them, and that the hoist is in working order with the safety check in date and fully charged. The sling must not be broken, the correct size for the individual and belongs to the individual which it is being used for. I must ensure that the environment is safe before beginning the manoeuvre (no rugs, lamps, bed wires in the way) and that there is enough space to do the manoeuvre in. I must always ensure that I have gained consent from the individual before I make the move and do not rush the manoeuvre, ensuring that the individual is safe and comfortable throughout. I must ensure that any equipment used is cleaned and stored safely after the manoeuvre. I must ensure that I am wearing the correct clothing and footwear (no sandals or flipflops and nothing that can get caught in the equipment or on the individual) and that I have followed the correct hand washing techniques before and after and that I am wearing the correct PPE during the manoeuvre. I must also ensure that there are the correct amount of staff doing the manoeuvre and that I am not putting any individual in danger by doing it on my own. I must always ensure that I have the correct and up-to-date training before using any equipment or moving and positioning any individuals.
3.4. Describe actions to take in relation to identified risks
The actions to take in relation to identified risks are firstly identifying the risks, then you must decide what actions must be taken to prevent any injuries or accidents. You must draw up an action plan of how to manage these risks and re-evaluate the risks regularly once the action plan is in place. For example, if an individual is at risk of falls you must put into action procedures to prevent the risks such as encouraging the individual to ring the bell when they wish to walk somewhere so that they can have someone to support them during the manoeuvre but if an individual doesn’t have the capacity to ring the bell or they choice not to, the risk could still be there. You must also check if the current walking aid they are using is still appropriate for them if they are using a stick or no walking aid could that be the reason the individual keeps falling? You must make sure that the individual has the appropriate walking aid maybe this individual needs a frame now rather than just a stick. Or maybe the individual keeps falling over because of the furniture in their rooms maybe there is a loose piece of carpet or a slope to floor or some loose wiring which keeps making the individual trip, you must report your findings to the appropriate person’s and rectify the problem. The next step would be to put in a sensor mat so when the individual begins to move the mat will turn on and the care staff will be alerted so that they can go and check on the individual. Or if the individual is likely to fall out of bed but doesn’t want side rails there should be a crash mat put in place possibly with a sensor mat on to alert staff to when an individual has fallen out of bed. If you notice an improvement after following the action plan then it is obvious that the actions taken have limited the risks involved if not then there needs to be more actions taken to limit the risks.
3.5. 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
If the individual’s wishes conflict with their plan of care in relation to health and safety and their risk assessment, action should be taken. If the risk is because there is faulty equipment but the individual wishes for you to continue anyway, you must seek advice from a senior member of staff, explain to the individual the risks and remove the faulty equipment from the immediate area and an out of order sign must be put on it to ensure that other staff members are aware that it shouldn’t be used until it has either be fixed or replaced. If there are risks in the environment which can be moved to ensure safety, then I will do so with the individuals agreement. If an individual is unwell or there is a change in their normal behaviour you should not carry out the move as normal but instead report the risks to a senior member of staff and seek advice. If an individual asks me to move them in a way that isn’t stated in their care plan or risk assessment, I will explain to the individual why we need to do this way, why we must follow the care plan and their risk assessment, if necessary get another member of staff to reexplain why it must be done the way stated in the care plan. If the individual persists I will need to report the incident to a senior member of staff and then maybe get a senior member of staff to explain to the individual why we need to follow the care plan and that we cannot proceed with any moving until we’ve come to an agreement. I must also take active steps to record all risks, the date, time and the action that needs to be taken.
5.3. Describe the aids and equipment that may be used for moving and positioning
There are many different aids and equipment that can be used for the moving and positioning of individuals. There are different types of hoists such as standing hoists which are used for individual who cannot stand independently but still have some ability to bear weight on their legs and feet. There are also full body hoists which are used for individual who have no ability to move unaided these hoists can be mobile or fixed to the ceiling in purpose-built buildings. To attach an individual to any type of hoist you must have a sling, which come in various shapes and sizes depending on the hoist you are using and the size of the individual. There are also adapted baths which have fitted bath chairs to lift you in and out of the bath and the ability to adjust the height of the bath for the carer who is washing the individual. There are also adapted shower chairs for individual who are fully hoisted and are unsafe in normal shower chair, they allow for the carers to position and move individuals whilst dressing without the need of being re-hoisted to a different location. There are different types of transfer boards, hospitals normally use a large body sized board to assist with transfers from stretcher to beds, and there are smaller boards which can be used for quite mobile individuals to slide from seated positioned to another seated position from armchair to wheelchair. There are turntables and etac’s which can be used to help an individual to pull themselves into standing position then transferred to another place like a wheelchair. There are manual wheelchairs, which can be used to transfer individual to different locations, and specialist electric wheelchairs which individuals can use to transport themselves to different locations. There are handling belts which can be used to support individuals to walk who can support their own weight but are a little unsteady or are too large for carers to quite reach there arms around to do traditional moving and handling techniques, they shouldn’t be used for lifting. There are lifting cushions which can assist individuals to stand from chairs or the floor. There are electric reclining chair’s which can also be used in the assistance of standing individuals who have good mobility. There are bed levers, support rails and poles which can be used by an individual to move themselves in bed into an upright position. There are also walking aids such as sticks, frames, trolleys and tripods. There are also heightened toilet seats and grab rails which can make it easier for individual to stand after using the toilet independently. There is also specialist bariatric equipment for larger individual who do not fit in conventional moving and positioning equipment. There is also emergency evacuation equipment which is there to transport individuals in an emergency evacuation.
5.5. Encourage the individual’s active participation in the manoeuvre
It is incredibly important to encourage individuals to actively participate during a manoeuvre. It will promote a sense of independence and self-worth for the individual as they will feel like they are helping you and the task will become easier for the carers because they will have less work to do themselves. If you encourage an individual to help roll themselves over by grabbing onto the side of the bed and raising their own knee, the strain on the carers will be far less and the individual will feel a sense an increased self-esteem. You can then go about cleaning an individual, changing their bedding or putting a sling in place ready for hoisting. When you are hoisting if you encourage the individual to try and lift up their own legs to put the sling underneath then the manoeuvre will be easier, if you also encourage the individual to move their arms in to safe places then the manoeuvre will be far safer as the individual is far less likely to get trapped on the bars of the hoist. If you encourage an individual to support their own weight when standing by pushing themselves up on the arms of the chair and keeping there feet apart to encourage good balance and to try and stand straight this will encourage individuals to do more for themselves but also to have better movement making it far easier for the individuals which are assisting to help the manoeuvre.
5.7. Demonstrate how to report and record the activity noting when the next positioning manoeuvre is due
When entering a room and giving an individual a comfort check, you must investigate the individuals’ folder to see when they were last turned. You must take note of when they were last turned what position they were previously in and what position they need to now be positioned in. You need to then position the individual in to the next position and take note of when the individual needs to be repositioned again. You must then document clearly in the pressure ulcer management chart (turning/positioning chart) of what position you have moved the individual into, the time, date and the initials of yourself and the other carer who made the position change ensuring that you come back on time for the next position change and repeating the same prod
6.1. Describe when advice and/or assistance should be sought to move or handle an individual safely
Advice and assistance should always be sought to move and handle an individual safely. You should always ensure that you are seeking advice whenever you unsure of how to complete a task or how to use the equipment needed for the task. You must also seek advice when the individual is asking you to perform a manoeuvre that isn’t stated in their care plan for example if it is stated in the care plan that you must use a full hoist and the individual wants to walk, you must only follow what is stated in the care plan, otherwise you risk endangering yourself, your colleagues and the individual. It is important to seek advice because the care plan for that individual may have changed so that you may be able to walk them because they have been reassessed. You must always ensure that you seek assistance for any manoeuvre where it states that you need two people in the care plan. You must always seek advice when you have the wrong equipment, or the equipment is faulty as it is against the law to use incorrect or faulty equipment. You must also seek advice when you think that the individuals care plan does reflect what the individuals’ current mobility is like so that the individual can be reassessed, so no harm will come to the individual by making them do the wrong manoeuvre. You must also seek advice when you think a manoeuvre is too difficult and risks the health and safety of any individual including yourself.
6.2. Describe what sources of information are available about moving and positioning individuals
The first place to look for sources of information about the moving and positioning of individuals is in their care plan. In their care plan you will find their preferences, needs, practises to follow and the individuals risk assessment, which should have all the information that you need. There are also all the policies and procedures in a written format held within out care setting that can be referred to at any point, or searching the internet should help, our company also has online training which should hold the information you need about moving and positioning individuals. Attending training courses will also give you the correct information that you need in terms of moving and positioning individuals. If an individual is new to an establishment it may be necessary to ask the friends and family about the individual mobility as they will know the individual better than you. You can also ask your colleagues and manager for information and advice. It may also be necessary at times to work with a physiotherapist or other specialist to get advice and information about moving individuals, and to ask specific questions about any issues you have.