Authors (including presenting author) :
CHOW PS (1), YUE NT (1), SO TW (2), LEUNG YK (3), YEUNG WS (1), CHOY KL (1), CHEN KK (1), NG KW (1), WONG YFB (1), Wong SL(1), CHAN CN(1), LI CC(1)
Affiliation :
(1) Extended Care Ward, Department of Medicine & Geriatrics, North Lantau Hospital (2) Occupational Therapy Department, North Lantau Hospital, (3) Physiotherapy Department, North Lantau Hospital
Introduction :
Manual Handling Operation (MHO) related behavior is one of the main daily routines for rehabilitation care in extended care ward. It was found that the higher risk to induce injury on duty were related to MHO unsafe behaviors during patient care. Though mandatory MHO training programs were provided to ward staff according to Corporate guidelines, tailor designed training and coaching program which may enhance the quality and safety for specific ward setting. A pilot “Work Safe Behavior”(WSB) program for MHO was conducted in extended care (EC) wards with multidisciplinary collaboration approach.
Objectives :
1. To build up a team of MHO work safe behavior ambassadors via the “Work Safe Behavior” program among two EC wards for promoting work safe behaviors. 2. To identify Patient Care Assistants (PCA) workplace-based unsafe behaviors and conduct on-site coaching to improve working processes to ensure safe performance. 3. To minimize Injury on Duty (IOD) incidents during MHO in ward setting by periodically assessment and monitoring.
Methodology :
WSB program was implemented in EC wards from May 2021 to November 2021 in collaboration with Members of Ergonomics Functional Group under Hospital Occupational Safety and Health (OSH) Committee. (1) Work Safe Behavior Ambassador training was conducted to respective EC ward nurses. (2)An observational checklist was designed. Three commonest categories of work behaviors among PCAs in EC wards were being assessed before and after “Work Safe Behavior” coaching program. The categories included assisting patient bed-to-bed transfer, patient turn to bed, shift up patient in bed with related single items. Any single failure items in checklist would be counted as failure in whole assessment. All PCAs were coached by the trained ambassadors. (3) Periodic assessment and monitoring safe behavior performance were conducted for continuous quality improvement, especially for those newly recruited staff.
Result & Outcome :
There were 8 nurses trained as the MHO WSB Ambassadors by members of the Ergonomics Functional Group. Total 24 PCAs were being assessed before and after the coaching program by the WSB ambassadors. Before coaching program, the overall passing rate of the PCAs was 66.7% in assisting patients bed-to-bed transfer. 20.8% failed to adjust “appropriate bed height” and 12.5% failed to coordinate with co-workers and 8.3% failed to “lock the bed wheel”. For assisting patients turn to bed, the overall passing rate was 12.5%. There were 66.7% failed to lower the bed rail appropriately; 54.1% failed to adjust “appropriate bed height”; 33.3% failed to “keep back upright and standing in bow stance”. In assisting patients to shift up in bed, the overall passing rate was 20.8% and 54.1% failed to adjust “appropriate bed height”; 50% failed to lower the bed rail appropriately; 20.8% failed to “keep back upright and standing in bow stance”. All PCAs passed the assessment after the coaching period for a month, especially for those newly recruited PCAs. 3-month and 6-month interval assessments and timely reinforcement of the work safe behavior by ambassadors were planned for continuous improvement. “Work Safe Behavior” training program is an effective way to timely improve PCA MHO safe performance and reduce IOD risks during patient care.
