Prevent Back Injury in Nurses

Compared to other occupations, nurses are among the highest at risk for musculoskeletal disorders. Lower back injuries are the most common  disorder affecting nurses. Lower back pain can be caused by a variety of problems with any of spinal muscles, nerves, bones, discs or tendons in the lumbar spine. Typically, nurses are more likely to experience back pain from a lower back muscle strain or from within the disc space itself - such as a lumbar disc herniation or lumbar degenerative disc disease. 

As we all know, we can't completely prevent this by using proper techniques and body mechanics, still we can reduce the risk to a minimal extent. You should know certain things during lifting and moving to avoid patient and self injury.

1. Assess the situation

Know the Patient

• Patients condition, vital signs, any drainage or IV tubes, mental status
• How much weight patient can bear, any assistive device available

Know your abilities and limitation 

• Health and Pregnancy status
• Protective equipment available 

How safe is the environment

• Electrical cords
• Loose carpeting and slippery floor
• Wet surface
• Furniture, boxes and other obstacles
• Sharp edges
• Poor lighting

2. Prepare for the move

• Take steps to avoid or reduce manual handling.
• Get help if you need it ( 2 or more staff)
• Get the equipment you need ( Lifts, hoists, sliding board, turn sheet etc.)

3. Prepare the patient

• Explain the movement, why, how and the risks.
• Give clear instructions
• Ask if they have any questions
• Get patient consent if required

4. Position and adjust the equipment properly

Adjust the bed- Raise or lower it close to your center of gravity, just below your waist level

• Position the head of the bed up or low depends on the move
• Keep the side rails in the desired position
• Lock the wheels
• Position the equipment
• Place the wheel chair or stetcher as close to the patient a s possible
• Align it properly
• Adjust the handrails and foot rest
• Lock the wheels
• Make needed adjustments
• Keep equiment and bed at the same height if possible
• Make sure that the patient and helpers are properly positioned

5.Always use a proper Body Mechanics

• Maintain your balance
• Get a sure grip
• Keep loads as close to your body as possible
• Use your legs- knees bent and back straight.Lift with your legs to avoid back strain
• Dont twist, over reach or bend forward, instead change the position of your feet
• Encourage the patient to use his/her strength while moving

6.Use Equipment Properly

• Use belts, Lock wheels, Put side rails etc.

For your patient's health and safety, take precaution to protect their skin. Never drag patients, check their level of consciousness, comfort and vital signs after the move if indicated. Protect yourself by using proper body mechanics and report immediately any type of injuries. Maintain a healthy weight with helathy diet and do some simple back exercises like pelvic tilt and knee to chest rise

Pelvic Tilt

Lie flat, knees bent, feet flat on floor. Tense the stomach. Squeeze the buttocks and lift hips slightly off the floor. count up to ten and relax. Repeat

Knee- to- chest raise

Lie flat, legs straight. Grasp one knee and bring it close to chest. Count to 10. Relax. Repeat ( pull both legs at once for more result)

GIVE YOUR BACK A BREAK. STAY HEALTHY! :)

Injuries from Sharps- What You Should Know About

What are injuries from sharps?

They are injuries, cuts, punctures, scratches, nicks and gashes caused by medical instruments such as needles and other sharp objects.

What type of sharps can cause injuries?

Any sharp medical instrument or needle including: 

• Hypodermic needles 
• IV (intravenous) needles 
• Lancets 
• Razors, scalpels and other blades 
• Retractors 
• Suture needles 
• Many dental instruments
• Many surgical instruments

Who is in Danger?

1. Nurses- Suffer more injuries from sharps than any other group of health care staff.
2. Laboratory Personnel- Handle many types of sharp instruments as a regular part of their jobs.
3. Doctors- Use a wide variety of sharp medical instruments in treating patients.
4. Laundry Staff- Are injured by sharps when needles or other instruments are accidentally or carelessly left in bedding, linen or other laundry.
5. Nursing Assistants and other Volunteers- Are also exposed to potential injury from sharps.
6. Domestic Staff- Are often injured when some one else improperly disposes a sharp object or broken glass.

How do injuries from sharp happens?

In a variety of ways. Injuries from sharps can happen any time there is a sharp medical instrument nearby.

• Administering injection- An unexpected movement by a patient or colleague or a momentary lack of concentration can result in an injury.
• Taking blood- Many times it happened to health care professionals, even though the same procedure may be repeated hundred of times, it only takes one slip to cause a serious injury.
• Uncapping needle- The simple act of uncapping a needle can be a source of a troublesome injury.
• Resheathing needles- Resheathing is not recommended.If it ever must be done,use a needle guard holder.
• Disposing of needles- Most of the needle stick injuries occur during the disposal. Never attempt to bend or cut the needle, with out a proper designated instrument. Always use puncture proof containers to discard the needles.
• Collecting rubbish- Needles and other sharps some times end up in waste paper baskets, endangering domestic and portering staff.
• Cleaning  instruments- Instrument trays are hazardous because they may contain a number of contaminated sharps. 
• Processing laundry- Some times through carelessness or by accident used sharps end up on the floor , bedding or linen can cause injury.
• Other times- Injuries from sharps can happen any time, during any procedure. Since sharps are always used in health care, injuries from sharps are an important concern for every health care employee.

Risks of sharp injuries

Hepatitis B and C- Usually transmitted through contact with infected blood , blood products or other body fluids. Although most people recover, Hep-B can be very serious, incapacitating a person for weeks or months. A small percentage of those infected become chronic carriers, capable of spreading the disease for an uncertain period of time. They also have increased chances of other long term complications such as Cirrhosis and Cancer of liver.

HIV/AIDS- Human immunodeficiency virus(HIV) is a virus that causes HIV infection and acquired immunodeficiency syndrome (AIDS). AIDS is a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive. Without treatment, average survival time after infection with HIV is estimated to be 9 to 11 years, depending on the HIV sub type. Infection with HIV occurs by the transfer of blood, semen, vaginal fluid, or breast milk.

Other Diseases- Although statistically uncommon, it is possible to contract a great variety of conditions such as staphylococcal or herpes simplex infections due to injuries from sharps.

How to prevent sharp injuries?

• Let falling objects fall- Don't grab falling objects, which may lead to an injury
• Never carry loose sharps in your pocket
• Practice a safe handling techniques
• Discard defective sharps and glassware
• Get help with uncooperative patients
• Store sharps safely
• Dispose of sharps properly
• Never reach in to disposal containers
• Clean instrument trays carefully
• Handle laundry with care
• Don't rush or take shortcuts
• The person who uses the needle or sharp instrument must be responsible for its management and disposal. 
• Never re-sheath a used needle, except in special circumstances when a safe re-sheathing technique is used. 
• Make sure a sharps container is nearby every time a needle is used. 
• If a needle or sharp instrument has to be carried some distance to a sharps container, use a puncture-resistant dish or tray - do not carry it in your hand. 
• Never pass needles or sharp instruments to another person by hand, use a puncture-resistant tray. 
• Never bend used needles. 
• Never force needles into a sharps container. 
• Never overfill a sharps container
• Wear general purpose household gloves when cleaning non-disposable instruments. 
  
• Wear a mask and eye protection, or a face shield during procedures that are likely to cause splashes or sprays of blood or other

What to do if you receive a sharps injury?

Injury from a sharp which may be contaminated

• Encourage the wound to gently bleed, ideally holding it under running water
• Wash the wound using running water and plenty of soap
• Don't scrub the wound whilst you are washing it
• Don't suck the wound,do not squeeze the puncture site.
• Dry the wound and cover it with a waterproof plaster or dressing
• Seek urgent medical advice from your infection prevention and control team.
• Report the injury to your employer.

Exposure to blood or body fluids

If the blood or body substance is on intact skin, wash it off thoroughly with soap and water. The skin acts as a very effective barrier and most infections cannot pass through intact skin. All skin cuts, skin breaks or other lesions should be covered with a water-resistant occlusive dressing before you start work.

Exposure to blood or body substance in your eye

• Irrigate it gently and thoroughly with water
• DO NOT USE SOAP. 
• Gently pour water over the eye while pulling the eye lids up and down. 
• If you wear contact lenses, keep them in while you irrigate the eye. 
• Then take the contact lenses out, clean them in the normal manner and put them back in again. 
• Report the exposure to your supervisor or manager. 

Exposure to blood or body substance in the mouth: 

• Spit the blood or body substance out. 
• Rinse the mouth several times with water, spitting out after each rinse. 
• Report the exposure to your supervisor or manager. 

So protect yourself and others by handling sharps safely! Remember, left untreated, a tiny puncture can be the source of a major illness.

Useful Mathematics in Nursing

Nursing Related Calculations and Formulas

Nursing is one of the professions which need lot of knowledge and skills, especially when you work as a bedside nurse. To be a good  nurse, sometimes we have to prove that we are a good Mathematician too...:) cos we are doing lot of maths everyday....:) Here I am sharing few useful formulas and tips which will help you in your daily nursing practice.

Pediatric Nursing ( Mathematics)

IV Fluid Requirement Calculation In Pediatrics

Pediatric fluid requirements and calculations are entirely different from that for adults. Careful assessment of hydration and fluid calculations has vital important in saving the life of the child. Managing fluids and electrolytes in children is an important skill needed for nurses, who can play an important role in monitoring therapy. Fluid therapy is divided into maintenance, deficit, and replacement requirements. Monitoring fluid and electrolyte therapy is an important role of the pediatric nurse.