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Workbook
Support people to use assistive equipment and move in a health, disability or aged care context
US 27833
Level 3 Credits 5
Name:
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Contents
Before you start ...................................................................................................................................... 4
Supporting people to move .................................................................................................................. 7
Managing discomfort, pain and injury ................................................................................................ 8
Injury prevention ................................................................................................................................... 10
Back care ............................................................................................................................................... 11
Looking after yourself .......................................................................................................................... 12
General principles of moving ............................................................................................................. 13
Moving and handling programme ..................................................................................................... 18
Risk assessment .................................................................................................................................. 24
Assisting people ................................................................................................................................... 25
Assistive equipment ............................................................................................................................. 27
Using normal movement patterns .................................................................................................... 34
Caring for equipment ........................................................................................................................... 46
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Before you start
Welcome to this workbook for unit standard 27833:
Support people to use assistive equipment and move in a health, disability or aged
care context.
For this unit standard you will have:
this workbook.
an assessment.
In this workbook you will learn more about:
general principles of moving people.
self-care and injury prevention.
reducing the risk of discomfort, pain and injury.
risk assessment and hazards.
techniques for supporting people to move using normal movement patterns.
supporting people to use assistive equipment.
How to use this workbook This is your workbook to keep. Make it your own by writing in it.
Use highlighters to identify important ideas.
Do the learning activities included throughout this workbook. Write your answers in
the spaces provided.
You might find it helpful to discuss your answers with colleagues or your supervisor.
Finish this workbook before you start on the assessment.
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Workbook activities
Learning activity
You will come across learning activities as you work through this
workbook. These activities help you understand and apply the
information that you are learning.
When you see this symbol, you are asked to think about what you
know. This may include reviewing your knowledge or talking to a
colleague.
When you see this symbol, it gives you a hint, tip or definition.
The glossary and study hints book has study hints for
all trainees. It also explains key words and phrases
from the compulsory unit standards for Foundation
Skills and Core Competencies.
You can download it from www.careerforce.org.nz or
order it from http://shop.careerforce.org.nz
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Check your knowledge…
Before you begin, think about using assistive equipment
Name two pieces of equipment you use to assist people to move.
1
2
What do you have to do before you use the equipment?
How do you look after yourself when assisting people to move?
How do you report any unsafe equipment or hazards?
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Supporting people to move
In your role as a support worker you will support people to move themselves and support
them to use equipment to move.
You may use a handling belt, slide sheet or transfer board to help a person to move. You
may help a person transfer to and use their walking frame or wheelchair.
Assistive equipment allows a person to do something they need support to do or to assist
them to do something better. You as a support worker may use the assistive equipment to
assist the person. This can include shower and bath equipment and toileting aids.
There are many situations in which you will support a person to move. They include:
positioning, for example, repositioning a person in bed.
mobility, for example, transferring from bed to wheelchair.
bathing and showering, for example, getting into and out of a bath.
toileting, for example, transferring to a toilet from a wheelchair.
Helping people to move is called manual
handling work as it requires you to lift,
lower, push, pull, slide, carry or move, hold,
support or otherwise handle people.
Manual handling can lead to injuries and
you must look after yourself.
Under the Health and Safety in
Employment Act 1992:
it is the employer’s responsibility to
provide a safe working environment.
it is your responsibility to take all
practicable steps at work to ensure
your own safety and the safety of
others.
This workbook is based on the principles in
the Accident Compensation Commission
2012 publication Moving and handling
people: The New Zealand Guidelines.
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Managing discomfort, pain and injury
A major injury prevention programme promoted within workplaces by ACC is:
Preventing and Managing Discomfort, Pain and Injury (DPI).
ACC’s approach encourages workplaces to focus on both prevention and management of
musculoskeletal conditions.
DPI can be prevented or managed if the pain and its contributory factors are addressed in
the early stages. Where feasible, people should be able to stay at work, providing changes
are made to address factors contributing to their conditions.
There are seven contributing factors that may lead to DPI. They all interact with each
other and all must be identified and addressed. Of these seven factors, there is no clear
distinction between work and non-work contributory factors.
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Individual factors
These factors relate to things a person can’t change about the way they are, such as their
gender, age and height.
They also relate to things a person can change, such as their strength, physical fitness,
skills and training.
Psychosocial factors
These relate to the issues that may affect a person, and how the person deals with them,
both at work and outside of work.
These factors include the development of a culture of safety at work.
Workplace layout/awkward postures
This relates to the way the workplace is set up and the physical working positions that
workers adopt, which may be as a result of the facility design and available space.
Workplace layout should aim to minimise workers having to bend and reach.
Work organisation
This relates to how work is arranged and carried out. For moving and handling people this
includes adequate rest breaks, length of shift hours, management policies and support
and good training.
Task invariability
This relates to how much a task varies. Is it repetitive, or does it involve holding positions
for long periods of time? Is it boring or too challenging?
Load/forceful movements
These relate to what a person handles and the forces they have to apply to use them. This
also includes the use of specific client handling techniques and equipment.
Environmental issues
These relate to the conditions in which a person works, including room temperature, noise,
lighting, workplace size, resources and staff skill levels.
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Injury prevention
Pain and injury are not necessarily related to each other. You can have pain without injury
and injury without pain.
To prevent and manage discomfort, pain and injury you need to focus on three kinds of
prevention – primary, secondary and tertiary.
Primary prevention
Stop discomfort, pain and injury from happening. For example, warm up and stretch your
muscles before you start work, take rest breaks, eat wisely and drink plenty of water.
The ACC website has Smart Tips sheets for health workers to prevent and manage DPI
which includes warm up and stretching. See www.acc.co.nz/preventing-injuries/at-work
Secondary prevention
If it happens, stop it from getting worse. Self-help and self-management are a vital part of
the process.
Report any DPI to your manager early. The aim is to reduce the chances of the support
worker being off work.
Tertiary prevention
If it does get worse, manage it for the best possible outcome. The goal is to get back to
work with the greatest level of health and function possible.
Effective primary prevention initiatives should be put in place to keep the worker safe at
work and to prevent re-injury.
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Back care
Your back is not naturally designed to move equipment or people. However there are
tasks that we all do every day that involve moving. People may be heavy and they are
often hard to grip.
Back injury is one of the most common forms of workplace injury and a back injury can
stay with you for life. Poor manual handling practices can lead to musculoskeletal injuries,
including sprains and strains and overuse disorders.
Several research studies have identified that manual handling tasks are associated with
an increased risk of injuries, including an extensive study based on ACC claims in New
Zealand.
Between July 2007 and May 2009 ACC claims that involved 60 days or more off work, the
most frequent task leading to long term claims was lifting patients. Lifting patients involved
74% (129) of the 176 claims for injuries that occurred while moving and handling patients
within the New Zealand residential care (or retirement village) sector.
Of the lifting claims which had information about the task, 54% involved transferring
patients to or from equipment (bed, chair, wheelchair, toilet, commode), 25% involved
catching falling patients and 11% involved picking patients up from the floor.
54%
25%
11%
10%
Cause of injury
Transferring patients
Catching falling patients
Picking up patients off floor
Other
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Looking after yourself
Our backs do a huge amount of work and you must take care of yourself and your back.
Warm up and stretch your muscles before you start work. See the ACC Smart Tips sheets
on www.acc.co.nz/preventing-injuries/at-work
Organise your environment in a way that will assist you when moving people. Arrange
things to minimize bending and reaching. Work at a comfortable height and raise or lower
equipment, such as beds where possible.
Minimise the people handling hazards that could cause harm to your back. If you do a lot
of moving and transferring, spread the tasks out and take frequent small breaks between
the tasks.
Things to consider:
make sure your grip is stable.
maintain a good posture and spinal alignment.
push rather than pull wherever possible.
utilise your body weight, using your whole body, not just your arms.
move your whole body when changing direction.
keep your line of vision clear.
If it feels heavy, it is heavy. A person weighing
50 kgs requires a 40 kg pulling force to
re-position them. A slide sheet reduces this to
12 kgs.
If it is difficult, find another way, for example:
use moving equipment.
get another person to assist you.
You need to be aware of the safety of yourself
and others at all times.
Under the Health and Safety in Employment
Act 1992:
it is the employer’s responsibility to
provide a safe working environment.
it is your responsibility to take all
practicable steps at work to ensure your
own safety and the safety of others.
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General principles of moving
It is important to apply safe biomechanical principles of posture, position and technique so
you can provide the best support for the person whilst minimising the risk of harm to
yourself.
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Biomechanical principles
Stand in a stable position.
Your feet should be
shoulder distance apart.
The circle gives you a safe
and stable base to work in.
Moving out of this circle
can put your safety at risk.
Avoid twisting.
Keep your feet pointing in
the direction of movement.
This is the step-stand
position.
Make sure your shoulders
and pelvis stay in line with
each other. This will avoid
twisting your back.
Bend your knees slightly.
Maintain your natural spinal
curve.
Avoid stooping by bending
slightly at the hips (bottom out).
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Keep your elbows tucked in.
Keep the person close to your body.
Avoid reaching - the further away
from you the person is, the greater
the potential for harm.
Tighten your abdominal muscles
to help support your spine.
Keep your head raised.
Keep your chin tucked in.
Head, shoulders and hips should
all be facing the same direction.
Move smoothly throughout the
technique and avoid fixed holds.
Move upper and lower body as one unit
to avoid twisting at the waist.
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Learning activity
You can help yourself prevent and manage discomfort, pain and injury.
Consider each of the seven contributory factors below and write down what you can
do for yourself. The first one has been done for you as an example. Hint: The ACC
website www.acc.co.nz has a useful list of possible solutions to manage DPI.
Individual factors
My contributory factors are that I am not feeling well at the moment due to
lack of sleep, eating poorly, not drinking enough water and not exercising
enough. I can take more control of my life. I will try to get rest when I can
and eat and drink properly. I am going to join a walking group to encourage
myself to exercise regularly.
Psychosocial factors
Workplace layout/awkward postures
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Work organisation
Task invariability
Load/forceful movements
Environmental issues
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Moving and handling programme
ACC research shows that training people in moving and handling techniques alone is
ineffective in reducing injuries. Only a moving and handling programme with multiple
components is effective in reducing back problems and other injuries.
Core programme components typically include:
a policy on moving and handling clients.
a training programme in moving and handling people.
risk assessment protocols, documentation and an incident reporting system.
the provision of moving and handling equipment.
facilities that are designed or modified for moving and handling people.
Your workplace will have a moving and handling programme and a risk assessment
process that needs to be done before moving and handling people. The purpose of risk
assessment is to identify and manage hazards to reduce the likelihood of incidents
occurring that could cause harm or injury for carers and clients.
A ‘risk’ refers to the possibility of an injury or other negative outcome occurring. A low risk
means a low likelihood of a negative outcome. A ‘hazard’ is a feature of a task or
environment that may lead to injury or harm to a carer or to a client.
Hazards
Hazard identification should be part of risk assessment to reduce the risk of injury to
carers. You must be aware of the hazards in your workplace so that the risks can be
managed by eliminating, isolating or minimising them.
Hazards related to people being supported
People who are difficult to move because of their size or condition.
A client’s ability to hear, see and understand, which may affect their mobility and
ability to cooperate.
Lack of understanding due to cognitive issues such as confusion and dementia, or
language and cultural differences.
Unpredictability of client when being moved.
Client anxiety and fear of moving or falling, which can limit cooperation.
Medical attachments to client, which may limit their ability to help.
Pain, which can affect a client’s ability to cooperate.
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Hazards in the physical work environment
Slip, trip and fall hazards such as electrical cords, wires and wet or slippery floors.
Uneven work surfaces, such as steps.
Space limitations - small rooms with lots of equipment and clutter.
Inadequate space around beds and toilets for transfers.
Facility design inadequate for transfer tasks in the transfer area and for the
equipment required.
Inadequate lighting.
Hazards related to working hours and place
Staffing levels. Insufficient number of carers for moving and handling tasks for the
number of clients can result in increased work demands being placed on the existing
staff. For example, more transfer tasks (repetition) on each shift and long durations
can lead to fatigue and reduced work capacity, and to staff taking shortcuts and
following unsafe practices.
Extended workdays. More than eight hours work without a break increases the risk of
injury. This can occur when overtime becomes necessary because staff on the next
shift are suddenly not available, or staff are working regular 12 hour shifts.
Inadequate rest breaks. Not allowing enough time between people moving and
handling tasks can contribute to fatigue and overexertion. An example is busy work
schedules leading to missed breaks.
Working in isolation. For example when caring for a dependent person in their home,
a carer generally does not have the opportunity to call for assistance.
Hazards for carers using moving and handling techniques
Inadequate training. Carers are not trained in the task, or do not know how to use the
equipment properly.
Equipment not provided, not maintained adequately, not enough equipment, some
types of equipment not available, equipment outdated or obsolete.
Force - the amount of physical effort required to perform a task (such as pushing and
pulling) and to maintain control of equipment.
Repetition - performing the same movement or series of movements frequently
during the working day. Lack of variability can increase the load on body tissues and
muscles owing to a lack of changes in posture and the reduced chance of recovery.
Awkward positions that place stress on the body, such as leaning over a bed,
kneeling or twisting the trunk while moving a client, reaching away from the body or
over shoulder height for long periods and while exerting force.
Carer may be wearing inappropriate footwear and clothing.
Not having enough people to do the task.
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Managing hazards
Take action to manage the hazard.
Can the hazard be eliminated?
If not, can it be isolated?
If it can’t be isolated, then it must be minimised.
Eliminating – getting rid of the hazard.
Isolating – protecting people from the hazard with barriers/signs.
Minimising – lessening the hazard.
Reporting hazards and incidents
Your organisation will have policies and procedures in place for reporting incidents,
accidents, hazards and unsafe equipment. You need to be aware of what you have to do.
Ask your supervisor to show you where the hazard identification forms are kept, and how
to fill them in.
When making a report, write the facts – what happened, where and when it happened,
who was involved. Do not include unrelated details.
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Here is an example of a hazard identification and reporting form.
An injury, incident or
accident that happens in
the workplace must be
reported.
Here is an example of an
injury/accident/incident
report form.
You’ll find information on
equipment safety and
reporting forms for
equipment faults later
in this workbook.
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Learning activity
For each of the four types of hazards describe two potential hazards
in your workplace. Describe what you would do to eliminate, isolate or
minimise them and how you would report them.
Hazards related to people being supported
1
2
Hazards in the physical work environment
1
2
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Hazards related to working hours and place
1
2
Hazards for carers using moving and handling techniques
1
2
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LITE =
Load
Individual
Task
Environment
Risk assessment
When assisting people to move, you must first do a risk assessment of the moving and
handling activity and any actual or potential risks. An example of a risk assessment tool
is LITE. The LITE principles can be applied to any moving task.
Applying the LITE principles will enable you to:
plan the task, check the environment, assess the risks
and identify hazards.
prepare for the task – minimise hazards, get any equipment,
prepare the people.
apply safe bio-mechanical principles of posture, position and
technique.
Load
Characteristics of the person being moved can affect the handling risk.
Consider age, gender, dependency, size, weight, diagnosis and disabilities, pain, fall risk,
ability to understand and cooperate, ability for independent movement, medical
attachments, moving and handling plan.
Individual
This relates to the capabilities and training of the support worker. For example their age,
fitness level, size, fatigue, knowledge and training.
Task
This relates to the nature of the task, ie what has to be done. It may require supporting a
person to sit up in bed or transfer to and use a mobility aid.
Consider the best handling method that will be needed, for example: lifting, pushing,
pulling, or carrying.
Environment
This relates to the work environment, the space available for moving and transferring, the
layout of the working area, the brightness of lighting and the type of flooring surface.
Before moving, check access ways are clear and that the destination is ready, for
example, the bathroom is unoccupied. Check for hazards, such as furniture in the way,
wet and/or slippery floors, uneven surfaces or steps, or tripping hazards like electrical
cords or loose mats. In a client’s home, additional tripping hazards may be children’s toys
and pets.
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Assisting people
Make sure your clothing and footwear are appropriate for the task. Clothes should allow
free movement but have nothing loose that may get caught. Shoes should be non‑slip,
supportive and stable. If you have to remove your outside shoes in a client’s home, take
some clean house shoes with you. Tie up long hair and do not wear rings or bracelets.
Know your own capabilities and do not exceed them. Tell your manager if you need
training in the technique to be used. Talk to your manager or the moving and handling
adviser if you need advice on the techniques and equipment you should be using.
The person’s needs
You must follow the person’s service plan and/or moving and handling plan if they have
one. The plan will outline the support the person may need and how that support should
be given.
The equipment used is based on the individual’s needs and will be documented in their
plan. Make sure you know what equipment a person needs, what the equipment is used
for and how the equipment is to be used.
The length of time a person may use equipment can vary. For example, a person may
need a walker temporarily to regain mobility, while for another person they may always
need a walker to move around their home or go out.
Over time a person’s abilities and needs can change so the equipment they once used
may no longer be the best option for them. The equipment will be monitored to ensure it is
assisting the person and not restricting them.
The person’s plan will note any changes in the person’s ability and how they affect the use
of the equipment. If you become aware of any changes in the person’s abilities that are
not noted in the plan, you should inform your supervisor.
When you are supporting a person to move:
only do tasks that you are trained to do.
only use equipment you’ve been trained to use.
use the equipment correctly and safely.
do a risk assessment before you move the person.
follow the person’s moving and handling plan.
follow all your organisation’s policies and procedures.
follow the manufacturer’s user manuals and instructions.
evaluate the move once completed.
report faults promptly.
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Preparing a person to move
Before a person is moved or assisted, you must explain to them what is going to happen
and how you are going to support them.
Think about the person and what might affect your ability to assist them safely.
Do they understand and will they cooperate?
Make sure their clothing and footwear is appropriate for moving.
Check if they have any medical attachments that need to be taken into account.
Remember to take any aids with them.
Before you move a person:
ask them how they feel today - they may want more or less support today than last
time you supported them.
tell them what you plan to do and what technique and equipment you will use.
show them the equipment if it is new to them and explain how it works.
explain to them what, if anything, is expected of them.
ask them if they have any questions, or would like a demonstration.
If more than one support worker is needed for moving or handling a person, it is important
to have a recognised leader. They will consult the person’s moving and handling plan,
check on the person’s capabilities, including mobility, cognitive ability and their need for
assistance.
The leader will coordinate the move and give instructions, like
“Ready.”
“Steady.”
Then an action word like stand, sit-up, move, roll, slide.
Get the person to rock gently forward on each word. If necessary, gently rock the person
backwards and forwards to build up momentum.
People must be treated at all times with dignity, respect and consideration for their
capabilities.
Make sure the person is comfortable during and after the move. Ask them for feedback.
This is a great way to learn about the effects of what you are doing and to get suggestions
for improvement in your moving technique. Always evaluate what you are doing and have
done.
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Assistive equipment
Assistive equipment allows a person to do something they
need support to do or to assist them to do better something
that they can already do.
This can include shower and bath equipment and toileting
aids like raised toilet seats and a commode.
Furniture like handrails and grab handles and bars (also
known as monkey bars or bed poles) above the bed assist
the person with their positioning and mobility.
Canes, crutches and walkers also assist a person’s mobility.
Assistive equipment gives the person more control over tasks or activities, giving or
increasing independence and reducing the amount they need to rely on other people for
support.
It is helpful to know the normal sequence for an action, such as standing up or rolling over
in bed so that you can encourage the person to help. You can coach the person in their
movement, providing guidance.
Encourage normal actions and movement. Encouraging independent movement benefits
the person and makes the moving task safer. Help the person with any movements they
have difficulty with. Be adaptable when assisting them.
Where possible, promote independence. There is a continuum from dependent to
independent. You need to match the technique and/or level of assistance with the ability of
the person.
Dependent ________________________________________________Independent
mechanical 2 carers 1 carer assistive
assistance equipment
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Mobility
Mobility is the ability to move or be moved freely and easily. It is a key aspect of a
person’s independence to be able to complete some tasks for themselves and to move
within their home and around their neighbourhood, such as to the shops or to the doctor.
A person may need your support with their mobility, for example:
to balance themselves and to stand.
to explain how to use their mobility aid.
to position their mobility aid where they can access and use it.
to transfer to their mobility aid, such as their walker or wheelchair.
Mobility aids include specialised assistive equipment that is used to help people:
to walk, especially to support speed and evenness of stride. For example, walking
frames and wheeled walkers.
to maintain an upright body posture, for example, walking sticks and canes.
to redistribute their weight when walking, from their legs to the arms of a walking
frame or cane as it is used for support.
to feel more confident, steady and balanced. For example, a walker or walking stick
may help the person feel as if they are less likely to fall.
Canes and walking sticks
A cane can help maintain mobility, as weight is transferred to the forearm.
A correct length cane will keep the person upright while providing support. A cane is
usually about half the person’s height. The top of the cane should reach the crease on the
underside of the person’s wrist. The elbow should be flexed at 15-20 degrees when
holding the cane while standing still.
The cane should be held using the hand that is on the same side as the stronger or good
leg. As we walk, we swing our hands as we move our legs. As we step out with our left
foot, we swing our right arm, and vice versa. Holding a cane in the hand opposite the
injury replicates the natural arm movement, allowing the hand and cane to absorb some of
the weight as the person walks forward with their bad leg.
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Crutches
Crutches are needed if a person cannot put weight on a leg. Two crutches provide greater
stability than using one crutch.
Crutches are designed for either forearm or underarm use. The top of underarm crutches
should come to 2-3 cm below the armpit, and the crutches grip should be at the person’s
hip height.
To walk, the person should place the ‘feet’ of both crutches on the ground in front of them
by about 30cm, and lean forward slightly. Moving as though they are going to step on their
injured side, they need to shift their weight to the crutches and swing forward between the
crutches. They must come down on their uninjured leg, keeping their injured leg up, so
that no weight is placed on it.
To sit down, the person should hold both crutches in the hand on the good leg side, like a
long cane. Using the crutches for balance, the person should lower themselves down. To
stand up, the person should use the crutches for balance as they push themselves
upright.
Walkers
People who have difficulty balancing or are at risk of falling should use a walker. Walkers
may have no wheels, two wheels or four wheels. Walkers without wheels, which have to
be picked up and moved forward, are best if stability is a significant concern.
A two-wheeled walker is easy to push forward and is then safe from rolling as the person
steps forward. A four-wheeled walker moves easily and has brakes if stability is needed
only intermittently.
To fit a walker for height, get the person to step inside the walker. With their arms relaxed
at their side, the top of the walker should line up with the crease on the inside of the wrist.
With their hands on the grips, their elbows should be at an angle of 15 degrees. A well-
adjusted walker fits the person’s arms comfortably and reduces stress on their shoulders
and back as they use their walker.
If a walker is used for taking weight, the person pushes the walker forwards. Keeping the
walker still, the person places their first leg inside the walker, followed by the second leg,
keeping their back upright. They move the walker forward again and repeat the actions.
If the person uses the walker for balance, not for placing weight on it, then they can stand
inside it and walk as they normally would, guiding the walker in front of them.
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Careerforce – Issue 1 0 – Sep 2013 US27833 Support people to use assistive equipment and move … 31
Equipment used for positioning and mobility
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Equipment for showering, bathing and toileting
The risk of falling while showering, especially on wet and/or slippery floors, can present
one of the greatest areas of concern for people. A person may need equipment to
support them.
The person may toilet independently with the use of assistive equipment, for example, a
raised toilet seat, or hand rails fixed to the wall that give extra support.
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Learning activity
Name four items of assistive equipment and four items of moving
and handling equipment in your workplace and explain what they are
used for.
Equipment name What is the equipment used for?
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Using normal movement patterns
In your role as a support worker you will assist people to move and to use assistive
equipment. Encourage normal actions and movement and coach the person in their
movement, providing guidance. These pictured techniques are from the ACC 2012
publication Moving and handling people: The New Zealand Guidelines. It is also online
and can be downloaded from the ACC website www.acc.co.nz
Handling belts
You may use a transfer or handling belt to assist a person to move to give you a secure
hold on the person. Make sure a layer of clothing is between the person’s skin and the belt
to avoid abrasion. Ensure the belt is securely fastened and cannot be easily undone
during use.
Handles on the belt are positioned so that the
support worker does not have to hold onto the
person’s clothing or directly onto their body.
Belts with padded handles are easier to grip
and increase security and control. Keep the
person as close as possible to you.
Support workers are advised not to place their full
hand through the handle of the belt as this will
prevent the release of their hold of the person in
the event of a sudden movement.
More than one caregiver may be needed. In most
cases the far handle should be used and with two
carers, the arms would be crossed.
Always transfer to the person’s strongest side. Use good bio-mechanical principles and a
rocking and pulling motion.
Handling belts should not be used for lifting people.
Handling belts can be used to provide support in walking. However, all manufacturers and
suppliers provide warnings regarding inappropriate use and advise carers to undertake a
specific risk assessment in respect of the weight bearing ability of the person and other
relevant factors.
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Repositioning a person
There are two basic techniques carers need to be familiar with.
Instruct the person to look
in the direction of the
move. This helps the
movement.
The lunge position is a
basic position for carers.
The lunge is not just a
position, but a movement.
You shift your whole body weight from one foot to another in the same plane. Using the
whole body increases strength and makes a move safer and easier.
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Using a slide sheet
Always place a slide sheet underneath a bed sheet to protect the person’s skin.
Keep the edge of the slide sheet to the edge of the bed.
Roll the person on to their side.
Pull through the slide sheet, using the lunge position.
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Sitting to standing
The chair height must allow the person to place their feet firmly on the ground, with their
hips and legs at right angles. The chair will ideally have arm rests, but if it doesn’t, the
person can push on the edge of the chair.
Use instructions, saying “ready, steady, stand” and get the person to rock gently forward
on each word. If necessary, gently rock the person backwards and forwards to build up
momentum.
Standing to sitting
Have the person stand with the back of their legs against the chair or bed.
Ask them to keep their head up, to lean forward slightly and put their hands on the chair
armrests or on the edge of the chair or bed. Tell them to slowly sit down with their bottom
as far back in the chair or on the bed as possible. The person then needs to straighten up,
with maybe a slight adjustment or repositioning for comfort.
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Before repositioning a person in bed, make sure it is the correct height (if adjustable). The
mattress should be at your hip level, so your knuckles can rest on the bed.
If a person is going to stand up, lower the bed so that their feet will be on the floor when
they are sitting on the bed.
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Sitting to sitting transfers
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A small transfer board can be used to
bridge gaps between seats.
These boards can be straight or
curved. Curved transfer boards make
it easier to transfer around fixed
armrests.
If possible, have the surface to which
the person is being transferred slightly
lower. This makes it easier for the
person to move. You may also need to
use a slide sheet.
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Moving in bed
A person can use an overhead pole or
monkey bar to move themselves in bed,
provided they have upper arm strength.
The person should firmly pull on the bar,
bend their knees and lift their buttocks
off the bed, while pushing their feet into
the bed. This moves their body up the
bed.
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An excellent resource is the ACC videos on many of these procedures.
Go to www.acc.co.nz and search for the ‘moving and handling people’ videos.
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Assisting a person who has fallen
When a person has fallen the first thing you need to do is check the area for anything that
may present a hazard. Ask the person if he or she is having any trouble breathing or if
anything hurts. In the majority of falls, the person will be able to respond to you.
If the person appears to be unwell or injured, you will need to call for medical assistance. If
you are unsure, follow the policies and procedures of your organisation which may include
contacting your supervisor.
Signs that a person may be injured
Signs that a person is injured or unwell and needs medical assistance urgently include:
severe pain.
difficulty breathing.
difficulty moving.
confusion/drowsiness.
severe bruising or bleeding.
vomiting.
seizure.
clear fluid or blood coming from the nose, ears or mouth.
unusual position or shape of limb.
unusual behaviour.
If the person is injured
If you suspect the person is injured or unwell, do not try to move them. Make them as
comfortable as possible, keep them warm, and stay with them to wait for medical
assistance to arrive.
Follow any instructions given by the emergency services. For example, you may be asked
to put pressure on a cut to stop severe bleeding.
If the person is not injured
A person who appears to be uninjured may be able to get up independently. You may be
able to coach a person into each step and assist with getting up, but do not try and lift the
person’s whole weight because you are very likely to injure your back by doing so.
Stop, at any point, if the person feels unable to move, dizzy or if pain levels increase.
Assist the person into a comfortable position and call for help.
The next page shows the sequence of steps for a person to get up from a fall.
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A person who has fallen and is not injured may be able to get up independently by using
this method.
1 Roll on to side and then push up 2 Move into a position on hands
on one arm to a side sitting position. and knees and crawl to a chair.
3 Put closest hand on the chair 4 Lift your body by pushing with outside
and bring outside leg up. hand on knee and inside hand on chair.
5 Pivot body around to sit
on the chair.
Trying to catch a person who is
falling is very dangerous.
Someone who is 60 kg in weight
has the force of more than
480 kg by the time they reach the
floor, which is far too heavy to
catch safely.
Calculated by physiotherapist and ergonomist Dr Mike Fray
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Caring for equipment
When using equipment it is important to ensure the device is used correctly and for what it
was originally designed. You should familiarise yourself with the manufacturer’s user
manuals and follow your organisation’s policies and procedures when using equipment.
This is to ensure the person’s safety and comfort and to prolong the life of the equipment.
The correct care for equipment is extremely important. If a device is damaged it may mean
the person is without it for a period of time while repairs are undertaken, or the person
maybe unsafe while using the equipment. This can have a dramatic impact on their
wellbeing as they may be unable to do certain tasks or activities that the device enables
them to do.
Visual checks
You should inspect all equipment before you use it. There should be no visible damage,
contamination, soiling or leakage and there should be no rough or sharp edges. Fabric
handling aids such as slide sheets and hoist slings should be inspected for tears, loose
stitching, soiling and dampness.
Where relevant, check the equipment has a current certificate of fitness. The designated
safe working load (SWL) is shown on the equipment and the weight of the person must
not exceed the SWL.
For electrical items, which can cause fires or electrical shocks if damaged, you should:
check the cord and plug for fraying and cracks.
keep the plug and cord away from heat sources.
check battery has enough charge and the location of a spare battery is known.
never use the equipment if your hands are wet or you are standing in water.
turn equipment off before unplugging it.
For equipment that is on wheels ensure that:
the brakes work and that you can lock and unlock them.
the wheels move freely and the tyres are not loose or flat.
the spokes are all intact and that none are damaged and broken.
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Equipment safety and reporting faults
If equipment is damaged or faulty it may need to be replaced or returned to the
manufacturer. You should always report broken equipment to your supervisor.
You may need to place a ‘Do Not Use’ tag on the item. You’ll need to know where to put
the faulty equipment and you may need to fill out an equipment fault report.
Your organisation will have its own policies and procedures relating to reporting faulty
equipment. You should familiarise yourself with it, where equipment fault report forms are
kept and where faulty equipment is put.
You need to check your organisation’s policies and procedures to see what form is used.
Try filling the form out and show the form to your supervisor to ensure you can complete
the form according to requirements.
Here is a typical equipment fault report form.
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Maintenance checks
Periodic maintenance checks should be carried out every few months. This is more
extensive than a visual check and equipment is cleaned and decontaminated in line with
infection control procedures.
Scheduled maintenance checks are in line with the manufacturer’s recommendations and
according to how often the equipment is used. Maintenance covers wear and tear,
defects, replacement of worn or damaged parts, and cleaning and decontamination.
For mechanical or electrical equipment, check battery capacity, lubrication and adjustment
if needed and renew the fitness certificate. The equipment service schedule should then
be updated.
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My notes
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Completion and assessment
Congratulations!
You have come to the end of the workbook. Please check over all the activities in this
workbook to make sure you have completed them.
Your assessment is next.
You need to complete the assessment successfully to be credited with this unit standard.
Acknowledgements
Careerforce thanks the people who have contributed to this workbook by:
researching and validating content.
providing advice and expertise.
testing the activities.
sharing personal experiences.
appearing in photographs.
The images contained in these workbooks are visual illustrations only and are not representative of
actual events or personal circumstances. Careerforce thanks ACC for permission to use images from
their 2012 publication Moving and handling people: The New Zealand Guidelines.
Creative Commons
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You are free to copy, distribute and transmit the work and to adapt the work. You must
attribute Careerforce as the author. You may not use this work for commercial purposes.
For more information contact Careerforce www.careerforce.org.nz
© Careerforce – Issue 1.0 – Sep 2013