According to the International Ergonomics Association, ergonomics, or human factors, is the scientific discipline concerned with understanding interactions among humans and other system elements and the profession that applies theory, principles, data and methods to design and optimize human well-being and overall system performance.¹

The elements of a workplace system include facilities, management systems and people (see Figure 1). In residential care, facilities may include overhead lifts, the design of the care home, beds, and wheelchairs. Management systems may include point-of-care risk assessments, care plans, work hours, policies and procedures. People are the characteristics of people involved in the work, including caregivers, residents, families and visitors.

When the interaction of the elements is optimized for performance and human well-being, the quality of resident/client care improves, along with improved safety for caregivers². Other safety goals should also be considered as part of the care system, including pressure wound and fall prevention, infection control and violence prevention.

The Provincial Safe Resident Handling Standards for Musculoskeletal Injury Prevention in British Columbia, outline an ergonomics/human factors approach to safe handling. These standards were developed by the Provincial Residential Care Musculoskeletal Injury Prevention Team with input from stakeholders and organizations, including unions, frontline workers, clinical nurse leads, and many more. They also contain gap analysis tools that organizations can use to assess their current processes, systems and practices. The standards are comprised of the following topics:

Organizational support and ongoing commitment to safety

• The organization has a policy that requires staff to use safety equipment or assistive devices, whenever more than minimal assistance would be needed to manually lift some or all of a resident’s weight to reduce the risk of injury and ensure quality care.
• Managers at all levels of the organization demonstrate that employee safety is valued and integrate safety into all activities and decisions related to operations, capital, and care delivery design.

Facility, equipment, physical environment

• Appropriate facility design, equipment and physical environment are important to ensure the safety and well-being of residents and caregivers.
• Where residents need assistance with mobility, overhead lifts (ceiling-mounted, wall mounted or portable lifts) are recommended, specifically x-y gantry (traverse or H) systems, which offer more options and flexibility for transfers, repositioning and rehabilitation tasks.
• Appropriate slings, storage and maintenance are also essential features of the safe handling system.

Education and training

• All caregivers require education and training concerning safe handling and practice with equipment to feel comfortable using equipment with their residents.
• Residents and families also require education concerning the use of equipment to help them appreciate the benefits of quality care and safety for the residents.  Get family members in the lift to allow them to feel comfortable with the equipment and help their loved ones feel comfortable.

Safe work practice standards

• Care planning – resident assessment and plan for reassessment
• Documentation and communication
• Point of care (POC) risk assessment
• Regular audits/inspections
• Education and training- ongoing
• Safe work procedures are in place
• Safe handling equipment is readily accessible, in good working order and reflects the resident’s function and fit.
• Management strategies support safe handling.

Gina is a Canadian Certified Professional Ergonomist, a Certified Health and Safety Consultant and works as an Ergonomist in the Risk Analysis Unit at WorkSafeBC.

Pousette, A., Larsman, P., Eklof, M., and Tomer, M. (2017). The relationship between patient safety climate and occupational safety climate in healthcare – A multi-level investigation. Journal of Safety Research, 61, 187-198.