Home Healthcare Workers: How to Prevent Musculoskeletal Disorders

A work-related musculoskeletal disorder is an injury of the muscles, tendons, ligaments, nerves, joints, cartilage, bones, or blood vessels in the arms, legs, head, neck, or back that is caused or aggravated by work tasks such as lifting, pushing, and pulling. Symptoms include pain, stiffness, swelling, numbness, and tingling.

Lifting and moving clients create a high risk for back injury and other musculoskeletal disorders for home healthcare workers.

EMPLOYERS SHOULD

  • Develop policies to ensure all care plans determine whether ergonomic assistive devices are needed.
  • Provide ergonomic assistive devices (such as slide boards or gait belts) when needed.
  • Provide training on assistive ergonomic devices, their uses, the clinical situation requiring them, and how to order them in the plan of care.
  • Develop policies to assess the caregiver’s competence with the assistive devices once he or she has been trained and is using them.

EMPLOYEES SHOULD

  • Participate in ergonomic training.
  • Use ergonomic assistive devices if available.
    • Products such as slip sheets, slide boards, rollers, slings, belts, and mechanical or electronic hoists (to lift the client) have been designed to help healthcare workers and clients.
    • Equipment such as adjustable beds, raised toilet seats, shower chairs, and grab bars are also helpful for reducing risk factors for musculoskeletal injuries. These types of equipment can allow the client to help during transfer.
  • Use proper body mechanics. Even when assistive devices are used during client care, some amount of physical exertion may still be necessary.
    • Move along the side of the client’s bed instead of reaching while performing tasks at the bedside.
    • When manually moving the client, stand as close as possible to the client without twisting your back, keeping your knees bent and feet apart. To avoid twisting the spine, make sure one foot is in the direction of the move. Using gentle rocking motions can also reduce exertion.
    • Pulling a client up in bed is easier when the head of the bed is flat or down. Raising the client’s knees and encouraging the client to push (if possible) can also help.
    • Apply anti-embolism stockings by pushing them on while you are standing at the foot of the bed. You can use less force in this position than standing at the side of the bed.
  • Notify your employer promptly of any injury in the workplace.

This is one in a series of six fast fact cards developed to provide practical advice for home healthcare workers and is based on NIOSH Hazard Review: Occupational Hazards in Home Healthcare, NIOSH Pub No. 2010–125

Telephone: 1–800–CDC–INFO | TTY: 1–888–232–6348
Email: cdcinfo@cdc.gov | Web: www.cdc.gov/niosh/topics/healthcare
DHHS (NIOSH) Publication No. 2012–120
February 2012

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