SAFE Work Manitoba has made reasonable attempts to confirm the accuracy of information contained in this document. However, this document is intended for general information purposes only. SAFE Work Manitoba shall not assume responsibility or liability for actions taken or not taken as a result of reliance on information in this document alone. Manitoba employers must comply with the Workplace Safety and Health Act and Regulations, as may be amended from time to time.

1. Training standard topic

Safe patient handling

2. Purpose

The purpose of the safe patient handling (SPH) training program is to provide employers, supervisors and workers with:

• knowledge, skills and techniques for safely transferring and repositioning patients/clients/residents along with a return demonstration of these techniques.
• understanding of the legislative requirements pertaining to work that takes place during patient/client/resident care.

This training is intended for anyone who may perform tasks related to patients/clients/residents and for those supervising workers performing these tasks.

The SPH training program outlines the minimum requirements for the development and delivery of SPH training in Manitoba. It was developed in consideration of the Manitoba Workplace Safety and Health Act and Regulations and Canada Labour Code Part II.

Note: This training is applicable to the site-specific equipment being demonstrated.

3. Design

The design of the training program must meet the following criteria:

• Compliance with adult learning principles:

1. Ensure learners know why they need to learn specific content and its relevance to their workplaces
2. Relate training to learners’ own experiences when simulating workplace scenarios including using workplace specific equipment
3. Challenge and engage learners using a variety of activities that allow opportunities for participation, feedback and interaction
4. Recognize the limits of attention spans and apply techniques to address the various ways that adults learn
5. Use realistic activities and tools to support the transfer of learning to the workplace

• Use language that is appropriate for all learners.
• Provide content that is accurate and current.
• Include references to legal and technical information.
• Use a variety of technical teaching aids
• Provide learner materials that follow the principles of instructional writing and good graphic design
• Be consistent with provincial and federal legal requirements

4.    Delivery

Regardless of the delivery method, all Endorsed Training programs must meet the requirements of this standard along with the Accessibility for Manitobans Act and the delivery method must be reasonable and practicable to support the learner’s ability to attain the applicable learning outcomes.

4.1      Face-to-face Learning

 The following are the maximum ratio of learners to instructor:

• Basic theory module: 20:1
• Practical module: 12:1

The following are the minimum hours for training delivery:

• Basic theory module: 1 hour
• Practical module: 4 hours

Learners must complete the basic theory module prior to attendance at the practical module.

The timing for delivery of this training program may be extended for various reasons such as the amount of equipment available for demonstration of learning outcomes, instructor experience, the learning needs and/or number of training participants.

4.2       eLearning and blended learning

The eLearning content should be consistent with Manitoba eLearning instructional design guidelines.

This type of learning is acceptable for:

• Basic theory module
• Practical module – 6.1 video or instructor demonstration skill review only

4.3 Distance learning

Distance learning includes training via a live video link and a plan for interactivity with a qualified instructor should be developed and available.

This type of learning is acceptable for:

• Basic theory module
• Practical module – 6.1 video or instructor demonstration skill review only

5.    Learning outcomes

Employers will need to supplement any training program that meets the requirements of this training program standard with additional information, instruction and training in workplace specific policies and procedures along with specific equipment and hazards related to safe patient handling.

5 Basic theory module

5.1 Legal requirement:

Content must include:

• an overview of the legal framework, including rights, duties, responsibilities and general requirements pertaining to work that takes place during patient/client/resident care

• an overview of Part 8 Musculoskeletal Injuries, Part 39 Health Care Facilities (Specific to Part 39.2, 39.5 (1) (2), 39.10 (1) (2))

At the end of this module, learners will be able to:

• identify parts of the Manitoba Workplace Safety and Health Act and Regulation and/or Canada Labour Code Part II, as applicable, pertaining to work that takes place during patient/client/resident care
• identify the roles and responsibilities of the employer, contractor (if applicable), supplier, supervisor and worker as they relate to safe patient handling
• describe workers’ rights and how they relate to workers performing patient/client/resident care
• recognize the need and importance of checking and referencing Health Canada Alerts
• describe what a competent person is in relation to supervising safe patient handling work, inspecting equipment and monitoring tasks for compliance

5.2 Musculoskeletal injuries (MSIs)

Content must include:

• an overview of basic anatomy, definitions of acute and chronic MSIs and their cumulative effects
• an outline of signs and symptoms of MSIs with a duty to report
• a review of good body mechanics and ergonomics

At the end of this module, learners will be able to:

• understand basic anatomy and body structures
• describe acute and chronic MSIs and their cumulative effects
• explain the signs and symptoms of MSIs with a duty to report
• recall general concepts of correct body mechanics and ergonomics

5.3 Identification and assessment of patient handling hazards

Content must include:

• an overview of point of care screening including an observation of patient handling and environmental hazards, screening patient/client/resident, inspecting equipment and readiness of the healthcare worker and patient

At the end of this module, learners will be able to:

• assess their own ability to complete the required task (safe work procedures, appropriate number of workers and adequate equipment)
• identify the hazards of patient handling along with the measures to address the potential hazards
• inspect lift, sling and transfer equipment prior to care, to ensure proper working order
• understand the process to report and remove unsafe equipment from service.
• check the mobility status as posted at or near the bedside
• screen the current physical and cognitive status of a patient to safely proceed with the assigned transfer methods
• understand the process and lines of communication for point of care screening when the results do not align with the information provided (i.e. bedside logo, care plan, equipment inspections, etc)

6. Practical module

In this training module, practical skills will be demonstrated as prescribed below.

6.1    Video or instructor demonstration or procedure review

6.1.1    Repositioning

• repositioning and/or turning sling with mechanical floor lift or overhead lift
• repositioning a patient within in chair

6.1.2 Transfers

• supervised assist

6.1.3 Patient/resident/client falls

• supervised recovery from floor
• fall recovery from floor
• assisting a falling patient from standing

6.2 Practical skill review and return competency demonstration

This training is applicable to the site-specific equipment being demonstrated.

6.2.1 Pre-transfer screen

• alert, cooperative, extremities move and sits unsupported (e.g. ACES) or similar

6.2.2 Bed mobility

• repositioning with slider sheet system and/or bed sheet slider system
• inserting & removing sliders
• one and two minimum assist from lying to sitting position
• one and two minimum assist from sitting to lying position

6.2.3 Transfers

• one and two minimal assist with and/or without transfer belt

6.2.4 Mechanical lifts

• sling insertion/removal lying and/or seated positions
• mechanical lift sit to stand transfer
• overhead or floor based lift

7. Resource material

The safe patient handling training program standard has material requirements for both learners and instructors.

The date and version number should be indicated on all resource materials, which include:

• terms and definitions
• job aids, evaluation tools and templates
• copies of the applicable provincial or federal safety legislation
• manufacturers’ instructions for equipment
• participant and instructor manuals with copies of activities
• instructor manual and lesson plan
• date and version number on all materials

Learner materials will include:

• learning objectives, agenda, training content and evaluation/testing

Instructor materials will include:

• instructional methods, learning activities, and lesson plan timing
• detailed instructor manual and lesson plans including all learning activities and audio-visual resources

8. Equipment

For the practical module, learners must have hands-on, practical experience and must be trained on the proper use, care and limitations of the safe patient handling equipment according to manufacturer specifications and what is listed below. The safe patient handling equipment provided must comply with the requirements of the Manitoba Workplace Safety and Health Act and Regulations, such as meeting or exceeding the equipment specified in the National Standards of Canada and/or the Canadian Standards Association technical standards, as applicable.

9. Learner evaluation

The training program must include a plan for learner evaluation that meets the requirements below. There must be a variety of evaluation methods available to the instructor and/or evaluator that are appropriate to the learning outcomes.

9.1     Evaluation methods

The training program will include methods to evaluate that key concepts have been understood by the learner using a variety of evaluation methods which are appropriate to the learning outcomes, including:

• open discussion
• group discussion
• questions and answers
• written and/or oral test, where applicable

Evaluation methods must be clearly outlined in the evaluation plan and the corresponding results must be documented by the evaluator.

9.2     Evaluation of demonstration learning outcomes

1. Learning outcomes requiring demonstration must be performed satisfactorily in order to successfully complete the practical module.
2. For learners with language, literacy or accommodation needs, alternative evaluation methods may be employed to verify satisfactory demonstration of learning outcome by the learner. These evaluation methods must be clearly outlined in the evaluation plan and the corresponding results must be documented by the evaluator.

10. Validation/refresher requirements

Learners who have successfully completed an approved training program should periodically refresh their training in order to maintain its validity. This supports learners in maintaining their foundational knowledge and skills.

10.1  Validation/refresher requirements

Completion of the practical module in accordance with the criteria set out in this standard and the training provider standard is required to confirm a successful re-training program has been completed.

Training remains valid for a period of three years from the date of successful completion of the safe patient handling training program basic theory module and the safe patient handling training program practical module.

10.2  Refresher training

Refresher training should be provided to workers when concerns are identified through workplace monitoring for compliance with the Safe Patient Handling training program or at a minimum every three years.

A worker’s training is re-validated for another three year period after successfully meeting the learning outcomes within the safe patient handling practical module.

Additional refresher training may be deemed necessary as a result of changes to applicable legislation, standards, or safe work procedures; prolonged employee absence; injuries resulting from patient handling tasks; or at the discretion of the employer, to ensure compliance and reduce the risk of workplace injury.