Consultation and collaboration with staff to prevent hazardous manual handling injuries

Manual handling injuries

During 2018-19, the healthcare industry accounted for the highest number of claims relating to hazardous manual handling - work where you have to lift, lower, push, pull, carry or move something.

These injuries are complex and not caused by one isolated factor. To prevent these types of injuries, employers need to consult and collaborate with staff to identify effective controls and commit to continuous improvement.

The Women's Hospital and their relationship with workplace injury

Over the past four years, in line with industry statistics, the Women's Hospital has experienced a high number of injuries involving their midwives in the Birth Centre.

The Women's Hospital had limited educational resources for manual handling in place that specifically focused on the Birth Centre or midwifery tasks. Through extensive consultation with staff, the Women's Hospital identified:

• midwives were provided with generic patient handling resources and yearly refresher training
• there was room for improvement in the quality and breadth of information available, particularly on how to use patient handling equipment and perform safe patient handling tasks specific to midwifery
• training sessions were provided, however the level of competency was not rigorously assessed
• there was no central knowledge base for safe manual handling practices specific to midwives
• birthing beds were exposing staff to hazardous manual handling when removing and replacing bed ends during labour and birth common midwifery tasks in the Birth Centre were causing staff to be in awkward postures such as kneeling, over reaching, crouching and applying sustained force
• these positions were often repetitive and prolonged depending on the nature of the labour and birth
• minimal communication about staff safety across specialisations (eg midwives, anaesthetists, doctors) regarding good manual handling practices

Consultation and collaboration with staff to redesign the work

The occupational health and safety (OHS) and Birth Centre staff have worked collaboratively to establish and implement effective controls. Some examples of controls include:

• developing maternity patient handling procedures (in collaboration with staff across specialisations), that identify different ways of performing tasks to reduce awkward postures
• ensuring mirrors and kneeling pads are available to reduce awkward postures while assisting women during birth
• developing videos on safe manual handling practices starring the midwives, medical and theatre staff as actors (videos are now included in mandatory yearly refresher training)
• implementing multi-disciplinary simulation training for the Birth Centre, focusing on clinical and manual handling best practices to enhance awareness of work duties that cause awkward postures
• developing patient handling training videos (in partnership with La Trobe University) which are available to all staff and are shown to graduate midwives during their training, to ensure they understand practices to prevent injury in their future workplace
• collecting feedback at all training sessions from trainers and participants, to continuously identify areas for improvement redesigning competency assessments to evaluate procedure and training effectiveness

Successfully reducing workplace injury through collaboration

Over three years, the OHS and Birth Centre staff successfully reduced the percentage of incidents resulting in a standard claim by 8% and reduced the severity of reported injuries. Claims now have lower medical expense costs and faster return to work.

This contributed to the hospitals' WorkCover premium dropping significantly in 2018-2019.

Most importantly, the reduction in claims is accompanied with an increase in hazard and incident reporting. This highlights the improved safety culture.

Nurse educators also report midwives are much more willing to trial new equipment and practices. They now know it is possible to reduce the risk of injury, while maintaining the same quality of care for patients.

A commitment to ongoing improvement

The Women's Hospital is committed to continuing their reduction of workplace injuries and creating a culture where staff safety is highly valued. The OHS team are working on a range of initiatives in collaboration with staff, including:

• reviewing incident clusters to identify emerging risks using the PHIRES toolkit
• wireless foetal heart rate monitoring has been trialled to reduce sustained force and awkward postures for midwives
  • further trials will be conducted in future with new technology to ensure there is a viable option for all cohorts
• developing a job dictionary (from a staff perspective) to better understand the risks associated with midwifery tasks
• planning dedicated simulation training for maternity staff, integrating training on clinical practices with patient and staff safety introducing new beds with gas lift ends to eliminate manual handling

The Women's Hospital journey over the past three years illustrates the impact collaboration with staff can have on reducing and eliminating hazardous manual handling.