Risk Alert for Senior Living Communities

Resident lifting is a risk for both workers and residents

Strains are the No. 1 cause of workplace injuries reported by senior living communities insured by Church Mutual. Many of those strains result from improper manual handling of residents. Manual resident handling presents a serious risk to both your staff and to residents. When workers lift, transfer, position or slide residents, they greatly increase their risk of musculoskeletal injury. At the same time, the resident’s risk of injury and pain also increases. It’s a seemingly no-win situation. But there are some surprisingly simple ways to help decrease these risks of worker and resident injuries at your facility.

Lifting residents requires a different mind-set

One of the things that makes manual resident handling difficult is that residents cannot be lifted in the same way as other objects that works are accustomed. Unlike the typical inanimate load, residents cannot be held very close to the body, they are bulky, they have no handles and their midlift actions are unpredictable. However, there are some ergonomic lifting principles that remain applicable to lifting residents:

  • Make sure there is enough room to move without having to maneuver around obstacles during the lift
  • Keep your back straight but not vertical, tucking in your chin to achieve the right angle
  • Maintain stable footing
  • Do not twist your back or lean to the side
  • Move smoothly
  • Take your time — don’t cut corners with safety to get a move done quickly

Most importantly, workers should never attempt to lift or move a resident if they cannot easily manage the weight or movement involved with the task. In such situations, the two-person lift rule applies. Your facility needs to maintain adequate staffing to eliminate inappropriate one-person lifting.

Assessing residents assists workers

The first step your facility should take to move toward safer resident assisting is conducting resident assessments. To prepare workers for what to expect while lifting or moving a resident, identify each resident’s:

  • Ability to provide assistance with the move or lift
  • Upper and lower extremity strength
  • Height and weight
  • Special circumstances that could affect lifting or movement, such as sore spots, recent surgical procedures or wounds

Update your residents’ assessments as their health and abilities change. If you notice a particular resident requires assistance moving on a regular basis, assign a variety of employees to assist the resident so that no single worker is exposed to the repetitive motion of moving the resident.

Train and supervise

Workers, even the most experienced, need to be trained on resident handling techniques upon hiring and retrained at least annually to keep safety at the top of their minds. Also encourage workers to do flexibility and back strengthening exercises to help them prepare for manual resident handling tasks.

Your facility also needs to supervise workers in action to make sure they are practicing safe resident moving and lifting. Keep track of all resident handling incidents and follow up with workers who have been injured multiple times. They might need to be retrained on safe handling techniques, or the resident they are assisting might need to be reassessed.

Lifting the load off employees

Sometimes even the most well-practiced resident assisting techniques are not enough to prevent employees from getting injured. Because of this, a trend toward the use of mechanical lifts has risen in senior living communities. However, some states do not allow lifts to be used in the senior living setting, so contact your state department of health or department of human services before incorporating mechanical lifts at your facility.

 

Lifting residents requires a different mind-set

    Make sure there is enough room to move without having to maneuver around obstacles during the lift

  • Keep your back straight but not vertical, tucking in your chin to achieve the right angle

  • Maintain stable footing

  • Do not twist your back or lean to the side

  • Move smoothly

  • Take your time—don’t cut corners with safety to get a move done quickly

Assessing residents assists workers

    Ability to provide assistance with the move or lift

  • Upper and lower extremity strength

  • Height and weight

  • Special circumstances that could affect lifting or movement, such as sore spots, recent surgical procedures or wounds

Train and supervise

Lifting the load off employees

Prevent disastrous lightning losses

With lightning packing up to 100 million volts of electricity, a lightning strike to an unprotected building can be disastrous. When lightning strikes a building, it will travel through the building and wiring until it finds the ground. This extra voltage can travel through electronic equipment and overload it—the type of damage that is often reported by senior living facilities insured by Church Mutual. The heat from the lightning and the heat generated from the resistance it encounters can quickly start a fire.

Create a lightning protection system

When you think about things that are most likely to be struck by lightning in a storm, a senior living facility probably isn’t top of mind. But fire and lightning losses account for nearly one-third of property claims filed by Church Mutual’s senior living facility customers.

  • Almost 60 percent of lightning strikes result in either one or all of the following systems being knocked out of service at a senior living facility: fire alarm, security, call service or telephones.

To protect your facility from the frightening consequences of a lightning strike, consider the following:

  • Lightning rod system – This system consists of rods at high points on the building connected to metal cables that run down the sides of the building to a point 2 feet to 10 feet below the ground. The lightning is intercepted and directed to the ground without causing damage to the building or its contents.
  • Surge protectors – The Institute of Electrical and Electronics Engineers (IEEE) notes that this common form of protection for electronic equipment is widely utilized by both consumer and commercial users but should not be relied upon as the only defense against a lightning strike. Look for a plug-in protector with the Underwriters Laboratories (UL) rating label to ensure that it meets minimum protection requirements. Also consider that higher quality protectors will typically provide higher levels of protection, although they cost more to purchase.
  • Unplug electronics – Even with surge protectors, take the extra step to unplug valuable and sensitive electronics, such as computers and sound systems, when not in use or before a storm begins.
  • Protect signal lines – Protect wires that extend outside the building. This is an area commonly lacking proper protection as many alarm systems are tied into the telephone lines. Ensure that telephone, fax machine, dial-up and DSL modem lines are connected to plug-in surge protectors. When purchasing a surge protector, look for one with multiple ports to provide circuit protection for all your signal line equipment.

Find the right installer

Total building protection, including lightning rod systems, will require professional installation. Look for a certified contractor. Ask for an Underwriters Laboratories or Lightning Protection Institute certified contractor to install the lightning protection system.

 

Create a lightning protection system

    Almost 60 percent of lightning strikes result in either one or all of the following systems being knocked out of service at a senior living facility: fire alarm, security, call service or telephones.

    Lightning rod system – This system consists of rods at high points on the building connected to metal cables that run down the sides of the building to a point 2 feet to 10 feet below the ground. The lightning is intercepted and directed to the ground without causing damage to the building or its contents.

  • Surge protectors – The Institute of Electrical and Electronics Engineers (IEEE) notes that this common form of protection for electronic equipment is widely utilized by both consumer and commercial users but should not be relied upon as the only defense against a lightning strike. Look for a plug-in protector with the Underwriters Laboratories (UL) rating label to ensure that it meets minimum protection requirements. Also consider that higher quality protectors will typically provide higher levels of protection, although they cost more to purchase.

    Unplug electronics – Even with surge protectors, take the extra step to unplug valuable and sensitive electronics, such as computers and sound systems, when not in use or before a storm begins.

  • Protect signal lines – Protect wires that extend outside the building. This is an area commonly lacking proper protection as many alarm systems are tied into the telephone lines. Ensure that telephone, fax machine, dial-up and DSL modem lines are connected to plug-in surge protectors. When purchasing a surge protector, look for one with multiple ports to provide circuit protection for all your signal line equipment.

Find the right installer

Needlesticks put millions of workers at risk

According to the Occupational Safety and Health Administration (OSHA), an estimated 5.6 million workers in the health care industry and related occupations are at risk of exposure to bloodborne pathogens. Much of that risk comes from the daily need to work with needles and other types of sharps. As an employer in the senior living industry, it’s your responsibility to help lessen the risk of needlesticks that your workers face.

Safer equipment, safer environment

For many senior living facilities, ordering needles and sharps has become a routine activity. But taking the time to evaluate and change the equipment you order can be the first step to creating a safer environment for workers.

To do this, put together a committee of front-line caregivers and managers from various units within your facility. This way, you can have access to the perspectives of workers who use the equipment in different settings when choosing which needles and sharps to order—plus OSHA requires you to involve a cross section of workers when purchasing or evaluating equipment. The object of the committee is not to identify which one type of needle or sharp will be sufficient for the entire facility to use but to find the appropriate type for each of the units that use the equipment.

When considering your options, don’t be tempted to buy less expensive devices simply because of economic constraints. The consequences can be costly—paying for an injured employee’s lost days, staff replacement, disability and/or OSHA fees and citations.

Devices with passively activated safety features (those that activate immediately after use), such as self-sheathing needles, can help reduce the risk of a needlestick. Whatever devices you choose should be tested in a pilot program at your facility before being ordered in large quantities.

Danger doesn’t end until disposal

Even with safer devices, the danger of bloodborne pathogen exposure for your workers isn’t over until the devices are properly disposed of. Disposal containers need to be:

  • Puncture- and leak-proof
  • Color coded
  • Clearly labeled
  • Available throughout the facility (including in the rooms of residents who self-test using sharps)
  • Large enough to hold the anticipated volume of sharps that will be used in a given area

Full disposal containers should be emptied regularly. If disposal containers cannot be safely emptied within a short time, keep them in a secure place until they can be.

Training serves as a friendly reminder

Supplement your safer equipment and environment with sharps safety training—even for your most tenured workers. Training should be administered upon hiring and at least once every year. Remind workers that all sharps injuries need to be reported and logged, including at least the following information:

  • Name(s) of the potentially exposed person(s)
  • Type and brand of the device used
  • Location of the incident
  • Description of the incident

The Centers for Disease Control and Prevention (CDC) point out some important training points for before, during and after sharps use.

Before

  • Organize needed equipment in a central location
  • Ensure adequate lighting
  • Know where the closest disposal container is located
  • Assess the resident’s ability to cooperate and ask him or her to avoid making sudden movements

During

  • Keep the sharp pointed away from you
  • Keep your eye on the sharp at all times
  • Do not pass an exposed sharp from person to person
  • Alert others when you are moving with a sharp
  • If necessary, activate the device’s safety feature as soon as the procedure is completed and ensure that it is locked in place

After

  • Make sure all sharps are accounted for
  • Dispose of used sharps in the nearest, appropriate disposal container
  • Never put hands or fingers into a sharps container

Safer equipment, safer environment

Danger doesn’t end until disposal

    Puncture- and leak-proof

  • Color coded

  • Clearly labeled

  • Available throughout the facility (including in the rooms of residents who self-test using sharps)

  • Large enough to hold the anticipated volume of sharps that will be used in a given area

Training serves as a friendly reminder

    Name(s) of the potentially exposed person(s)

  • Type and brand of the device used

  • Location of the incident

  • Description of the incident

    Organize needed equipment in a central location

  • Ensure adequate lighting

  • Know where the closest disposal container is located

  • Assess the resident’s ability to cooperate and ask him or her to avoid making sudden movements

    Keep the sharp pointed away from you

  • Keep your eye on the sharp at all times

  • Do not pass an exposed sharp from person to person

  • Alert others when you are moving with a sharp

  • If necessary, activate the device’s safety feature as soon as the procedure is completed and ensure that it is locked in place

    Make sure all sharps are accounted for

  • Dispose of used sharps in the nearest, appropriate disposal container

  • Never put hands or fingers into a sharps container

Parking lots are more than just first impressions

Your parking lot greets residents and visitors as they approach your facility—its condition and appearance giving them some insight as to the quality of care and professionalism you put into the rest of your operations.

Still, far more than first impressions, parking lot and sidewalk maintenance is an important part of your overall safety plan. Slips, trips and falls account for almost one-fourth of all injuries to employees, residents and guests at senior living facilities each year. Whether it is slipping on ice or tripping in a pothole, parking lots and sidewalks are among the most prevalent places for injuries to your residents and visitors.

  • In Illinois, a housekeeper slipped and fell on ice, bruising her lower back, while taking out the trash.
  • In Minnesota, a health aide was on her way into work when she slipped and fell on ice, fracturing her left wrist. She is expected to be away from work for several weeks.

From ice to cracks and debris, proper maintenance is key

Take the proper steps to keep the grounds clean, attractive and safe.

  • Clear snow/ice – Whenever snow accumulates, immediately clear the snow and ice. Melt the ice with an ice melt throw or, at minimum, use a sand-based cover.
  • Walk through lot – Periodically, walk through the parking lot looking for potential hazards, such as loose debris, water or ice.
  • Sweep it up – Keep the parking lot and the sidewalk swept of sand and other potential slip hazards in the spring and summertime. This also will help keep your lot clean and attractive.
  • Check for cracks – Routinely check the parking lot and sidewalks for cracks and other imperfections. Immediately take steps to fix any problems. If cracks and imperfections are discovered early, applying a rubberized sealant can cost as little as 5 cents per square foot. This type of maintenance can extend the life of a parking lot by seven years.
  • Drive-up area – Have a drive-up area close to the main doors for those who have difficulty walking on uneven and slippery surfaces. Sturdy handrails need to be installed on all ramps near the entryway.<p>
  • Keep painted lines visible – Keep painted parking space lines, crosswalks, drive-up areas and change in elevation lines maintained. Recoat faded or chipped painted areas.

    In Illinois, a housekeeper slipped and fell on ice, bruising her lower back, while taking out the trash.

  • In Minnesota, a health aide was on her way into work when she slipped and fell on ice, fracturing her left wrist. She is expected to be away from work for several weeks.

From ice to cracks and debris, proper maintenance is key

    Clear snow/ice – Whenever snow accumulates, immediately clear the snow and ice. Melt the ice with an ice melt throw or, at minimum, use a sand-based cover.

  • Walk through lot – Periodically, walk through the parking lot looking for potential hazards, such as loose debris, water or ice.

  • Sweep it up – Keep the parking lot and the sidewalk swept of sand and other potential slip hazards in the spring and summertime. This also will help keep your lot clean and attractive.

    Check for cracks – Routinely check the parking lot and sidewalks for cracks and other imperfections. Immediately take steps to fix any problems. If cracks and imperfections are discovered early, applying a rubberized sealant can cost as little as 5 cents per square foot. This type of maintenance can extend the life of a parking lot by seven years.

  • Drive-up area – Have a drive-up area close to the main doors for those who have difficulty walking on uneven and slippery surfaces. Sturdy handrails need to be installed on all ramps near the entryway.

  • Keep painted lines visible – Keep painted parking space lines, crosswalks, drive-up areas and change in elevation lines maintained. Recoat faded or chipped painted areas.

Preventing Injuries to Administrative Employees

Every year, Church Mutual senior living customers report more than 500 injuries to their employees. One occupation needing specific risk management attention is administrative employees.

Employees in this category include directors,executive directors, coordinators and bookkeepers. Past claims provide insight into key safety issues to help prevent similar injuries. Use the following guidelines to help evaluate, develop and implement good risk management practices and procedures for administrative employees:

Lifting Strains

  • Instruct employees on proper body mechanics and lifting techniques.
  • Arrange work areas so materials are within convenient reaching or lifting distances.
  • Eliminate high and low lifting exposures.
  • Provide material-handling equipment, such as carts, to limit lifting and carrying objects.

Repetitive Motion Strains

  • Rotate staff on jobs that are highly repetitive.
  • Conduct ergonomic evaluations of employee workstations.
  • Provide chairs, workstations and other office equipment with adjustable options and controls.
  • Limit the height of stacked material that leads to awkward lifting and handling postures.

Slips, Trips and Falls

  • Maintain clean working areas and walking surfaces to help eliminate slip-and-fall exposures.
  • Make housekeeping a top priority. Do not allow boxes to accumulate on floors.
  • Require all employees to wear slip-resistant footwear.
  • Arrange office furniture, telephone and electrical cords and office supplies to minimize hazards.

Caught-by Accidents

  • Secure loose rings or jewelry before operating office equipment.
  • Do not operate office equipment without proper covers or guards in place.
  • Do not leave file cabinet drawers open. Close them immediately after use.
  • Mark or pad obstructions that cannot be removed to help reduce the possibility of direct contact or injury if contact occurs.

Preventing Injuries to Caregivers

Every year, Church Mutual senior living customers report more than 500 injuries to their employees. One occupation needing specific risk management attention is caregivers.

Employees in this category include CNAs, LPNs and those giving hands-on care to residents. Past claims provide insight into key safety issues to help prevent similar injuries. Use the following guidelines to help evaluate, develop and implement good risk management practices and procedures for caregivers:

Lifting Strains

  • Instruct employees on proper body mechanics and lifting techniques.
  • Reinforce proper body mechanics for lifting and transferring residents.
  • Plan ahead to minimize the number of transfers a resident needs to complete an activity.
  • Enforce the two-person lift rule when needed.

Struck by or Collision With Objects

  • Place mirrors at corners or other visually obstructed areas to help reduce collisions.
  • Place guards over moving parts on heating, cooling, elevator and other equipment to prevent contact.
  • Clearly mark and define walkways. Keep carts out of hallways when not in use.
  • Mark or pad obstructions that cannot be removed to help reduce the possibility of direct contact or injury if contact is made.

Slips, Trips and Falls

  • Design the layout of hallways and rooms to allow smooth traffic flow.
  • Keep spill kits available in areas where spills are common. Clean up spills immediately.
  • Require all employees to wear slip-resistant footwear.
  • Arrange furniture, telephone and electrical cords and supplies to minimize slip-and-fall hazards.

Cuts, Punctures and Scrapes

  • Ensure that employees are trained in the safe use and disposal of needles.
  • Eliminate the use of needles where safe and effective alternatives are available.
  • Modify work practices to make them safer from needlestick injury hazards.
  • Dispose of used needles promptly in appropriate sharps disposal containers.

Preventing Injuries to Food Service Employees

Every year, Church Mutual senior living customers report more than 500 injuries to their employees. One occupation needing specific risk management attention is food service employees.

Employees in this category include chefs, cooks, dieticians, dishwashers, kitchen aides and similar support staff. Past claims provide insight into key safety issues to help prevent similar injuries. Use the following guidelines to help evaluate, develop and implement good risk management practices and procedures for food service employees:

Slips, Trips and Falls

  • Greasy or wet floors can lead to slips and falls. Immediately clean up spills and mop floors regularly.
  • Properly store all products and supplies to eliminate clutter.
  • Require all employees to wear slip-resistant footwear.
  • Ensure that nonskid floor mats are used in wet locations and that mats lay flat.

Cuts, Punctures and Scrapes

  • Teach employees how to properly handle, use and store knives.
  • Unplug slicers, mixers, blenders and similar machinery before cleaning.
  • Require cut-resistant gloves be worn when cutting.
  • Do not use hands or feet to manually compact trash.

Lifting Strains

  • Instruct employees about proper body mechanics and lifting techniques.
  • Arrange work areas so materials are within convenient reaching or lifting distances.
  • Organize storage areas to stock heavy items on lower shelves.
  • Provide material-handling equipment, such as carts, to limit lifting and carrying objects.

Burns

  • Require employees to use hand protection, such as oven mitts, when handling hot pans.
  • Teach the “standing-to-the-side” method when opening ovens and automatic dishwashers to allow steam to escape.
  • Instruct employees to never carry or move containers containing hot oil or boiling water.
  • Allow fryers and hot cooking pots to cool before performing cleaning procedures.

Preventing Injuries to Housekeeping Employees

Every year, Church Mutual senior living customers report more than 500 injuries to their employees. One occupation needing specific risk management attention is housekeeping employees.

Employees in this category include those whose primary job is cleaning or light-duty janitorial. Past claims provide insight into key safety issues to help prevent similar injuries. Use the following guidelines to help evaluate, develop and implement good risk management practices and procedures for housekeeping employees:

Lifting Strains

  • Instruct employees about proper body mechanics and safe lifting techniques.
  • Institute a team lifting policy when carrying tables or handling large, heavy or bulky items.
  • Supply easy-to-use vacuum cleaners that have adjustable handles and are lightweight.
  • Plan the day’s workload. Perform heavier tasks at the beginning of the work shift before fatigue starts.

Slips, Trips and Falls

  • Arrange furniture, telephone and electrical cords and supplies to minimize slip-and-fall hazards.
  • Require all employees to wear slip-resistant footwear.
  • Train employees on the proper use of mops and other cleaning equipment used to maintain floors.
  • Promote safe handling of materials. Do not carry objects that block vision.

Struck by or Collision With Objects

  • Place mirrors at corners or other visually obstructed areas to help reduce collisions.
  • Maintain clutter-free storage areas. Always return cleaning equipment to their proper storage location after use.
  • Clearly mark and define walkways. Keep carts out of hallways when not in use.
  • Mark or pad obstructions that cannot be removed to help reduce the possibility of direct contact or injury if contact occurs.

Cuts, Punctures and Scrapes

  • Focus attention on the work being performed. Inattentiveness is a top cause of lacerations.
  • Require employees to wear personal protective equipment. Make gloves available where appropriate.
  • Dispose of used needles promptly in appropriate sharps disposal containers.
  • Do not use hands or feet to manually compact trash.

Antifreeze in sprinkler systems can be deadly

Recently, a kitchen grease fire took one person’s life and seriously injured another. The kitchen was equipped with a sprinkler system that contained high concentrations of a combustible antifreeze solution.

According to the National Fire Protection Agency (NFPA), residential sprinkler systems remain reliable and effective. However, in light of this recent tragedy, the NFPA has established new requirements for the use of antifreeze in new and existing residential and nonresidential occupancies.

New requirements help prevent tragedies

Although the NFPA does not require the use of antifreeze in sprinkler systems, following their new standards regarding such use is required and can help prevent tragedies like the one described above.

The following is a summary of the new requirements. For full information, visit the NFPA’s website (see bottom of page).

Existing sprinkler systems containing antifreeze

  • Systems must be tested annually by a qualified individual before onset of freezing weather.
  • If solution found in the system no longer complies with requirements or the type of solution cannot be determined, the system must be drained and replaced with an acceptable solution.

New sprinkler systems containing antifreeze

  • Systems must use only factory premixed antifreeze solutions.
  • All factory premixed antifreeze solutions must be provided with a certificate indicating the type of antifreeze, concentration and freezing point.
  • After installation, systems must be tested in the same manner as existing sprinkler systems containing antifreeze (above).

Learn about your options

The NFPA also encourages property owners to look into other options—including insulation, dry pipe systems and heating areas where sprinkler piping is run—for preventing their wet pipe systems from freezing.

To learn more about your options and to see a detailed listing of the new requirements, visit http://www.nfpa.org/antifreeze.

New requirements help prevent tragedies

Existing sprinkler systems containing antifreeze

    Systems must be tested annually by a qualified individual before onset of freezing weather.

  • If solution found in the system no longer complies with requirements or the type of solution cannot be determined, the system must be drained and replaced with an acceptable solution.

New sprinkler systems containing antifreeze

    Systems must use only factory premixed antifreeze solutions.

  • All factory premixed antifreeze solutions must be provided with a certificate indicating the type of antifreeze, concentration and freezing point.

  • After installation, systems must be tested in the same manner as existing sprinkler systems containing antifreeze (above).

Learn about your options



For a complete collection of the Risk Alert for Senior Living Communities series, click here.

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