Back Safety - HealthStream

HealthStream Regulatory Script
Back Safety
Version: May 2007
Lesson 1:
Lesson 2:
Lesson 3:
Lesson 4:
Lesson 5:
Introduction
Back Injury
Spinal Anatomy and Physiology
Safe Operation of the Spine
Preventive Maintenance and Corrective Action
Lesson 1: Introduction
1001
Introduction
Welcome to the introductory lesson on back safety. This
lesson gives the course rational, goals, and outline.
IMAGE: 1001.JPG
As your partner, HealthStream strives to provide its customers with excellence
in regulatory learning solutions. As new guidelines are continually issued by
regulatory agencies, we work to update courses, as needed, in a timely
manner. Since responsibility for complying with new guidelines remains with
your organization, HealthStream encourages you to routinely check all relevant
regulatory agencies directly for the latest updates for clinical/organizational
guidelines.
If you have concerns about any aspect of the safety or quality of patient care in
your organization, be aware that you may report these concerns directly to The
Joint Commission.
Point 1 of 10
2
1002
Course Rationale
Healthcare is a high-risk industry for back pain and
injury.
FLASH ANIMATION: 1002.SWF/FLA
Nursing aides, orderlies, and attendants are at highest
risk. According to the BLS [glossary], these workers have
more back injuries than any other healthcare occupation.
This course will teach you:
• How back injury occurs
• The basic structure and function of the spine
• How to properly use the back and spine during
sleeping, sitting, standing, and lifting
• How to reduce your risk of back injury
Point 2 of 10
1003
Course Goals
After completing this course, you should be able to:
• Detail the occurrence of back pain and injury
among workers in the United States
• Identify risk factors for back injury
• Describe basic spinal anatomy and physiology
• Discuss safe operation of the spine during
sleeping, sitting, standing, and lifting
• Recognize the differences between lifting an
object and moving a patient
• Describe safe practices for handling patients
• Discuss the importance of proper posture and
regular exercise for back health
IMAGE: 1003.JPG
Point 3 of 10
1004
Course Outline
Lesson 1 provided the course rationale and goals.
FLASH ANIMATION: 1004.SWF/FLA
Lesson 2 will describe back injury.
Lesson 3 will review spinal anatomy and physiology.
Lesson 4 will describe safe operation of the spine.
Lesson 5 will review preventative maintenance and
corrective action.
Point 4 of 10
Lesson 2: Back Injury
2001
Introduction & Objectives
Welcome to the lesson on back injury.
FLASH ANIMATION: 2001.SWF/FLA
After completing this lesson, you should be able to:
• Recognize the high rate and cost of back pain and injury
in the United States
• Recognize the increased risk of back injury among
healthcare workers
• Identify healthcare workers at highest risk of back
injury
• Recall the three primary risk factors for injuring the
back during a physical task
• List strategies for preventing back injury
Point 1 of 8
2002
Prevalence of Back Injury
Back pain and injury are common in the United States.
IMAGE: 2002.JPG
Up to 80% of all Americans will suffer back pain at some point
in their lives.
According to NIOSH, back injuries cost American companies
an annual:
• Ten to fourteen billion dollars in worker’s
compensation
• 100 million lost workdays
Point 2 of 8
2003
Cost of Back Injury in the Healthcare Setting: Lost Workdays
Healthcare workers are at high risk for back pain and injury.
IMAGE: 2003.JPG
Among healthcare workers, nursing aides, orderlies, and
attendants have the highest rate of back injury. The BLS
reported 52,150 illnesses and injuries for this group. Of
these, over 20,000 involved the back.
Registered nurses are also at risk for back pain and injury.
Of the 20,100 injuries and illnesses reported by the BLS for
nurses, 7,050 involved the back.
Back injury and pain are types of musculoskeletal disorders
[glossary]. The table on the right compares workdays lost
due to musculoskeletal disorders for selected occupations.
Two groups of healthcare workers are among those most
affected by these disorders.
Point 3 of 8
2004
Cost of Back Injury in the Healthcare Setting: Money
According to the BLS, nursing personnel lose an average of
750,000 total workdays per year as a result of back injury.
IMAGE: 2004.JPG
The direct costs of each incident of back injury range from
$5,000 to $100,000. The average direct cost is $20,000.
Indirect costs of back injury may be as much as four times the
direct costs. These costs result from:
• Lost production
• The need to train new staff
• Sick and administrative time
Point 4 of 8
2005
Causes of Back Injury in the Healthcare Setting
Healthcare workers who lift or move patients as part of their
job are at highest risk for back pain and injury.
IMAGE: 2005.JPG
According to the BLS, over 80% of back injuries among
nursing personnel are related to moving patients. These tasks
are likely to cause injury because they tend to be forceful,
repetitive, and awkward.
Other hospital staff at risk include those who work in:
• Environmental services
• Laundry
• Food service
• Central transport
Like nursing personnel, these workers are at risk because of
the physical tasks they perform.
Administrative personnel are sometimes at risk, because of
long periods of sitting.
Point 5 of 8
2006
Prevention of Back Pain and Injury
Back pain can often be prevented.
IMAGE: 2006.JPG
The majority of pain comes from soft tissue injuries. These
injuries include strains and sprains of muscles, ligaments, and
tendons.
These injuries may be prevented through:
• Good posture
• Regular exercise
• Proper body mechanics
• Use of lifting devices
Preventive strategies will be discussed in greater detail later in
lesson 5.
Point 6 of 8
2007
Review
Which of the following statements is true?
MULTIPLE CHOICE INTERACTION
a. All workers in the United States are at equal risk for
back pain and injury.
b. Nursing aides, orderlies, and attendants have the
lowest risk of back pain and injury.
c. Healthcare workers who lift and move patients as
part of their job are at highest risk of back pain
and injury.
d. Healthcare administrative staff is at highest risk of
back pain and injury, because of long periods of
sitting.
[CORRECT ANSWER: C]
[FEEDBACK FOR A: Incorrect. The correct answer is C.
As a group, healthcare workers are at increased risk for
back pain and injury. Healthcare workers at highest risk are
those who lift and move patients as part of their job, for
example, nursing aides, orderlies, and attendants.]
[FEEDBACK FOR A: Incorrect. The correct answer is C.
As a group, healthcare workers are at increased risk for
back pain and injury. Healthcare workers at highest risk are
those who lift and move patients as part of their job, for
example, nursing aides, orderlies, and attendants.]
[FEEDBACK FOR A: Correct. As a group, healthcare
workers are at increased risk for back pain and injury.
Healthcare workers at highest risk are those who lift and
move patients as part of their job, for example, nursing
aides, orderlies, and attendants.
[FEEDBACK FOR A: Incorrect. The correct answer is C.
As a group, healthcare workers are at increased risk for
back pain and injury. Healthcare workers at highest risk are
those who lift and move patients as part of their job, for
example, nursing aides, orderlies, and attendants.]
Point 7 of 8
2008
Summary
You have completed the introductory lesson on back pain and
injury.
NO IMAGE
Remember:
• Up to 80% of all Americans will suffer back pain at
some point in their lives.
• Healthcare workers are at elevated risk for back pain
and injury.
• Back injury is the most common job-related health
problem among healthcare workers.
• Healthcare workers who lift or move patients as part of
their job are at highest risk for back pain and injury.
• Force, repetition, and awkward posture are the three
primary risk factors for injury during physical tasks.
• Back pain and injury may be prevented through good
posture, regular exercise, proper body mechanics, and
appropriate use of lifting equipment.
Point 8 of 8
Lesson 3: Spinal Anatomy and Physiology
3001
Introduction & Objectives
Welcome to the lesson on anatomy and physiology of the spine.
FLASH ANIMATION: 3001.SWF/FLA
To help keep your back healthy, you need a basic understanding
of its structure and function.
After completing this lesson, you should be able to:
• Recall the basic structure and functions of the spine
Point 1 of 8
3002
Functions of the Spine
The spine plays an important role in your daily activities.
IMAGE: 3002.JPG
First, it supports your body weight as you:
• Sit
• Stand
• Walk
• Move
Second, it gives you flexibility to lift and carry objects.
Finally, it acts as a coat of armor to protect your spinal cord.
Point 2 of 8
3003
Structure of the Spine
The spine is made up of:
• The vertebrae
• The sacrum
• The coccyx
IMAGE: 3003.JPG
The vertebrae of the spine are aligned to create three natural
curves:
• An inward curve at the neck
• An outward curve at the ribcage
• An inward curve at the low back
These three natural curves of the spine are important. They keep
the weight of the head, chest, and lower body centered and
aligned.
Point 3 of 8
3004
Spinal Discs
The vertebrae are separated from one another by cushions of
cartilage [link to glossary] called discs.
IMAGE: 3004.GIF
Discs act as shock absorbers. A healthy disc compresses [link to
glossary] when bearing weight. It then expands like a spring
when the weight is removed.
Discs also provide space between the vertebrae. This gives the
bones room to move relative to one another, without creating
friction.
Point 4 of 8
3005
Disc Injury
Approximately 90% of all back pain results from soft tissue
injury. However, 10% of cases are associated with more serious
conditions of the spinal discs including:
•
•
CLICK TO REVEAL
[Disc herniation] 3005a.JPG
Disc herniation
Degenerative disc disease
Click on each condition to learn more.
[Degenerative disc disease] 3005b.JPG
Point 5 of 8
3006
Review
The three natural curves of the spine keep the weight of the
head, chest, and lower body centered and aligned.
a. True
b. False
TRUE/FALSE INTERACTION
[CORRECT ANSWER: A]
[RESPONSE TO A: Correct. The three curves of
the spine are inward at the neck, outward at the
ribcage, and inward at the low back. These three
curves keep the weight of the head, chest, and
lower body centered and aligned.]
[RESPONSE TO B: Incorrect. The three curves of
the spine are inward at the neck, outward at the
ribcage, and inward at the low back. These three
curves keep the weight of the head, chest, and
lower body centered and aligned.]
Point 6 of 8
3007
Review
Disc herniation is the most common cause of back pain.
TRUE/FALSE INTERACTION
a. True
b. False
[CORRECT ANSWER: A]
[RESPONSE TO A: Incorrect. Ninety percent of
all back pain is the result of soft tissue injury.
[RESPONSE TO B: Correct. Ninety percent of all
back pain is the result of soft tissue injury.]
Point 7 of 8
3008
Summary
You have completed the lesson on spinal anatomy and
physiology.
IMAGE: 3008.JPG
Remember:
• The spine has three main jobs. It supports the weight of
the body. It provides flexibility for lifting and carrying. It
protects the spinal cord.
• The spine is made up of 24 individual vertebrae, the
sacrum, and the coccyx.
• The spine has three natural curves. These curves keep the
weight of the head, chest, and lower body centered and
aligned.
• Spinal discs act as shock absorbers. They also provide
space between vertebrae.
• Disc herniation and degenerative disc disease are not
common causes of back pain.
Point 8 of 8
Lesson 4: Safe Operation of the Spine
4001
Introduction & Objectives
Welcome to the lesson on safe operation of the spine.
FLASH ANIMATION: 4001.SWF/FLA
After completing this lesson, you should be able to:
• Recognize how to protect your back while standing,
sitting, and sleeping
• Identify the correct use of body mechanics to lift an
object from the floor
• Recognize how handling a patient differs from lifting a
box
• Recognize the importance of using lifts and devices
when moving patients
Point 1 of 19
4002
The Back and Spine
The back and spine are designed for strength and flexibility.
IMAGE: 4002.JPG
When the back and spine are used correctly:
• Many movements are possible
• There is little risk of pain or injury
Unfortunately, we often use the back and spine incorrectly. This
strains the muscles and increases the risk of injury.
In this lesson, you will learn about proper use of the back and
spine during:
• Sleeping
• Sitting
• Standing
• Lifting
Point 2 of 19
4003
Sleeping
Poor sleeping habits can weaken the back.
IMAGE: 4003.GIF
This can:
• Contribute to work-related back pain
• Increase the risk of back injury at work
Therefore, proper sleeping habits are pertinent to back safety at
work.
Point 3 of 19
4004
Sleeping Positions
Sleeping on the stomach exaggerates the forward curve of the
low back. This can lead to back pain.
IMAGE: 4004.GIF
It is best to sleep on your back or on your side.
When sleeping on your back, place:
• One pillow under your head
• One or two pillows under your knees
This placement of pillows:
• Decreases the forward curve of the low back
• Reduces pressure on the spinal discs
Point 4 of 19
4005
Sleeping Positions
When sleeping on your side:
• Place a medium-sized pillow under your head
• Bend your knees up toward your chest
• Place a pillow between your knees
IMAGE: 4005.GIF
This positioning of the legs decreases the pull of the legs on the
lower back.
Point 5 of 19
4006
Standing
Standing puts more pressure on the spine than sleeping.
IMAGE: 4006.JPG
When the body maintains a standing position for a long time, the
weight of the body compresses the spinal discs.
This compression:
• Exaggerates the forward curve of the low back
• Strains the muscles of the back
Point 6 of 19
4007
Protecting the Back While Standing
To protect the back while standing:
• Keep the knees flexed
• Stand up straight and do not slouch
• Use a footrest for one of your feet. When standing for
long periods of time, switch feet every few minutes.
• Wear good, comfortable shoes
IMAGE: 4007.JPG
Point 7 of 19
4008
Sitting
Remember: Standing puts more pressure on the spine than
sleeping (standing > sleeping).
IMAGE: 4008.JPG
You may be surprised to learn that sitting puts more pressure on
the spine than standing (sitting > standing > sleeping).
To protect the back when sitting:
• Move all the way back in the chair
• Keep the soles of the feet flat on the floor
Also, think in 90-degree angles:
• With the soles of the feet flat on the floor, the knees should
be bent at a 90-degree angle. Adjust the height of the chair
to make this work.
• The back and thighs should form a 90-degree angle. Sit up
straight to make this work.
• When your hands are on the desk or keyboard, the elbows
should be bent at a 90-degree angle. However, the wrists
should be straight.
Sit close to the desk, so that you do not have to bend to reach for
items. Bending while reaching is an awkward posture. This can
put the back and spine at risk.
When sitting for long periods of time, you may want to use a
pillow or a rolled-up towel to support your low back.
Point 8 of 19
4008b
Sitting (2)
Sit close to the desk, so that you do not have to bend to reach for
items. Bending while reaching is an awkward posture. This can
put the back and spine at risk.
IMAGE: 4008.JPG
When sitting for long periods of time, you may want to use a
pillow or a rolled-up towel to support your low back.
Point 8 of 19
4009
Stretching While Sitting
While working in a seated position, take breaks to:
• Stretch
• Walk
• Move in the chair
IMAGE: 4009.JPG
This will help prevent muscle stiffness.
Point 9 of 19
4010
Lifting
Lifting is a common activity in the healthcare setting.
IMAGE: 4010.JPG
This activity places a high level of stress on the low back.
Lifting puts far more pressure on the back than sleeping,
standing, or sitting.
Point 10 of 19
4011
Body Mechanics for Lifting
Use proper body mechanics to help prevent back injury when
lifting objects such as boxes.
IMAGE: 4011.JPG
When lifting an object from the floor:
• Stand close to the object. Position your feet to create a
broad base of support.
• Bend at the hips and knees. Do not bend at the back or
waist. Use the muscles of your legs to lower yourself.
• Keep your head up and your back aligned. Maintain the
three natural curves of the spine.
• Hold the object close to your body.
• Use the muscles of your legs to stand up and lift the
object.
If you must turn while carrying an object, pivot at the hips. Do
not turn at the back. Never turn or twist while lifting.
If possible, adjust your work environment so that you do most of
your lifting from waist height, instead of from the floor or
overhead. For example, store heavy objects and supplies on
shelves at waist- to shoulder- level.
Point 11 of 19
4012
Lifting a Patient
The basic principles for lifting objects often do NOT translate
well to the manual handling of patients. Patients do not have
handles.
IMAGE: 4012.JPG
The weight of a patient is not evenly distributed. Patients are
asymmetric and bulky. They cannot always be held close to the
body.
Patients are unpredictable. During a lift or transfer, a patient may
start to resist, have muscle spasms, or suddenly lose balance.
Many patient handling tasks are not simple vertical lifts. Instead,
many tasks involve horizontal movement. These tasks often do
not allow the worker to use the strong muscles of the legs. The
more vulnerable muscles of the back must be used.
Point 12 of 19
4013
Eliminating Manual Patient Lifts
Finally, manual patient handling tasks are inherently unsafe
from a mechanical standpoint.
IMAGE: 4013.JPG
This means that no amount of proper body mechanics can make
these tasks safe.
Therefore, OSHA [glossary] recommends that strict manual
lifting[glossary] of patients should be used as little as possible.
Point 13 of 19
4014
Use of Lifting Equipment and Assistive Devices
To limit manual lifting, motorized lifts and assistive transfer
devices are available.
IMAGE: 4014.JPG
These devices should be used when a patient:
• Is not willing or able to assist in a transfer
• Is not able to bear weight on one leg or both arms
• Is not able to maintain balance while standing
• Is not able to move or straighten the hips, knees,
shoulders, or elbows
• Is unpredictable, uncooperative, or aggressive
Point 14 of 19
4015
Examples of Lifting Equipment and Assistive Devices
Examples of lifting equipment and assistive devices include:
• Overhead track lifts
• Portable total lifts
• Sit-to-stand lifts
• Devices for lateral transfer
• Easy-to-slide inflatable mattresses
• Reduced friction sheeting
• Transfer boards
• Gait belts or transfer belts with handles
FLASH ANIMATION: 4015.SWF/FLA
These devices can help prevent back injury for healthcare
workers who lift and move patients as part of their job.
Point 15 of 19
4016
Lifting and Risk Factors
Do you remember the three primary risk factors for injury during
physical tasks?
They are:
• Force
• Awkward posture
• Repetition
Click on each risk factor to learn strategies for minimizing the
associated risk during lifting.
CLICK TO REVEAL
To limit the risk of force:
• Check the weight of an object before lifting
it.
• If the object is too heavy to lift manually, use
a lifting device.
To limit the risk of awkward posture:
• Use proper body mechanics.
To limit the risk of repetition:
• Perform non-lifting tasks between lifts.
• Take frequent breaks.
Point 16 of 19
4017
Review
You are sitting at a desk. You have your hands on the computer
keyboard. You should have 90-degree angles at all of the
following joints EXCEPT the:
a.
b.
c.
d.
Knees
Hips
Elbows
Wrists
MULTIPLE CHOICE INTERACTION
[CORRECT ANSWER: D]
[FEEDBACK FOR A: Incorrect. The knees, hips,
and elbows all should be bent at ninety-degree
angles. The correct answer is D. The wrists should
be kept straight.]
[FEEDBACK FOR B: Incorrect. The knees, hips,
and elbows all should be bent at ninety-degree
angles. The correct answer is D. The wrists should
be kept straight.]
[FEEDBACK FOR C: Incorrect. The knees, hips,
and elbows all should be bent at ninety-degree
angles. The correct answer is D. The wrists should
be kept straight.]
[FEEDBACK FOR D: Correct. The knees, hips,
and elbows all should be bent at ninety-degree
angles. The wrists should be kept straight.]
Point 17 of 19
4018
Review
FLASH INTERACTION: 4018.SWF/FLA
[FEEDBACK: Did you discuss all of the
following?
Nurses often receive training in body mechanics.
Patients do not have handles.
However, proper body mechanics alone cannot prevent injury to
the back during manual patient handling.
The weight of a patient is not evenly distributed.
Why not?
Type your thoughts in the box below. Then click Submit to
compare your answer to ours.
Patients are asymmetric and bulky. They cannot
always be held close to the body.
Patients are unpredictable. During a lift or
transfer, a patient may start to resist, have muscle
spasms, or suddenly lose balance.
Many patient handling tasks are not simple
vertical lifts. Instead, many tasks involve
horizontal movement. These tasks often do not
allow the worker to use the strong muscles of the
legs. The more vulnerable muscles of the back
must be used.
Manual patients handling tasks are inherently
unsafe from a mechanical standpoint. This means
that no amount of proper body mechanics can
make these tasks safe.]
Point 18 of 19
4019
Summary
You have completed the lesson on safe operation of the spine.
NO IMAGE
Remember:
• Sleep on your back or side.
• When standing, keep the knees flexed. Place one foot on a
footrest, switching feet every few minutes.
• When sitting, keep the soles of the feet on the floor. Think
in 90-degree angles.
• Sit close to your desk, so that you do not have to bend to
reach for items.
• When lifting an object, use proper body mechanics. Bend
at the knees and hips, not at the back or waist. Use the
muscles of the legs to perform the lift.
• Principles of proper body mechanics do not translate well
to the manual handling of patients.
• Strict manual lifting of patients should be used as little as
possible.
• Assistive devices can decrease the need for strict manual
lifting of patients.
Point 19 of 19
Lesson 5: Preventive Maintenance and Corrective Action
5001
Introduction & Objectives
Welcome to the lesson on preventative maintenance and
corrective action.
FLASH ANIMATION: 5001.SWF/FLA
After completing this lesson, you should be able to:
• Recognize proper posture
• Identify visualization techniques for helping to improve
posture
• Specify the role of the stomach muscles for proper posture
• Identify the parts of an exercise program for back health
• List symptoms of back injury
• Recognize the importance of addressing symptoms of
back injury
Point 1 of 15
5002
Correcting Bad Habits
Years of bad habits can weaken the spine and the abdominal
muscles. This increases the risk of back pain and injury.
IMAGE: 5002.JPG
Proper posture and regular exercise, on the other hand, can help
maintain back health.
Point 2 of 15
5003
Proper Posture
Proper posture means sitting or standing upright without:
• Slouching
• Rounding the shoulders
• Exaggerating the natural curves of the spine
IMAGE: 5003.JPG
Proper posture:
• Aligns the three curves of the spine
• Centers the head, chest, and lower body over one another
• Balances the weight of the body
Point 3 of 15
5004
Improving Your Posture
Changing your posture can be difficult.
IMAGE: 5004.JPG
If you have been standing with slumped shoulders for years, this
posture probably feels “right” to you.
To begin the process of improving your posture, stand in front of
a mirror so that you can see your profile.
Compare the alignment of your spine with the alignment
shown to the right.
Point 4 of 15
5005
Improving Your Posture
Now, imagine a cord dropped through the center of your head.
IMAGE: 5005.JPG
In the front-to-back plane of the body, the cord should pass
through the:
• Ear
• Front of the shoulder
• Center of the hip
• Area behind the kneecap
• Ankle
If your cord misses some of these marks, imagine a new cord,
attached to the crown of your head. Imagine the cord being pulled
straight upward.
Feel how this:
• Draws your head up
• Brings the curves of the spine into alignment
Point 5 of 15
5006
Seated Posture
Practice good posture while seated, too.
IMAGE: 5006.JPG
Maintain alignment of the three natural curves of the spine.
Point 6 of 15
5007
Posture and Muscles
Strong and flexible muscles are essential for good posture.
IMAGE: 5007.JPG
About 400 muscles work together to maintain the natural curves
of the spine.
The stomach muscles, in particular, act like a giant rubber band.
These muscles connect the upper and lower body and prevent
overarching of the low back.
Weak stomach muscles allow the lower spine to curve too far
forward. This puts stress on the back and can lead to pain or
injury.
Point 7 of 15
5008
Posture and Excess Weight
People who carry excess weight on their stomachs also may have
an exaggerated curve in the lower spine.
IMAGE: 5008.JPG
Why?
Excess weight on the stomach pulls the spine forward and out of
alignment.
Remember: When the lower spine curves too far forward, the
back muscles are strained. This increases the risk of pain and
injury.
Point 8 of 15
5009
Regular Exercise
Regular exercise can help you keep the muscles of your back and
stomach strong and flexible.
FLASH ANIMATION: 5009.SWF/FLA
Regular exercise also can help you maintain a healthy weight, to
avoid excess stress and strain on the back.
For back health, your exercise program should include:
• Cardiovascular conditioning
• Stretching and strengthening exercises
Point 9 of 15
5010
Cardiovascular Conditioning
Cardiovascular conditioning means aerobic exercise, such as:
• Walking
• Swimming
• Biking
FLASH ANIMATION: 5010.SWF/FLA
Aerobic exercise:
• Contributes to overall fitness
• Benefits the back by increasing blood flow to the spine
Point 10 of 15
5011
Stretching and Strengthening
Stretching exercises keep the muscles of the back and stomach
flexible. Stretch five to seven days a week.
IMAGE: 5011.JPG
Strengthening exercises keep the muscles of the back and
stomach strong. Strengthen four to five days a week.
Different people often need different types of stretching and
strengthening exercises, especially if they have preexisting back
problems. To find out which exercises you should do, ask a
physical therapist or physician.
Point 11 of 15
5012
Reporting Injuries
If you injure your back at work, report the injury immediately.
IMAGE: 5012.JPG
Recovery from back injury is optimal when:
• The injury is reported within 24 hours.
• Medical care and treatment are started within 48 hours.
Point 12 of 15
5013
Review
FLASH INTERACTION: 5013.SWF/FLA
Mrs. Longfellow has very poor posture. Help her correct her
posture by imagining a cord dropped through the center of her
head. Drag an orange tag to each part of the body the cord should
pass through. Click submit to check your answer.
[Then, after clicking submit, the figure appears with the orange
tags labeled, and some commentary that says:]
You have helped Mrs. Longfellow improve her posture. The three
natural curves of the spine are now aligned. The head, chest, and
lower body are centered over one another.
Point 13 of 15
5014
Review
Strengthening the stomach muscles can help improve posture by:
MULTIPLE CHOICE INTERACTION
a.
b.
c.
d.
Drawing the spine forward
Drawing the stomach in
Straining the muscles of the back
Increasing blood flow to the spine
[CORRECT ANSWER: B]
[FEEDBACK FOR A: Incorrect. The correct
answer is B. Strong abdominal muscles draw the
stomach in. This prevents overarching of the
lower spine.]
[FEEDBACK FOR B: Correct. Strong abdominal
muscles draw the stomach in. This prevents
overarching of the lower spine.]
[FEEDBACK FOR C: Incorrect. The correct
answer is B. Strong abdominal muscles draw the
stomach in. This prevents overarching of the
lower spine.]
[FEEDBACK FOR D: Incorrect. The correct
answer is B. Strong abdominal muscles draw the
stomach in. This prevents overarching of the
lower spine.]
Point 14 of 15
5015
Summary
You have completed the lesson on prevention and correction.
NO IMAGE
Remember:
• Proper posture 1) aligns the three curves of the spine; 2)
centers the head, chest, and lower body over one another;
and 3) balances the weight of the body.
• To help improve your posture, imagine a cord attached to
the crown of your head. Imagine the cord being pulled
upward, to draw the three natural curves of the spine into
alignment.
• Practice good posture while seated, as well as while
standing.
• The stomach muscles act like a rubber band. This
prevents overarching of the low back.
• Weak stomach muscles and excess weight on the stomach
contribute to overarching of the low back. This puts stress
on the muscles of the back and can lead to pain or injury.
• An exercise program for back health should include
cardiovascular conditioning, stretching, and
strengthening.
• If you injure your back at work, report the injury
immediately.
Point 15 of 15
[Back Safety]
Course Glossary
#
1.
Term
BLS
Definition
Bureau of Labor Statistics
2.
strict manual lift
patient lift performed without the use of any lifting equipment or assistive device
3.
4.
cartilage
ergonomics
5.
6.
compress
lumbar vertebrae
7.
8.
Musculoskeletal disorders
vertebrae
tough elastic tissue
fitting the job or workplace to match the abilities and limitations of the human
body, rather than forcing the human body to fit the job
press together
five bones of the lower spine; largest and strongest of the bones of spine; bear
most of the weight of the body
disorders involving both the muscles and skeleton, including back pain and injury
bones of the spine
[Back Safety]
Pre assessment
1. You are sitting at a desk. You have your hands on the computer keyboard. You should have 90-degree angles at all of the following
joints EXCEPT the:
a. Knees
b. Hips
c. Elbows
d. Wrists
Correct answer: D
Rationale: The knees, hips, and elbows all should be bent at ninety-degree angles. The wrists should be kept straight.
2. Back injury is the third most common job-related health problem for healthcare workers.
a. True
b. False
Correct answer: B
Rationale: Back injury is the most common job-related health problem for healthcare workers.
3. Healthcare workers at highest risk of back pain and injury are:
a. Food service staff
b. Administrative personnel who sit for long periods
c. Those who work in the laundry
d. Patient-care staff who lift and move patients as part of their job
Correct answer: D
Rationale: Healthcare workers who lift and move patients as part of their job are at highest risk for back pain and injury. According to
the BLS, over 80% of back injuries among nursing personnel result from tasks that involve patient handling.
4. Which of the following is a primary risk factor for injury during physical tasks?
a. Staff shortages
b. Mandatory overtime
c. Repetition
d. Long shifts
Correct answer: C
Rationale: The three primary risk factors for injury during physical tasks are force, repetition, and awkward postures.
5. Approximately 90% of all back pain results from what condition?.
a. Disc herniation
b. Degenerative disc disease
c. Soft tissue injury
d. Bone fracture
Correct answer: C
Rationale: Soft tissue injury is the most common cause of back pain..
6. Which of the following statements is (are) true?
a. The three natural curves of the spine are formed when the vertebrae fuse during fetal development.
b. The spine curves outward at the neck, inward at the ribcage, and outward at the lower back.
c. The three natural curves of the spine keep the weight of the head, chest, and lower body centered and aligned.
d. All of these statements are true.
e. None of these statements is true.
Correct answer: C
Rationale: The spine curves inward at the neck, outward at the ribcage, and inward at the lower back. These three natural curves
keep the weight of the body centered and aligned.
7. All of the following statements are true EXCEPT:
a. Spinal discs are cushions of cartilage.
b. Spinal discs act as shock absorbers for the spine.
c. Only ten percent of all back pain results from damage to the spinal discs.
d. Spinal discs act as a coating of armor to protect the spinal cord.
Correct answer: D
Rationale: The vertebrae create a coating of armor to protect the spinal cord. Spinal discs separate and cushion the vertebrae.
8. To protect your back, it is best to sleep:
a. On your back, with a pillow under your head and one or two pillows under your knees
b. On your stomach, with a pillow under your hips
c. On your side, with your legs straight and a pillow under your head
d. All of these
e. None of these
Correct answer: A
Rationale: It is best to sleep on your back or on your side. When sleeping on your side, however, bend your knees up toward your
chest and place a pillow between the knees.
9. Of the following lists, which one places activities in order of INCREASING stress on the low back?
a. Sitting. Standing. Vertical lifting (bending at the knees). Vertical lifting (bending at the waist).
b. Standing. Sitting. Vertical lifting (bending at the knees). Vertical lifting (bending at the waist).
c. Sitting. Standing. Vertical lifting (bending at the waist). Vertical lifting (bending at the knees).
d. Standing. Sitting. Vertical lifting (bending at the waist). Vertical lifting (bending at the knees).
Correct answer: B
Rationale: Standing places less stress on the back than sitting. Sitting places less stress on the back than lifting. When lifting, bending
at the knees places much less stress on the back than bending at the waist.
10. Manual patient handling tasks are inherently unsafe and proper body mechanics cannot make these tasks safe. True or False?
a. True
b. False
Correct answer: A
Rationale: Because manual patient handling tasks are inherently unsafe, no amount of proper body mechanics can make these tasks
safe. For this reason, OSHA recommends that manual patient handling be kept to a minimum.
11. To stand with proper posture, exaggerate the arch in the lower back.
a. True
b. False
Correct answer: B
Rationale: Exaggerating the arch in the lower back puts strain on the muscles of the back. Proper posture aligns the three natural
curves of the spine.
12. All of the following statements are true EXCEPT:
a. Weak stomach muscles allow the lower spine to curve forward. This puts stress on the back and can lead to pain or injury.
b. About 20 muscles work together to maintain the natural curves of the spine.
c. People who carry excess weight on their stomachs may have an exaggerated curve in the lower spine.
d. An extra ten pounds of weight on the stomach puts an additional 100 pounds of strain on the back.
Correct answer: B
Rationale: About 400 muscles work together to maintain the natural curves of the spine.
13. You are putting together an exercise program for back health. Your program should include:
a. Aerobic exercise, stretching exercises, and strengthening exercises
b. Stretching and strengthening exercises only
c. Aerobic exercise only
d. Aerobic exercise and strengthening exercises only
Correct answer: A
Rationale: For back health, your exercise program should include aerobic exercise, stretching, and strengthening.
14. You injure your back at work. True or False: For optimal recovery, you should report the injury within 24 hours and start treatment
within 48 hours.
a. True
b. False
Correct answer: A
Rationale: For optimal recovery, you should report the injury within 24 hours and start treatment within 48 hours.
[Back Safety]
Final Exam
1. Aerobic exercise:
a. Increases blood flow to the spine
b. Improves overall fitness
c. Reduces risk of back injury
d. All of these answers
Correct Answer: All of these answers
Answer Rationale: Aerobic exercise has all of these benefits.
2. Back and stomach muscles help:
a. Maintain posture.
b. Stabilize the spine.
c. Maintain proper alignment of the three natural curves of the spine.
d. All of these answers are correct.
Correct Answer: All of these answers are correct.
Answer Rationale: About 400 muscles of the back and stomach work together to 1) stabilize the spine and 2) maintain proper
alignment of the three natural curves. This contributes to proper posture.
3. _____ act as shock absorbers by _____ when bearing weight.
a. vertebrae compressing
b. vertebrae expanding
c. discs expanding
d. discs compressing
Correct Answer: discs compressing.
Answer Rationale: Spinal discs are cushions that absorb shock between the vertebrae by compressing when bearing weight.
4. Sleeping on the side puts more stress on the spine than sleeping on the stomach.
a. True
b. False
Correct Answer: False
Answer Rationale: To promote back health, sleep on your back or on your side. Do not sleep on your stomach.
5. To lift a 20-pound box from the floor with proper body mechanics:
a. Bend at the waist. Keep the arms extended to hold the box away from the body.
b. Bend at the knees and hips. Keep the back aligned. Hold the box close to the body.
c. Bend at the waist. Pull the box into the chest with the muscles of the arms. Use the muscles of the back to lift.
d. None of these descriptions is correct.
Correct Answer: Bend at the knees and hips. Keep the back aligned. Hold the box close to the body.
Answer Rationale: To lift an object from the floor: Stand close to it. Bend at the knees and hips, keeping the back aligned. Lift with
the muscles of the legs, holding the object close to your body.
6. Most back pain results from:
a. Disc herniation
b. Degenerative disc disease
c. Bone fracture
d. Soft tissue injury
Correct Answer: Soft tissue injury
Answer Rationale: Approximately 90% of all back injury results from soft tissue damage.
7. Which of the following is not a function of the spine?
a. To allow flexibility
b. To protect the spinal cord
c. To support the weight of the body
d. To protect internal organs
Correct Answer: To protect internal organs
Answer Rationale: The three functions of the spine are support, flexibility, and protection of the spinal cord.
8. How many natural curves does the spine have?
a. One
b. Two
c. Three
d. Four
Correct Answer: Three
Answer Rationale: The spine has three natural curves: inward at the neck, outward at the rib cage, and inward at the low back.
9. Using proper body mechanics is a strategy for minimizing which risk factor for injury?
a. Force
b. Awkward posture
c. Repetition
d. Stress
Correct Answer: Awkward posture
Answer Rationale: To limit the risk of awkward posture, use proper body mechanics.
10. You think you might have injured your back while assisting with a patient transfer. You should:
a. Ice the injured area and return to work as soon as possible.
b. Wait and see if the symptoms go away within a week. If not, report the injury to your supervisor.
c. Report the injury to your supervisor immediately.
d. Use a heating pad for several hours each day until the symptoms go away.
Correct Answer: Report the injury to your supervisor immediately.
Answer Rationale: If you injure your back at work, report to your supervisor immediately. Recovery from back injury is optimal
when the injury is reported and treated promptly.