Download Injury Prevention as an Emerging Practice in Occupational Therapy

Objectives: Participants will...
1. Explain the relationship between wellness, well-being and injury
prevention.
2. Discuss the difference between “accident” and “injury” and why it
is significant with injury prevention.
3. List 3 examples of occupational therapy programs that promote
primary injury prevention.
4. Evaluate opportunities in your own work environment where injury
prevention can be implemented and developed.
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Injury Prevention & Ergonomics Regional
Manager, Eastern Washington & Montana
• Administrative
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Develop administrative support
Develop leaders
Analyze injury data; look for trends
Provide benchmarking information
Assist with budgets for inj prevention
Write/modify policies & standards
based on evidence & industry norms
• Safe patient handling
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Develop policy
Training
Recommend equipment
Provide injury data
• Manual Material Handling
• Identify high risk areas
• Work with managers and employees
to identify problems/solutions
• Recommend equipment,
modifications
• Computer workstations
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Individual workstation evaluations
Group in-services
Set standards for equipment
Develop online self-help resources
Develop online ergonomic evaluation
request form
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A Path to Injury Prevention
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• Illness-Wellness Continuum – first proposed by John W Travis in 1972
• Well-being is more than simply an absence of illness but also
incorporates the individual’s mental and emotional health
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• If a treatment model is used, an
individual can move right, only
to the neutral point
• Example: a person with
hypertension who only takes
medications without making any
other life-style changes
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• If a wellness model is used, an
individual can move right past
the neutral point
• Example: a person with
hypertension who not only takes
medications, but stops smoking,
looses weight, starts an exercise
program, etc.
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Health, Wellness & Well-Being
• Health – A state of complete
physical, mental and social wellbeing and not merely the absence of
disease or infirmity.
• Wellness – The quality of being
healthy in body and mind, especially
as the result of deliberate effort
• Well-being – The presence of positive
emotions and moods, satisfaction
with life, fulfillment with positive
functioning.
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Health
Well-being
Wellness
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Injury Prevention
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Well-being
Injury
Prevention
• To prevent or reduce the
severity of bodily injuries
caused by external
mechanisms.
• Improves the health of the
population by preventing
injuries and hence improving
wellness and well-being.
Health
Wellness
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Injury Prevention
• Primary – prevent disease/injury
Health
• Change workstation design to
eliminate hazards
• Secondary – early detection and
treatment of disease/injury
Well-being
Wellness
• Tertiary – prevent disability
• Make splint for patient with stroke
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Injury
Prevention
• Teach correct body mechanics
with ADLs to injured workers
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Injury – Injury Prevention – Wellness
Continuum
Reactive
Injury &
Disease
Disease
Injury
Treatment
Prevention
Disability, Symptoms, Signs
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Proactive
Health,
Wellness, Wellbeing
Awareness, Education, Growth
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Where did Injury Prevention come from?
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Accident vs Injury
• Accident
• Unhealthy behavior resulting from individual choice
• The best way to change unhealthy behavior is to show people the error of
their ways and urge them to act differently through education
• Injury
• Significant change from biological and behavioral emphasis on the individual
to a concern with the environmental context within which injury occurs
• Connected to another theoretical advance of the growing awareness that
single-cause explanations of injury events are incomplete and misleading
• Involved a wide range of disciplines looking at the problem of injury
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Accident vs Injury
• Accident
• Motor fatality caused by a drunk driver
• Associates the event with a single causation – drunk driving – and then infer
causation
• Injury
• Why did this drunk driver crash while another did not?
• Why did he or she crash during this trip and not during any previous drunk
driving episodes?
• Why did her or she crash at this place and not a mile earlier?
• Why was this crash fatal?
• Why was it fatal to this driver but not the passenger?
• In short, was this fatality inevitable and, if not, what could have prevented it?14
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Evolution of Injury Prevention – High Points
• 1788 – Johann Peter Frank
• Described injury prevention activities as a desirable part of
comprehensive public health programs
• Message not accepted by highly individualistic, non-interdependent
frontier America
• 1942 – Hugh De Haven, WWI pilot, Physiology Researcher
• Survived a plane crash in 1917 and did research to better understand
reasons why
• Led to Crash Injury Research Project at Cornell University, 1942
• Data led to redesign of cockpits and seats in aircraft and subsequently
wide range of safety features in car design, culminating in the car air bag
• The injury event is only the beginning of understanding the injury
process
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Evolution of Injury Prevention – High Points
• 1950’s – John Gordon, Epidemiologist, Harvard
• Applied scientific study of epidemiology/infectious disease
prevention to injury prevention
• Described injuries as being “the result of forces from at least
three sources… the host… the agent… the environment... in
which host and agent find themselves.”
• Host = curious mobile two year old
• Agent = Potentially poisonous bottle of cleaning fluid that looks similar
to apple juice
• Environment = a screw top bottle in an accessible area at the toddler’s
level
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Evolution of Injury Prevention – High Points
• 1961 – James Gibson
• Advanced the concept of injury by
suggesting that “energy interchange” was
the agent of injury harm
• Injury defined as the “transfer of energy to
human tissues in amounts and at rates that
damages the cellular structure, tissues,
blood vessels and other bodily structures.”
• e.g. mechanical, thermal, chemical, electrical,
radiation
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Evolution of Injury Prevention – High Points
• 1960s – William Haddon, physician/engineer
• Considered as “Founding father” of modern-day
injury prevention
• Expanded definition by including injury caused by
the absence of necessary energy elements
• e.g. oxygen or heat occurring in drowning or hypothermia
• 1966 – First administrator of the newly created
National Traffic Safety Agency and the National
Highway Safety Agency to help reduce the mounting
number of deaths and injuries from traffic accidents
• Promoted use of the air bag as a device for reducing
injuries, and he remained its champion throughout
the long debate over its effectiveness
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Evolution of Injury Prevention – High Points
1989 – The National Center for Injury Prevention and Control (NCIPC)
defined injury as...
“Any unintentional or intentional damage to the body resulting from
acute exposure to thermal, mechanical, electrical, or chemical energy
or from the absence of such essential as heat or oxygen.”
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Need for Legislation
• 1939 – Creation of the Federal Security Agency to bring together in
one agency all Federal programs in the fields of health, education,
and social security.
1. Office of the Administrator
• Food and Drug Administration
2. Public Health Services
• Centers for Disease Control and Prevention (1946)
3. Civilian Conservation Corp
4. Office of Education
5. Social Security Board
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Need for Legislation
• 1960s – Workplace injuries/illnesses increasing
• Need for more comprehensive and uniform protection of nation’s workers
• Size of national workforce increasing
• Congressional hearings on worker safety were held
• 1970 – Congress considered these figures
• 14,000 worker deaths
• 2.5 million workers disabled
• 300,000 new occupational diseases cases
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Occupational Safety and Health Act (OSHA)
• December 29, 1970
• Public Law 91-596 creating OSHA
• Signed by President Nixon
• Became effective on April 29, 1971
• Purpose of Act
• “... to assure so far as possible every working man and woman in the Nation
safe and healthful working conditions and to preserve our human resources.”
• Established three agencies
• Occupational Safety and Health Administration (OSHA)
• National Institute for Occupational Safety and Health (NIOSH)
• Occupational Safety and Health Review Commission (OSHRC)
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Purpose – to reduce workplace hazards
Issues workplace health and safety regulations
Establishes training programs for OSHA personnel
Develops mandatory job and health standards
Develops recordkeeping and reporting requirements
General Duty Clause applies where OSHA has not passed specific standards
• Safe patient handling, ergonomics, workplace violence, heat stress, combustible dust
• Employer must protect employees from recognized hazards likely to cause death
or serious harm:
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Industry and consensus standards
Common safe practices
Hazards recognized by similar employers
Manufacturer requirements or manuals
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• Part of the U.S. Centers for Disease Control and Prevention (CDC) in
the U.S. Department of Health and Human Services (DHS)
• Mandate to assure “every man and woman in the Nation safe and healthful
working conditions and to preserve our human resources.”
• Strategic Goals and Objective 2016-2020
• Goal 1: Conduct research to reduce worker illness and injury, and to advance
worker well-being
• Goal 2: Promote safe and healthy workers through interventions,
recommendations and capacity building
• Goal 3: Enhance international worker safety and health through global
collaborations
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– June 2011
• NIOSH launched TWH Program as an evolution of other NIOSH safety
and healthy worker programs.
• Recognizes that work is a social determinant of health.
• Advocates for a holistic understanding of the myriad of factors that influence
safety, health. and well-being.
• Integrative approach recognizing that risk factors in the workplace can
contribute to many health problems previously considered unrelated to
work, including cardiovascular disease, obesity, depression, and sleep
disorders.
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Affordable Care Act (ACA) – March 23, 2010
• Increases emphasis on preventing disease and injury as key to the health of
Americans
• Healthcare shifts away from reactive toward a system that makes wellness
and prevention a priority
• Established The National Prevention, Health Promotion and Public Council to
guide the shift from a focus on sickness/disease to wellness/prevention
• Requires healthcare plans to cover certain preventive services without cost
sharing (no out-of-pocket costs)
• Puts consumers back in charge of their health care by establishing a new
“Patient’s Bill of Rights”
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Occupational Therapy – ghg
• AOTA – “Occupational therapy maximizes health, well-being, and
quality of life for all people, populations and communities through
effective solutions that facilitate participation in everyday living.”
• Holistic approach is particularly useful in wellness, health promotion
and prevention
• OT occurs in health care and education settings and in communitybased agencies and organizations
• AOTA – “The timing is optimal for occupational therapy in the area of
wellness and prevention.”
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Occupational Therapy and Injury Prevention
AOTA Core Tenets
• Accessible: Occupational therapy provides culturally responsive and
customized services.
• Collaborative: Occupational excels in working with clients and within
systems to produce effective outcomes.
• Effective: Occupational therapy is evidence-based, client-centered
and cost-effective.
• Leaders: Occupational therapy is influential in changing policies,
environments, and complex systems.
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Occupational Therapy and Injury Prevention
• Identify and eliminate risk factors
for disease, injury and disability
Ergonomic worksite evaluations
Falls prevention for adults
Backpack safety
Helmet and car seat fitting for
children
• Parenting skills
• Safe patient handling
• Computer workstation evaluations
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Health
Well-being
Tertiary Injury
Prevention
• Primary Injury Prevention
Wellness
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Occupational Therapy and Injury Prevention
• Early detection and treatment
after disease/injury has occurred
• Designed to prevent or disrupt the
disabling process
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Job modification for RTW
Socialization programs
Rehabilitation services
Sensory processing
Education programs for people with
recent dx, e.g. osteoporosis, mood
disorders, obesity
Health
Well-being
Tertiary Injury
Prevention
• Secondary Injury Prevention
Wellness
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Occupational Therapy and Injury Prevention
• Prevent further disability
• Pt education and treatment to
manage and optimize new level of
wellness after an already
diagnosed disease or condition
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• Transitional or independent-living
skills training for people who have
mental illness or cognitive
impairments
• Groups for older adults with
dementia to prevent depression,
enhance socialization and improve
quality of life
• Support groups for people with
stroke, brain injury, spinal cord injury
Health
Well-being
Tertiary Injury
Prevention
• Tertiary Injury Prevention
Wellness
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Occupational Therapy and Injury Prevention
• Traditional health care –
hospitals, outpatient clinics,
skilled nursing facilities
• Evaluation of patients for risk of
hospital acquired conditions
• Home assessment and
modifications
• Self-management of chronic
disease
• Fall prevention
• Aging in place
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Occupational Therapy and Injury Prevention
• Education
• Handwriting curriculum
• Backpack awareness
• After school empowerment
groups – stress management,
coping skills, health living
• Bullying education
• Mock job interviews with students
and disabled.
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Occupational Therapy and Injury Prevention
• Community
Fall prevention partnerships
CarFit programs
Aging-in-Place & Universal design
Peer support, socialization and
skills training for people with
disabilities
• Health promotion
• Child growth & development
education for parents & daycare
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Occupational Therapy and Injury Prevention
• Employers
• Injury prevention training
• ADA
• Promote emotional well-being;
training in work/life balance
• Ergonomic assessments and
interventions
• Body mechanics training
• Return to work programs
• Safe patient handling programs
and training
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Occupational Therapy and Injury Prevention
To be effective, health promotion efforts cannot focus only on intervention at the
individual level.*
• Organizational-level
• Consult to businesses to promote emotional well-being through identification of problems
and solutions for balance amount work, leisure and family life
• Consult to schools regarding implementing ADA
• Community or population-level
• Consult with contractors, architects and city planners regarding accessibility/universal design
• Address health and occupation needs of the homeless population by eliminating barriers and
enhancing opportunities for occupational engagement
• Policy-level
• Promote policy that offer affordable, accessible health care
• Promote policy for safe patient handling in healthcare
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*Occupational Therapy Services in the Promotion of Health and the Prevention of Disease and Disability.
AJOT, Nov/Dec 2008, Vol 62, No 6, 694-703.
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Occupational Therapy and Injury Prevention
OT has an important role in health promotion and disease or disability
prevention due to its focus on the health effects of purposeful, productive
and meaningful occupation.*
• Evaluate occupational capabilities, values and performance
• Provide education regarding occupational role performance and balance
• Reduce risk factors and symptoms through engagement inoccupation
• Provide skill development training in the context of everyday occupations
• Provide self-management training to prevent illness and manage health
• Modify environments for healthy and safe occupational performance
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*Occupational Therapy Services in the Promotion of Health and the Prevention of Disease and Disability.
AJOT, Nov/Dec 2008, Vol 62, No 6, 694-703.
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Occupational Therapy and Injury Prevention
• Consult and collaborate with health care professional, organization,
communities and policymakers regarding occupation perspective of health
promotion and disease or disability prevention
• Promote the development and maintenance of mental functioning abilities
through engagement in productive and meaningful activities and
relationships
• Provide training in adaption to change and in coping with adversity to
promote mental health
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*Occupational Therapy Services in the Promotion of Health and the Prevention of Disease and Disability.
AJOT, Nov/Dec 2008, Vol 62, No 6, 694-703.
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OT/Injury Prevention Case Studies
1. Primary Prevention – Individual Level: A retired husband and wife
consult an OT regarding a home safety assessment for the purpose
of remaining in their home as they age.
2. Primary Prevention – Organization Level: An OT working in an
outpatient industrial rehab clinic attached to a large medical center
treats many nurses from the facility who were injured while
transferring and taking care of patients.
3. Tertiary Prevention – Individual Level: A rehab unit in a hospital
decides to offer health promotion classes to former patients with
chronic conditions. A COTA is chosen to led a class for patients with
chronic obstructive pulmonary disease.
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Occupational Therapy and Injury Prevention
• Occupational therapists and occupational therapy assistants possess
the basic knowledge to carry out health promotion and interventions
to prevent disability and disease. However, this is a very broad area
of practice and practitioners need to continually expand their
knowledge in health promotion to be effective and competent
members of the team.
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*Occupational Therapy Services in the Promotion of Health and the Prevention of Disease and Disability.
AJOT, Nov/Dec 2008, Vol 62, No 6, 694-703.
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Prepare Yourself
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4.
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6.
7.
Passion – Identify your passion
Need – Identify a need you see at work or in the community
Experience – Find a place to develop your interest/skills
Education – Seek education, continuing education, mentors
Certification – Pursue certification from credible groups
Computer skills – Develop computer skills – Word, Excel, Powerpoint
Begin small and do more as you go and grow
• If you fail and fall flat on your face, you are at least falling forward!
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Occupational Therapy & Ergonomics
• Share basic principles, common
interests and body of knowledge
• Anatomy, Physiology, Biomechanics,
Anthropometry, Kinesiology, Human
Development, Psychology
• Task Analysis / Worksite Analysis
• Energy Conservation, Work Simulation
• Holistic approach
• Physical, cognitive, social, organizational,
environmental and other relevant factors
are taken into account
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Occupational Therapy & Ergonomics
• Utilize the scientific method to solve problems
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Define the problem broadly
Assess/analyze in detail
Search for solution
Evaluate plan
Implement solutions
Evaluate effectiveness
Modify solutions
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Occupational Therapy & Ergonomics
• Value work
• Modify the work environment to
accommodate the worker
• Design tools to make work easier
for the worker
• Emphasis on safety and
productivity
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Occupational Therapy & Ergonomics
• Occupational Therapy
• Focus is secondary and tertiary
injury prevention
• Works with disabled population
• Focus on treating the individual
• Goal is functional restoration of
individual
• Work = activity of daily living
• Medical model
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• Ergonomics
• Focus is on primary injury prevention
• Studies “normal” populations
• System approach with focus on the
work environment
• Goal is improvement of safety,
comfort, efficiency, performance
• Work = human-machine interface
• Ergonomic model
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Medical vs. Ergonomics Model
• Medical
• Treats symptoms to resolve acute
injuries and prevent disability
• Does not address or correct the
cause of the injury
• Returns injured worker to the
same job  worker is at risk for
re-injury
• Worker may not immediately
return to work
• May contribute to development of
chronicity
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• Ergonomics
• Identifies risk factors in the work
environment
• Corrects or reduces the level of
hazard
• Modifies work environment with
improved safety and better design
• Allows the worker to stay
connected with the work
environment
• Returns worker to a productive life
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Ergonomics
• Ergonomics = Ergo (work) + nomos (law)
• The study of work
• Term first introduced by a Polish educator
and scientist, Wojciech Jastrzebowski
(1799-1882)
• Ergonomics / Human Factors
• The scientific discipline to understand the
interactions between humans and other
elements of a system
• Design the workplace to fit the capabilities
and limitations of the human
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Ergonomics
• Initial users were military and
aerospace industries
• Used in WWII to solve design and
training problems in aircraft, radar
and other equipment
• Since 1950’s, Department of
Defense has required a concurrent
human factors design in every
system and aerospace design
• Includes aircraft cockpits, manned
space capsules, astronaut training
simulators
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Ergonomics in Daily Life
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What does an ergonomist look at?
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Ergonomic Analysis
1. Look for clues
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OSHA Log
Employee incidents
Observe work activities for risk
factors
Partner with Safety and Human
Resources
Employee safety committee
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Ergonomic Analysis
2. Prioritize jobs for improvement
• Frequency, severity of injuries
• Frequency, severity of complaints
• Technical resources
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Ergonomic Analysis
3. Make improvements
• Involve employees in the process =
Participatory Ergonomics
• Use online guidelines, industry
standards, eTools, ANSI, NIOSH
standards
• Contact others in industry
• Look through equipment catalogues
• Talk to equipment vendors
• Consult with ergonomic experts
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Ergonomic Analysis
4. Follow-up and evaluation
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Talk with employees
Has it reduced fatigue, discomfort, symptoms, and/or injuries?
Does the worker accept the changes, equipment and modifications?
Have the changes caused any new risk factors, hazards or other problems?
Is there a decrease in productivity and efficiency?
Is there a decrease in product and service quality?
Has equipment been supported with training needed to make it effective?
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Ergonomics – Controls
Individual Changes –
stretches, posture, body
mechanics, work style
Organizational Changes –
job rotation, breaks, staffing,
schedules, policies/procedures
Worker
Controls
Administrative
Controls
Environmental
Controls
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Workplace Design –
chair, desk, equipment, tools,
work station set up
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Ergo Controls – Car Safety
• Worker controls
• Driver’s education
• Cognitive functioning – drugs,
alcohol, texting, distractions,
sleepiness
• Administrative controls
• Rules of the road
• Laws
• Engineering controls
• Design – air bags, Eyesight, radio
controls on steering wheel, backup
camera
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Ergo Controls – Car Safety
• Worker controls
• Driver’s education
• Cognitive functioning – drugs,
alcohol, texting, distractions,
sleepiness
• Administrative controls
• Rules of the road
• Laws
• Engineering controls
• Design – air bags, Eyesight, radio
controls on steering wheel, backup
camera
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Ergo Controls – Computer Workstation
• Worker controls
• Posture, body mechanics
• Stretching
• Administrative controls
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Equipment standards
Workstation guidelines
Telecommuting
Rest breaks
• Engineering controls
• Sit/stand desk
• Special keyboard
• Adjust workstation
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Ergo Controls – Patient Handling
• Worker controls
• Body mechanics
• Administrative controls
• WA State SPH Law
• OSHA General Duty Clause
• Safe Patient Handling Policy
• Engineering controls
• Ceiling lifts, portable patient lifts
• Air-assisted lateral mattress
• Glide tubes
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Injury Prevention & Ergonomics
Regional Manager
• Promote a Culture of Safety, Health and Prevention
• Establish best practices for risk reduction and prevention of musculoskeletal
injuries.
• Implement programs for injury prevention, safe patient handling, and
ergonomics.
• Evaluate risk factors for injuries based on injury data and risk analysis and apply
solutions to decrease rates; identify departments/units/jobs with highest injury
rates and establish an action plan for lowering injury rates and expenses.
• Collaborate with leadership to integrate injury prevention into hospital practice
through education, participation in safety related meetings and leading special
projects.
• Provide input into annual budget for injury prevention training, capital equipment
expenditures, personal protective equipment and other department needs.
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Injury Prevention & Ergonomics
Regional Manager
• Assist with regional new construction, remodel projects, new equipment
purchases and ergonomic equipment standardization.
• Provide ergonomic assessments and injury prevention strategies to
Providence hospitals and medical clinics/facilities outside the hospital
setting as needed.
• Collaborate with Injury Prevention Team to establish best practice
guidelines/standards/policies, and develop action plans for injury
prevention.
• Stay current with local, regional, state, and national standards for patient
and staff safety as well as regulations applicable to injury prevention and
job modification.
• Promote Providence Injury Prevention Program as best practice by
participation/ presentations in regional and national conferences.
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Safe Patient Handling Resources
• OSHA – Worker Safety in Hospitals, Safe Patient Handling
• Home Page https://www.osha.gov/dsg/hospitals/index.html
• Safe patient handling https://www.osha.gov/dsg/hospitals/patient_handling.html
https://www.osha.gov/SLTC/healthcarefacilities/safepatienthandling.html
• CDC – Safe Patient Handling and Movement
• https://www.cdc.gov/niosh/topics/safepatient/
• When Is It Safe to Manually Lift a Patient http://www.asphp.org/wpcontent/uploads/2011/05/When_Is_It_Safe_To_Manually_Lift_A_Patient.pdf
• Association of Rehab Nurses – SPH Toolkit
• http://www.rehabnurse.org/members/content/SafePatientHandling.html
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Safe Patient Handling Resources
• Safe Patient Handling Guidebook, Tampa Research and Education
Foundation - http://www.tampavaref.org/safe-patient-handling.htm
• Safe Patient Care Ergonomics Resource Guide
http://www.nursingworld.org/MainMenuCategories/WorkplaceSafety
/Healthy-Work-Environment/SafePatient/Resources/ergonomics1.pdf
• AOHP – Resource Guide for Implementing a SPH Program in an Acute
Care Setting
• https://www.aohp.org/aohp/Portals/0/Documents/AboutAOHP/BGS_Summe
r2011.pdf
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Safe Patient Handling - Certifications
• OSHA Safe Patient Handling
• http://www.oshatrain.org/courses/mods/774e.html
• Safe Patient Handling Certification
• http://www.asphp.org/certification/
• Back School of Atlanta
• https://thebackschool.net/certified-ergonomics-assessment-specialist/
• Association of Safe Patient Handling Professionals
http://www.asphp.org/certification/
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Ergonomic Resources
• Washington L&I Ergonomics Website http://www.lni.wa.gov/safety/topics/ergonomics/default.asp
• WA L&I Computer Workstation and Mobile Computing
• http://wishatraining.lni.wa.gov/Training/flash/ComputerWorkstation/ErgoOfficeLauncher.htm
• OSHA and Ergonomics
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http://www.osha.gov/SLTC/ergonomics/index.html
https://www.osha.gov/dts/osta/oshasoft/index.html
https://www.osha.gov/SLTC/etools/computerworkstations/
www.osha.gov/SLTC/ergonomics/controlhazards.html
http://www.oshatrain.org/courses/studyguides/722studyguide.pdf
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Ergonomic Resources
• CDC/NIOSH – Ergonomics and Musculoskeletal Disorders
• http://www.cdc.gov/niosh/topics/ergonomics/
• Ergonomic Guidelines for Manual Material Handling
• http://www.cdc.gov/niosh/docs/2007-131/
• A Guide for Selecting Non-Powered Hand Tools
• http://www.cdc.gov/niosh/docs/2004-164/default.html
• Ergonomics and Healthcare Workers
• http://www.cdc.gov/niosh/topics/healthcare/
• WorkSafeBC – Ergonomics
• http://www2.worksafebc.com/Topics/Ergonomics/Home.asp
• https://www.ccohs.ca/oshanswers/ergonomics/handtools/tooldesign.html
• Cornell University Ergonomics Website
• http://ergo.human.cornell.edu/cuergoresearchtools.html
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Ergonomic Resources – Certification
• BCPE – Board of Certification in Professional Ergonomics
• http://ergo-plus.com/ergonomic-assessment-tools/
• OSHA Ergonomics Online Training Certification -
• https://www.compliancetrainingonline.com/osha_ergonomics_training.cfm?gclid=CjwKEAjwuo-BRDDws3x65LL7h8SJABEDuFRXgzB78aBm87yaji1vRikj6mk0CFxmuIKY4RDnobtgRoCSqbw_wcB
• http://www.oshatrain.org/courses/studyguides/722studyguide.pdf
• OSHA Office Ergonomics -
• https://www.compliancetrainingonline.com/office_ergonomics.cfm
• OSHA Safe Patient Handling
• http://www.oshatrain.org/courses/mods/774e.html
• Safe Patient Handling Certification
• http://www.asphp.org/certification/
• Back School of Atlanta
• https://thebackschool.net/certified-ergonomics-assessment-specialist/
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Thank you!
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