KELSEY TRAIL HEALTH REGION Occupational Health

& Safety Program

Job Safety Analysis (JSA) Parkland Place Includes: Occupational/Physical Therapist Assistants, Physiotherapy,

Department: Supervisor: Effective: September 2004 Revisions: Therapies Director of Therapy Services

Position/Job: Occupational/Physical Therapist Assistants, Physiotherapists, Occupational Therapists

Task JSA Tasks: : Complete Controls: () Safe Work Practices: Training Required: Traveling • Rapidly changing • Prioritize work load • Safety training re: working / weather conditions • Plan and record route traveling alone • Working alone • Carry survival kit • Training re Hazardous Travel • Vehicle safety / • Maintain vehicle and have full • Training re refusal to work policy accidents tank of gas • Training re rules of road - safe • Road conditions • Carry cell phone if available vehicle operation • Unexpected incidents • Listen to weather reports • Professional Assault Response - keys locked in car • Have survival gear, shovels in car Training (PART) training • Potential for • Schedule visits so clients expect • TLR training aggressive / violent visit and report if you don’t arrive • Personal Protective Equipment confrontations • Let family know when leaving (PPE) training • Muscle strain / back client (if working after hours) • Training Behaviour Management injury • Let office know if changing route techniques • Wear appropriate clothing for conditions of travel • Hazardous Travel procedure • Drive safely - according to road conditions • Follow principles of Transfers, Lifts and Repositioning (TLR) and good body mechanics in/out of car • Safety while working alone procedure • Follow Professional Assault Response Training (PART) guidelines

JSA for Occupational/Physical Therapist Assistants, Physiotherapists, Occupational Therapists Page 2

Position/Job: Occupational/Physical Therapist Assistants, Physiotherapists, Occupational Therapists

Task JSA Tasks: Hazards: Complete Controls: () Safe Work Practices: Training Required:

Unstable / Volatile • Aggressive/ Violent • Follow guidelines of PART • Worker training and information Clients, Clients client or family program on Behavior Management with various member • Follow Behavior management Techniques psychological • Violence techniques • Training re Zero Tolerance Policy needs • Injury • Personal Safety awareness - Be for abuse, harassment • Harassment alert, Recognize signs of danger, • PART training • Verbal abuse / have escape route available • Training re: working alone policy conflicts • Review care plans prior to giving • Training re Code White protocols • Emotionally charged care • Training re: dealing with clients environments • Behavior mapping with special needs • Anxiety re: dealing • Contact behavior management • Training re refusal to work policy with unexpected consultant • Training re: Harassment and Abuse (Alzheimer’s clients) • Effective and frequent reporting policy • Stress / Burn Out to manager / other workers • Training re: EFAP availability • Safety while working alone • Immunization Program procedure—two care givers for known aggressors • Zero tolerance to harassment/violence/abuse • Communication procedure • Inform office of whereabouts, route, time of appointment, etc. • Do not enter if unsafe • Refusal to work if unsafe / dangerous conditions • Client referral to appropriate agency • Call RCMP if appropriate • Utilize EFAP if needed • Follow routine practice/infection control procedures, exposure to blood and body fluids, PEP kit protocols • Immunizations complete and • Good physical / emotional health • Journal / document / incident reporting • Change or increase number of workers Rural Yards - • Accidents/ Mishaps • Plan ahead with client and family • Training re hazards and how to driveways filled with vehicle and • Do not leave vehicle to walk minimize/remove with snow, icy or potential for injury • Carry cell phone if available • PPE training muddy conditions • Slips/trips/falls • Delay visits • TLR Training • Difficult to carry • Let office or someone else know supplies / equipment your travel route and times, so they can check on you • Request assistance • Wear proper footwear • Carry smaller loads • Reschedule visit if conditions very hazardous JSA for Occupational/Physical Therapist Assistants, Physiotherapists, Occupational Therapists Page 3

Position/Job: Occupational/Physical Therapist Assistants, Physiotherapists, Occupational Therapists

Task JSA Tasks: Hazards: Complete Controls: () Safe Work Practices: Training Required:

Carrying • Muscle strain / back • Follow principles of TLR • TLR Training Equipment injury • Good body mechanics • Training re: problems and • Slips/trips/falls • Do stretch exercises precautions • Development of poor • Limit load to safe amount • PPE training posture • Frequent inventory so not • Stretch Program • Vehicle break in if carrying more than needed equipment visible • Take into home only what is needed • Distribute load - use two hands or one load at a time • Replace equipment as needed • Use case that is appropriate - good shape, sturdy handles, light • Keep bag out of public view • Maintain good physical health • Wear proper foot wear • Clear paths if necessary Turning / • Muscle strain • Follow principles of TLR • TLR training Positioning Client: • Potential for program and good body • Stretch Program • in bed aggression mechanics • PART training • in chair • Do stretch exercises • Behaviour Management • Client Assessment re: aggression Techniques • Use of principles of PART program • Use of brakes on wheel chairs, beds, special chairs (brodas), etc. • Adjusting bed height Transferring • Muscle strain • Follow principles of TLR • TLR Training Client: • Back injury program • Stretch Program • 1 or 2 person • Potential for • Good body mechanics • PART training • With aggression • Do stretch exercises mechanical • Poor body mechanics • Use of brakes on wheel chairs and lift • Lift doesn’t beds maneuver under • Adjusting bed height some beds • Proper use of transfer belts • Proper use of mechanical lifts / slings

Client Ambulation • Muscle strain • Follow principles of TLR • TLR training • Back injury program • Stretch Program • Potential client • Good body mechanics • PART training aggression – clients • Do stretch exercises unpredictable • Behavior Management techniques • Follow guidelines of PART program • Use of walking belts • Client assessment JSA for Occupational/Physical Therapist Assistants, Physiotherapists, Occupational Therapists Page 4

Position/Job: Occupational/Physical Therapist Assistants, Physiotherapists, Occupational Therapists

Task JSA Tasks: Hazards: Complete Controls: () Safe Work Practices: Training Required:

Use of Mechanical • Lift failure • Mechanical Lift Manual • Mechanical lift operation training, Lifts • Inappropriate sling • Proper documentation of manuals available to staff application equipment maintenance and • TLR training • Inappropriate lifting replacement • Stretch Program and lowering of • Demonstration of lift operation by • PART training client an experienced worker for new • Training re client assessment • Positioning of chair / staff • Behavior Management training commode • Two staff to move the lift—one • Proper use of brakes directing the lift, the other moving • Proper charging of the resident in the sling batteries / back-up • Follow principles of TLR manual control program and good body • Twisting injuries mechanics • Running over co- • Do stretch exercises workers toes with lift • Behavior Management • Client aggression / Techniques resistance • Be alert to and aware of signs of aggressive outbursts • Constant client assessment • Avoid reaching to pull resident in sling into chair • Side approach to Brodas • Clear Worker communication • Regularly scheduled and documented preventative maintenance program Working with • Exposure to blood / • Follow infection control • Routine Practice / Infection Blood / Body Fluid body fluids procedures, routine practices & Control and blood and body fluid Exposure • Infectious diseases blood and body fluid policy exposure training and enforcement and substances including Post Exposure including Post Exposure Prophylaxis (PEP) kit information Prophylaxis (PEP) kit information • Use PPE appropriately • PPE training Range of Motion • Muscle strains • Follow principles of TLR • TLR training Exercises • Potential client program and good body • Stretch Program aggression mechanics • PART training • Do stretch exercises • Follow principles of PART program • Uses Behavior Management Techniques • Constant client assessment • Be aware of and alert to aggressive outbursts • Ergonomic awareness JSA for Occupational/Physical Therapist Assistants, Physiotherapists, Occupational Therapists Page 5

Position/Job: Occupational/Physical Therapist Assistants, Physiotherapists, Occupational Therapists

Task JSA Tasks: Hazards: Complete Controls: () Safe Work Practices: Training Required:

Working Alone • of Violence • 2 care givers for known or • PART training potentially violent clients • Behaviour Management training • Follow principles of PART • Training re client assessment program • Staff awareness and • Behavior Management communication of potential risk Techniques • Know how to summon assistance if needed • Keep an escape route accessible • Be alert to aggressive outbursts • Be aware of your approach to the client—allow for “time outs” and come back later • Constant client assessment Working with • Harassment, violence • Promote and maintain working • Harassment/Violence Policies coworkers • Infections/illnesses environment free of harassment • PART Training • Follow guidelines as per infection • Routine Practice/Infection Control control and routine practices General Foot Wear • Muscle aches • Good supportive shoes with • PPE training • Potential injury from enclosed toes dropped or sharp • Use PPE appropriately objects • Working with • Potential for fire / • Follow safe work procedures in • Follow safe work procedures in explosion policy/procedure re compressed policy/procedure re compressed gas cylinders gas cylinders • Client / family education • Client / family education • Use of appropriate PPE • Use of appropriate PPE • Follow WHMIS guidelines • Follow WHMIS guidelines • Follow fire plans • Follow fire plans • Proper documentation of • Proper documentation of inspections and maintenance for inspections and maintenance for oxygen tanks and equipment oxygen tanks and equipment • Regular inspection and • Regular inspection and maintenance of oxygen tanks and maintenance of oxygen tanks and equipment equipment Working in • Muscle strain / back • Follow guidelines of TLR • TLR Training Crowded Rooms injury • Good body mechanics • Stretch Program • slips/trips/falls • Do stretch exercises • Policy re: resident rooms - personal • Limit amount of personal effects effects in rooms • Good housekeeping • Adequate storage space JSA for Occupational/Physical Therapist Assistants, Physiotherapists, Occupational Therapists Page 6

Position/Job: Occupational/Physical Therapist Assistants, Physiotherapists, Occupational Therapists

Task JSA Tasks: Hazards: Complete Controls: () Safe Work Practices: Training Required:

Working at home • Risk of injury from • Initial contact with client re: • with dogs or other bites or scratches presence of pets pets • If pets are loose, remain in vehicle until client or family appear to direct/control the animal • Inform all staff providing care of presence of animals • Document on SCIP and nursing file • Call ahead to client so pet can be removed/locked up • Refuse service if environment unsafe • Right to refuse service if unsafe Bathing - Bed • Muscle strain • Follow principles of TLR • TLR training • Back injury program and good body • Stretch Program • Slip injury mechanics • Training re client assessment • Potential client • Do stretch exercises • PART training aggression • Follow principles of PART • Routine Practice training program • Infection Control training • Behavior Management • Training re exposure to blood and Techniques body fluids education • Constant client assessment • PPE training • Be alert and aware of signs of • Behavior Management training aggressive outbursts • Immunization Program • Follow Infection Control program guidelines • Use of PPE appropriately Bed Making • Muscle strains • Follow principles of TLR • TLR training • Pinching program and good body • Stretch Program • Biohazards / mechanics • Training re Routine Practices, Infection • Do stretch exercises Infection Control • Follow principles of Routine • Immunization Program Practices and Infection Control policies and procedures • Immunizations complete and current • Ergonomic awareness Physically • Potential for stress • Good supportive shoes with • Training on proper clothing / demanding job. • Muscle aches enclosed toes footwear On your feet most • Potential injury from • Wear comfortable, non-restricting • Training on stress management of the shift, dropped or sharp clothing standing, objects, equipment • Come to work well rested walking—busy wheels rolling over • Adopt healthy lifestyles- workload toes nutrition, exercise, fun times

Use of • Residents / co- • PPE policy • PPE training – proper footwear Wheelchairs workers running over toes JSA for Occupational/Physical Therapist Assistants, Physiotherapists, Occupational Therapists Page 7

Position/Job: Occupational/Physical Therapist Assistants, Physiotherapists, Occupational Therapists

Task JSA Tasks: Hazards: Complete Controls: () Safe Work Practices: Training Required:

Feeding Clients • repetitive motion • Follow principles of TLR • TLR training injury – shoulders, program and good body • Stretch Program wrists mechanics • PART training • client aggression / • Do stretch exercises at the • Blood body fluid exposure policy resistance (biting, beginning of each shift training spitting, body fluid • Frequent position changes/vary • Training re routine practices contact) tasks • Training re infection control policy • Ergonomic awareness and procedures • Proper positioning of chairs/ • Behaviour Management training stools • Training re client assessment • Behaviour management • Immunization program techniques • Be alert to and aware of aggressive outbursts • Constant client assessment • Follow guidelines as per blood/body fluid, routine practices, infection control policies and procedures • Immunizations complete and current Giving / Removing • Muscle strains • Follow principles of TLR • Training re of Routine Practices Bedpans • Biohazard / Infection program and good body • Training re Infection Control Toileting Control Risks mechanics program • Potential client • Do stretch exercises • TLR training aggression • Lifting bed to proper height • Stretch Program • Constant client assessment • PART training • Be alert to and aware of • Behaviour Management training aggressive client outbursts • Immunization Program • Follow principles of Routine Practices and Infection Control policies and procedures • Follow principles of PART program • Behaviour Management Techniques • Immunizations complete and current JSA for Occupational/Physical Therapist Assistants, Physiotherapists, Occupational Therapists Page 8

Position/Job: Occupational/Physical Therapist Assistants, Physiotherapists, Occupational Therapists

Task JSA Tasks: Hazards: Complete Controls: () Safe Work Practices: Training Required:

Care for Clients • Exposure to infectious • Use appropriate PPE • Worker training re isolation with infectious organism • Follow WHMIS program precautions diseases i.e. guidelines • PPE training tuberculosis • Follow Infection Control/ Routine • WHMIS training Practice procedures • Training re Infection Control • Follow isolation technique— • Routine Practice training communicate with appropriate • Immunization program departments • Immunizations complete and current Care of Aggressive • Exposure to Blood / • Follow PART protocols • PART training Client body fluids • Follow Behavior Management • Behavior Management training • Physical injury protocols • Training re Client assessment • Follow Violence Policy • Routine Practice / Infection • Be alert to aggressive/violent Control and blood and body fluid outbursts exposure training and enforcement • 2 care givers for known including PEP kit information aggressors • Immunization program • Communication procedure • Violence Policy • Follow Routine Practice/ • Training re Code White protocols Infection Control procedures, exposure to blood and body fluids, PEP kit protocols • Immunizations complete and current Moving Carts • Muscle strain / back • Follow principles of TLR • TLR training injury program and good body • Stretch Program mechanics • Do stretch exercises Needle Usage: • Needle sticks • Follow guidelines of Prevention • Worker training and enforcement • Injections • Blood /body fluid of Blood / Body Fluid Exposure of body fluid exposure policies and • Intravenous exposure • Follow PEP Procedure if procedures including PEP kit • Med exposure occurs information preparation • Use of appropriate PPE • PPE training • Sharps containers at point of use • Training re location of sharps • Immunizations current and containers complete • Immunization program

Training Required: • TLR Client Care, Good Body Mechanics, Ergonomics • WHMIS • PPE • Routine Practices / Infection Control • Biohazardous Waste Management • PEP Kit • Use of Equipment • OH&S Policies and Procedures • PART • Harassment / Abuse / Zero Tolerance • Behavior Management Techniques • Identification • Use of journals / communication with others •

Orientation: Use of equipment for less strain JSA for Occupational/Physical Therapist Assistants, Physiotherapists, Occupational Therapists Page 9

Position/Job: Occupational/Physical Therapist Assistants, Physiotherapists, Occupational Therapists

Task JSA Tasks: Hazards: Complete Controls: () Safe Work Practices: Training Required:

Refusal to Work Policy Hazard Identification Policies and Procedures TLR PART Communication – Charting System PPE MSDS Safety Check List Immunization Non-Smoking Policy Hazards re: Oxygen Use EFAP Working Alone Policy Hazardous Travel Policy CPR, First Aide

PCN, PHN, CMHN, Physiotherapist, Nurse Educator, also refer to Home Care Nurse job