The patient cantered nursing care can also involve close handling of the patients, such as holding or lifting them, which is considered as manual handling. Manual handling has been defined as “actions that require the application of force to perform a particular task or task sequence” (Kay, Evans, & Glass, 2015, p. 62). Manual handling is considered as a necessary procedure that nurses might require to practice. The main physical issues that occur due to manual handling is the Musculoskeletal disorders (MSDs). Studies have reported that healthcare professionals experience the high rate of Musculoskeletal disorders mainly due to manual handling of patients. It can cause serious injuries to workforce and unsafe handling can also be a serious issue for the patient’s safety. Manual handling is a common procedure in the aged care setting, because the patients or the residents of the aged care setting are often physically and cognitively vulnerable and require manual handling for various activities. Such patient requires very individualistic care due to which nurses have to provide close attention and care to the patients. Manual handling procedure is common in nursing practice, but it is required to be practiced according to policies, protocols and safety management. However, the study De Bellis (2010) identified hat unsafe manual handling is witnessed in the aged care setting due to the lack of necessary documentation and ambulation policies, which further places the nursing staff and the residents on the risk of getting injured.
Therefore, manual handling can be a serious issue for nurses that could result in work related musculoskeletal disorders as well a in the back injuries and shoulder strains. Lifting, transferring and repositioning the patients are some of the manual handling procedures that can exert more pressure on nurses, as it requires force. This physically demanding activity can be emotionally challenging for the nurses and could be highly challenging and difficult in the case of mentally and physically vulnerable patients (Clemes, Haslam, & Haslam, 2009). According to the study of Kneafsey, Clifford, & Greenfield (2015) manual handling can cause the risk of slip and falls among patients and can increase the problems associated with mobility. One of the major reasons of the physical and emotional risks associated with manual handling are, increased care demands of patients, high workload, lack of staff, physical and cognitive vulnerability of patients, unsafe handling practices and lack of compliance to manual handling standards and policies (Kneafsey et al, 2015).
According o the study of Shea, De Cieri, Sheehan, Donohue, & Cooper (2016) the physical labour that are required by the nurses can significantly affect their mental and emotional state. Therefore, manual handling in the healthcare system and in aged care setting require specific focus. It is very important to identify the hazards, assess the risks and controlling the physical and emotional risks to nurses as well as to the patients. It is very important to enhance and improve the working conditions for the nurses in order to reduce the risk of occupational health hazards (Gifkins, Loudoun, & Johnston, 2017). Due to the medical advancement and increasing demand of the primary healthcare, the roles and responsibilities of the nurses have also increased. The scope of nursing practice has become very broad including manual handling. The nurses are required to be provided with compulsory education and training for manual handling before working in residential aged care setting (Kay, Evans, & Glass, 2015). Australian Nursing and Midwifery Federation. (2015) informs that appropriate assessment of the risks are significant for identifying the need of handling equipment, training, supervision and support for making manual handling safe for both, nurses and patients.
Family and care givers play a significant role in improving the health and well-being of the patients. The roe of family cantered care is being acknowledged and applied in he primary healthcare system. The holistic approach to health care not only requires to support patients and improving their health outcomes, but it also requires to provide patient centred and family centred care and understand the significance of family and care givers (Bee, Brooks, Fraser, & Lovell, 2015). The role of carers is important because patients depend on their carers for many activities, such as navigating to healthcare facilities, communicating with professionals and handling patients. In the case of patients suffering with physical impairments or cognitive impairments or from any kind of mental health condition (Mitnick, Leffler, Hood & American College of Physicians Ethics, 2010). The carers role in decision making are highly significant in order to ensure that, when they patients loses their power to make their own decisions, carer are encouraged to participate in decision making in order to make the correct decisions about patient’s health and life. The family carers can be the relatives, friends, partners or children of the patients, who assist the patient in the activities of daily life and also handle their complex care needs (Diffin, Spence, Spencer, Mellor, & Grande, 2017).
Caring for the patients suffering with dementia or any other disease that could affect the decision-making power of the patients can lead to many ethical and legal issues. The studies have informed that patients and their carers are the experts to make healthcare decisions. For preventing the ethical dilemma of decision making the carers are required to be involved, so that they could make effective decisions regarding the health of the patients. The ethical principles of autonomy and non-maleficence informs that dignity and rights of the patients and carers must be acknowledged in order to promote safe healthcare practice and improving patient outcomes (Tuffrey-Wijne, Giatras, Goulding, Abraham, Fenwick, Edwards, & Hollins, 2013). Family care givers significantly help in managing patient’s conditions and applying treatment recommendations. The disease or illness of the patient can increase the financial, emotional, physical and spiritual burdens and not involving them in decision making results in making the carers feel marginalized and unsatisfied with services provided. Carers play a significant role in reassuring the patients, which means they help patient to cope with hospital environment and also act as the bridge between the health professionals and patients and help in communicating patient’s needs and concerns when patients are unable to do so (Javed, & Herrman, 2017).
Understanding the patient’s concern, respecting the rights and autonomy of the patient and respecting the right of carers in decision making are significant aspects of family centred care. Carers can significantly contribute in providing the expert knowledge regarding the health and concerns of patients, because they live with patients and understand their problems. Therefore, carers can provide important health information to healthcare professional regarding patient in the case when there are no legal directives. Therefore, sharing the information with carers and respecting their right to make decision is highly significant.
Australian Nursing and Midwifery Federation. (2015). Safe Patient Handling. Retrieved from: https://anmf.org.au/documents/policies/P_Safe_Patient_Handling.pdf
Bee, P., Brooks, H., Fraser, C., & Lovell, K. (2015). Professional perspectives on service user and carer involvement in mental health care planning: a qualitative study. International Journal of Nursing Studies, 52(12), 1834-1845.
Clemes, S. A., Haslam, C. O., & Haslam, R. A. (2009). What constitutes effective manual handling training? A systematic review. Occupational medicine, 60(2), 101-107.
De Bellis, A. (2010). Opinion piece: Australian residential aged care and the quality of nursing care provision. Contemporary Nurse, 35(1), 100-113.
Diffin, J., Spence, M., Spencer, R., Mellor, P., & Grande, G. (2017). Involving healthcare professionals and family carers in setting research priorities for end-of-life care. International journal of palliative nursing, 23(2), 56-59.
Gifkins, J., Loudoun, R., & Johnston, A. (2017). Comping strategies and social support needs of experienced and inexperienced nurses performing shiftwork. Journal of Advanced Nursing, 73(12), 3079-3089. 10.1111/jan.13374
Javed, A., & Herrman, H. (2017). Involving patients, carers and families: an international perspective on emerging priorities. BJPsych international, 14(1), 1-4.
Kay, K., Evans, A., & Glass, N. (2015). Moments of speaking and silencing: Nurses share their experiences of manual handling in healthcare. Collegian, 22(1), 61-70.
Kneafsey, R., Clifford, C., & Greenfield, S. (2015). Perceptions of hospital manual handling policy and impact on nursing team involvement in promoting patients’ mobility. Journal of clinical nursing, 24(1-2), 289-299.
Mitnick, S., Leffler, C., Hood, V. L., & American College of Physicians Ethics, Professionalism and Human Rights Committee. (2010). Family caregivers, patients and physicians: ethical guidance to optimize relationships. Journal of general internal medicine, 25(3), 255-260.
Shea, T., De Cieri, H., Sheehan, C., Donohue, R., & Cooper, B. (2016). Occupational health and safety issues for aged care workers: A comparison with public hospital workers. Victoria: Institute for safety, compensation and recovery research.
Tuffrey-Wijne, I., Giatras, N., Goulding, L., Abraham, E., Fenwick, L., Edwards, C., & Hollins, S. (2013). Involving carers as partners in care.
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