[MCOH-EH] fit for duty

[Hudson, T. Warner]

The NIOSH lifting equation http://www.cdc.gov/niosh/docs/94-110/ which OSHA and state OSHAs use; has 50 pounds as the starting point maximum for a safe lift and then has multiplier factors which are all reducing from this number; frequency of lift, distance away from the midline of the live from and to heights, asymmetric lift and whether there are handles.   Suzanne Rodgers; PhD advised California OSHA in the creation of an ergonomic lifting guide a few years ago and told me in a real world setting I had hired her to consult on over a several year period, that 35 lbs, was reasonable target maximum lift.  Ou can certainly take measurements and plug them into the lifting equation and I suspect will find results in the 19, 25, lb range on many occasions, You are supposed to have team lifts or assistive devices if lifts are above NIOSH's calculated number.

Push pull force measurement is often done using more expensive devices; around $2k for good ones and like Melanie says; you can get by using simple think like a fish scale hook attached to a belt to measure the foot pounds or Newtons you need.


T. Warner Hudson, MD FACOEM, FAAFP
Medical Director, Occupational and Employee Health
UCLA Health System and Campus
Office 310.825.9146
Fax 310.206.4585
Pager 800.233.7231  ID 27132
E-mail twhudson at mednet.ucla.edu
Website www.ohs.uclahealth.org


-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Kim.Thompson at hcahealthcare.com
Sent: Friday, May 08, 2015 9:55 AM
To: mcoh-eh at mylist.net
Subject: [MCOH-EH] fit for duty

Awhile back, I asked this group for opinions related to value of Fit for Duty exams for pre-employment screens. Thanks to those who answered. Now, regardless of your opinion of their value, I need your help once more.

I have attached a Fit for Duty for a RN position. We do these to ensure that the individual can meet the physical demands of the job. It is also a good way to detect perhaps undisclosed pre-existing issues. We are struggling with the 'lift 80#' and the 'push/pull 150#' portions. A couple of pros/cons are listed below and I would like you opinion and/or experience with this.

For what it is worth, we have only had 2 people fail the Fit for Duty exam since we implemented this process. Approximately 80 have successfully passed. Healthcare is a physically demanding job and we want to ensure our employees are strong and healthy enough to prevent injury to themselves and/or our patients.

Thank you in advance.

Pro:
While we don't expect our employees to lift >35# without lift equipment, the reality is that they do transfer/reposition patients without the equipment AND patients faint/fall which causes a sudden load of weight onto the caregiver. The Fit for Duty piece which requires them to lift 80# one time is to ensure that they are physically strong enough to handle that load.
Con:
Obviously, we don't want anyone to get hurt during their pre-employment screen. Is 80# too much? If so, what is reasonable - 50, 60, 70#? Or should it be a % of their body weight? We already have them lift/carry a 40# box around the room.
Another solution might be to simulate their job duties more appropriately and we are thinking of having them do a lateral transfer and a repositioning in bed of a dummy/sandbag of 150#....

Pro:
Employees are required to push beds/stretchers with patients in them. Because these are on wheels, it is hard to know exactly how much weight they are actually pushing but 150# seemed reasonable. The push/pull of the sled of 150# has not posed a problem for any of our new hires so far but the question was raised re: using this weight for some of the shorter and/or lighter (100-100#) employees.


Kim Thompson RN, BSN
Employee Health Nurse Manager
Medical Center of McKinney
4500 Medical Center Drive - MOB, Suite 105 McKinney, TX     75069

972- 540- 4218 (phone)
469 - 713- 8660 (fax)






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