The background to update of the 2003 NZPHG (New Zealand Patient Handling Guide) to the “Moving and...
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Dr John WallaartPhD, MBA, DBS, Dip.Chem., Dip.OH&S Mgt
Programme Manager ACC Corporate Office
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Background• Industry
– Heavy metal (aluminium), Pulp and paper, etc
• Research– The world’s first FPBR (Fan Supplied Positive Pressure Respirator)
• ACC - programme management– Agriculture, e.g. FarmSafe– Construction, e.g. SiteSafe– NIHL (including “Dangerous Decibels”)– Road transport– Health
- etc
• Aviation– CPL/Instrument Rating, etc– Flew post around the southern part of NZ in evenings
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Overview
• The history and background
• The 4 reports that led to the update of the guidelines
• The process in updating the guidelines
• Where to from here?
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John
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ACC Work Related Entitlement DPI Claims in Health Services Sector
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DHB and residential/aged care services, by duration of claim (on year)
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$3,500,000
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Active Entitlement
Cost of Active Claims
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DHB and residential/aged care services, by injury site (one year)
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$1,500,000$2,000,000
$2,500,000
$3,000,000$3,500,000
$4,000,000
Activ
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title
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New Claims
Cost of Active Claims
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DHB and residential/aged care services, by cause of claim 2008/2009
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New Claims
Cost of Active Claims
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Taxonomy-Residential care (2009)
925 claims353 > 60 days
Human 72%
Patient handling 50%
Equipment handling 16%
Gravitational 25%
Falls to the same level 17%
Patient handling
Lift 37%
Push/Pull 5%
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The “lead-up” to the new guidelines
• Thomas D and Y L. (2010). Survey of users of the New Zealand Patient Handling Guidelines.
• Thomas D et al. (2009). Report on the review of the New Zealand Patient Handling Guidelines.
• Thomas et al. (2009). Patient Handling Guidelines: Literature Review.
• Ludcke J and Kahler R. (2009). Taxonomy of injuries in Residential Care.
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Survey of previous users
• Remove the 16kg weight limit
• Simplify forms and audit tools
• Make clear who the audience is for each section
• More information about training for patient handling
• Techniques for handling disabled or non-compliant patients
• Update injury stats data- etc
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Report on the review of the 2003 NZPHG
• Many providers had done very little to develop an adequate safety culture related to safe patient handling
• Review Panel strongly supported the guidelines as a single comprehensive document
• The document is a resource for a wide range of organisations
• The 2003 guidelines needed revision
• Cost/benefit information needed to be provided.
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Literature Review
• Health care workers vulnerable because of:– Job strain– High physical workload– Lack of lifting or other devices
- Etc
• Lateral transfers particularly • Psychosocial • Multi-factorial approaches
• Cost-Benefit analysis
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Literature Review
• Cost-Benefit analysis
• Increasing weight of patients
• Legislative enforcement?
Many studies are limited in their usefulness - etc
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Moving and handling of people - the New Zealand guidelines 2012
• Produced by a panel of people with different backgrounds
• People with relevant experience brought in periodically
• Written by Prof. D. Thomas followed by– International expert (SME) review
– Public submissions
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Chapters increased from 9 (2003) to 14 (2012)
Has taken into account:• Changing use of equipment
• Bariatric patients and other developments– Recommendations based on best
available information– It is not a Code of Practice
• Aiming to set a benchmark for future development and improvement
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Where to from here?
• Freely available– CD/DVD format– Online format
• Supported by short versions for front-line staff
• Translated versions
• Posters, etc
• Regional seminars planned for May and June
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Immediate future plans
• Home Care industry– Addition to the Guidelines
• Extramural course (co-operative alliance between universities)
• Other views/ideas?
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Questions