1、BSI Standards PublicationPD ISO/TR 12296:2012Ergonomics Manualhandling of people in thehealthcare sectorPD CEN ISO/TR 12296:2013PD CEN ISO/TR 12296:2013 PUBLISHED DOCUMENTNational forewordThis Published Document is the UK implementation of CEN ISO/TR 12296:2013. It is identical to ISO/TR 12296:2012.
2、 It supersedes PD ISO/TR 12296:2012, which is withdrawn.The UK participation in its preparation was entrusted by Technical Committee PH/9, Applied ergonomics, to Subcommittee PH/9/-/4, Ergonomics Anthropometry and Biomechanics.A list of organizations represented on this subcommittee can be obtained
3、on request to its secretary.This publication does not purport to include all the necessary provisions of a contract. Users are responsible for its correct application. The British Standards Institution 2013. Published by BSI Standards Limited 2013ISBN 978 0 580 82214 8ICS 13.180Compliance with a Bri
4、tish Standard cannot confer immunity from legal obligations.This British Standard was published under the authority of the Standards Policy and Strategy Committee on 30 June 2012.Amendments/corrigenda issued since publicationDate Text affected30 September 2013 This corrigendum renumbers PD ISO/TR 12
5、296:2012 as PD CEN ISO/TR 12296:2013TECHNICAL REPORT RAPPORT TECHNIQUE TECHNISCHER BERICHT CEN ISO/TR 12296 September 2013 ICS 13.180 English Version Ergonomics - Manual handling of people in the healthcare sector (ISO/TR 12296:2012) Ergonomie - Manutention manuelle des personnes dans le secteur de
6、la sant (ISO/TR 12296:2012) Ergonomie - Manuelles Bewegen von Personen im Bereich der Pflege (ISO/TR 12296:2012) This Technical Report was approved by CEN on 19 August 2013. It has been drawn up by the Technical Committee CEN/TC 122. CEN members are the national standards bodies of Austria, Belgium,
7、 Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, Former Yugoslav Republic of Macedonia, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, Switzerlan
8、d, Turkey and United Kingdom. EUROPEAN COMMITTEE FOR STANDARDIZATION COMIT EUROPEN DE NORMALISATION EUROPISCHES KOMITEE FR NORMUNG CEN-CENELEC Management Centre: Avenue Marnix 17, B-1000 Brussels 2013 CEN All rights of exploitation in any form and by any means reserved worldwide for CEN national Mem
9、bers. Ref. No. CEN ISO/TR 12296:2013: EPD CEN ISO/TR 12296:2013CEN ISO/TR 12296:2013 (E)CEN ISO/TR 12296:2013 (E) 3 Foreword The text of ISO/TR 12296:2012 has been prepared by Technical Committee ISO/TC 159 “Ergonomics” of the International Organization for Standardization (ISO) and has been taken o
10、ver as CEN ISO/TR 12296:2013 by Technical Committee CEN/TC 122 “Ergonomics” the secretariat of which is held by DIN. Attention is drawn to the possibility that some of the elements of this document may be the subject of patent rights. CEN and/or CENELEC shall not be held responsible for identifying
11、any or all such patent rights. Endorsement notice The text of ISO/TR 12296:2012 has been approved by CEN as CEN ISO/TR 12296:2013 without any modification. PD ISO/TR 12296:2012ISO/TR 12296:2012(E) ISO 2012 All rights reserved iiiContents PageForeword iv Introduction . v 1 Scope 1 2 Terms, definition
12、s and abbreviated terms 1 3 Recommendations 2 3.1 General aspects . 2 3.2 Risk assessment . 3 3.2.1 Hazard identification . 4 3.2.2 Risk estimation and evaluation 6 3.3 Risk reduction 7 Annex A (informative) Risk estimation and risk evaluation . 8 Annex B (informative) Organizational aspects of pati
13、ent handling interventions . 38 Annex C (informative) Aids and equipment . 43 Annex D (informative) Buildings and environment . 59 Annex E (informative) Staff education and training 71 Annex F (informative) Relevant information regarding the evaluation of intervention effectiveness . 74 Bibliography
14、 80 PD ISO/TR 12296:2012ISO/TR 12296:2012(E) ISO 2012 All rights reserved iiiContents PageForeword iv Introduction . v1 Scope 12 Terms, definitions and abbreviated terms 13 Recommendations 23.1 General aspects . 2 3.2 Risk assessment . 3 3.2.1 Hazard identification . 4 3.2.2 Risk estimation and eval
15、uation 6 3.3 Risk reduction 7 Annex A (informative) Risk estimation and risk evaluation . 8B Organizational aspects of patient handling interventions . 38C Aids and equipment . 43D Buildings and environment . 59E (informative Staff education and training 71F (informative Relevant information regardi
16、ng the evaluation of intervention effectiveness . 74Bibliography 80. . vPD CEN ISO/TR 12296:2013ISO/TR 12296:2012 (E)PD ISO/TR 12296:2012ISO/TR 12296:2012(E) ISO 2012 All rights reserved vIntroductionNational and international statistics provide evidence that healthcare staff are subject to some of
17、the highest risks of musculoskeletal disorders (particularly for the spine and shoulder), as compared with other jobs. Manual patient handling often induces high loads on the musculoskeletal systems, in particular on the lower back. Manual patient handling ought to be avoided where possible1)or be p
18、erformed in a low-risk manner. Factors such as the number, capacity, experience and qualification of caregivers can interact with the following conditions to produce an increased risk of musculoskeletal disorders: number, type and condition of patients to be handled; awkward postures and force exert
19、ion; inadequacy (or absence) of equipment; restricted spaces where patients are handled; lack of education and training in caregivers specific tasks. An ergonomic approach can have a significant impact on reducing risk from manual patient handling. A good analysis of work organization, including han
20、dling tasks and the above-mentioned risk determinants, is extremely important in reducing risks to caregivers. The recommendations presented in this Technical Report allow identification of hazards, an estimation of the risk associated with manual patient handling and the application of solutions. T
21、hey are based primarily on data integration from epidemiological and biomechanical approaches to manual (patient) handling and on the consensus of international experts in patient handling. The assessment and control of risks associated with other aspects of manual handling can be found in ISO 11228
22、-1, ISO 11228-2, ISO 11228-3 and ISO 11226. 1) As per European Council Directive 90/269/EEC on the minimum health and safety requirements for the manual handling of loads where there is a risk particularly of back injury to workers. PD ISO/TR 12296:2012ISO/TR 12296:2012(E) iv ISO 2012 All rights res
23、ervedForewordISO (the International Organization for Standardization) is a worldwide federation of national standards bodies (ISO member bodies). The work of preparing International Standards is normally carried out through ISO technical committees. Each member body interested in a subject for which
24、 a technical committee has been established has the right to be represented on that committee. International organizations, governmental andnon-governmental, in liaison with ISO, also take part in the work. ISO collaborates closely with the International Electrotechnical Commission (IEC) on all matt
25、ers of electrotechnical standardization. International Standards are drafted in accordance with the rules given in the ISO/IEC Directives, Part 2. The main task of technical committees is to prepare International Standards. Draft International Standards adopted by the technical committees are circul
26、ated to the member bodies for voting. Publication as an International Standard requires approval by at least 75 % of the member bodies casting a vote. In exceptional circumstances, when a technical committee has collected data of a different kind from that which is normally published as an Internati
27、onal Standard (“state of the art”, for example), it may decide by a simple majority vote of its participating members to publish a Technical Report. A Technical Report is entirely informative in nature and does not have to be reviewed until the data it provides are considered to be no longer valid o
28、r useful. Attention is drawn to the possibility that some of the elements of this document may be the subject of patent rights. ISO shall not be held responsible for identifying any or all such patent rights. ISO/TR 12296 was prepared by Technical Committee ISO/TC 159, Ergonomics, Subcommittee SC 3,
29、 Anthropometry and biomechanics.PD CEN ISO/TR 12296:2013ISO/TR 12296:2012 (E)PD ISO/TR 12296:2012TECHNICAL REPORT ISO/TR 12296:2012(E) ISO 2012 All rights reserved 1Ergonomics Manual handling of people in the healthcare sector1 ScopeThis Technical Report provides guidance for assessing the problems
30、and risks associated with manual patient handling in the healthcare sector, and for identifying and applying ergonomic strategies and solutions to those problems and risks.Its main goals are to improve caregivers working conditions by decreasing biomechanical overload risk, thus limiting work-relate
31、d illness and injury, as well as the consequent costs and absenteeism, and to account for patients care quality, safety, dignity and privacy as regards their needs, including specific personal care and hygiene. It is intended for all users (or caregivers and workers) involved in healthcare manual ha
32、ndling and, in particular, healthcare managers and workers, occupational safety and health caregivers, producers of assistive devices and equipment, education and training supervisors, and designers of healthcare facilities. Its recommendations are primarily applicable to the movement of people (adu
33、lts and children) in the provision of healthcare services in purposely built or adapted buildings and environments. Some recommendations can also be applied to wider areas (e.g. home care, emergency care, voluntary caregivers, cadaver handling). The recommendations for patient handling take into con
34、sideration work organization, type and number of patients to be handled, aids, spaces where patients are handled, as well as caregivers education and awkward postures, but do not apply to object (movement, transfer, pushing and pulling) or animal handling. Task joint analysis in a daily shift involv
35、ing patient handling, pulling and pushing or object handling and transport is not considered. 2 Terms, definitions and abbreviated terms For the purposes of this document, the following terms, definitions and abbreviated terms apply. 2.1aids and equipment assistive devices eliminating or reducing th
36、e caregivers physical effort during handling of a non- or partially cooperating patient 2.2caregiver individual required by his or her job specification to perform manual patient handling activities 2.3environment all physical conditions of the area where patients have to be handled, including space
37、, climate and surfaces PD CEN ISO/TR 12296:2013PD ISO/TR 12296:2012ISO/TR 12296:2012(E) 2 ISO 2012 All rights reserved2.4manual patient handling activity requiring force to push, pull, lift, lower, transfer or in some way move or support a person or body part of a person with or without assistive de
38、vices 2.5patient individual who requires assistance to move Note 1 to entry: Types of patients include totally non-cooperating patients (to be fully handled by a caregiver), partially cooperating patients (to be partially handled by a caregiver). fully cooperating patients.Note 2 to entry: Missing w
39、illingness of the patient for cooperation may induce an increase in musculoskeletal load for the caregiver.Note 3 to entry: Other types of patient classifications are mentioned in C.4. Abbreviated terms NC totally non-cooperating patient PC partially cooperating patient MSD musculoskeletal disorders
40、 MPH manual patient handling LBP low-back or lower-back pain PU pressure ulcer 3 Recommendations3.1 General aspects A systematic review of patient handling literature shows that a strategy for risk assessment, application of engineering controls and management must be comprehensive (multifactor inte
41、rventions) to be successful. Consequently, a strategy for risk prevention based on analytical assessment of the risk itself, all of its potential determinants (organizational, structural and educational), and on some key aspects of risk management is outlined below (see Figure 1). The strategy inclu
42、des the use of managerial processes and systems for reducing causes and effects of musculoskeletal and other organizational losses from healthcare institutions. The participatory approach is emphasized in all aspects especially in changing work practices, defining training needs, purchasing technolo
43、gy/equipment and designing work environments. PD CEN ISO/TR 12296:2013ISO/TR 12296:2012 (E)PD ISO/TR 12296:2012ISO/TR 12296:2012(E) ISO 2012 All rights reserved 3Risk assessment Risk management Based on: Organizational aspects; Adequate aids and equipment; Buildings and environment; Training and edu
44、cation; Check of effectiveness Figure 1 Comprehensive strategy The annexes present details of the main relevant aspects of the general strategy: risk assessment (Annex A); organizational aspects (Annex B); aids and equipment (Annex C); buildings and environment (Annex D); staff education and trainin
45、g (Annex E); effectiveness check (Annex F). The following sections (3.2 and 3.3) describe the basic recommendations for this strategy. 3.2 Risk assessmentRisk assessment is one of the pillars of preventive strategies. Risk assessment consists of the following steps: hazard/problem identification, ri
46、sk estimation/evaluation. It is emphasized that for the purposes of this Technical Report, hazard identification and risk assessment are related not just at health risk identification but also in problem identification and problem solving. A risk assessment is recommended when new equipment is intro
47、duced, organizational issues are modified (number of caregivers, number of non-cooperating patients), spaces are reorganized from an environmental viewpoint (rooms, services) and whenever other changes could affect risk characteristics, even if the previous condition was found to be acceptable. For
48、the purposes of this Technical Report, the risk assessment model shown in Figure 2 is used. PD CEN ISO/TR 12296:2013ISO/TR 12296:2012 (E)PD ISO/TR 12296:2012ISO/TR 12296:2012(E) 4 ISO 2012 All rights reservedStep 1Step 2Hazard identification3.2.1Risk management:- Organizational aspects (Annex B)- As
49、sistive devices (Annex C)- Environment (Annex D)- Training (Annex E)Check of effectiveness(Annex F)Risk estimation in outpatient operations, the number of access requests for patients; in hospital wards, the number of patients. Patient quantification will be a preliminary factor to assess the time, number and frequency of handling. Also the presence of a hazard requires that other factors should be taken into account that may address the subsequent risk evaluation. 3.2.1.1 Type of handlingThe type of handling i
