Each day, health care professionals are moving and handling a variety of items. This can range from small pieces of equipment, moving beds and trolleys or the manual handling of infants, children and young people. Each of these activities has their own challenges and can potentially cause harm to both the health care practitioner and the patient. The aim of any moving and handling procedure is to minimize the risk to its lowest practicable level. In order to achieve this, the health care practitioner must assess, discuss, plan, and evaluate each activity to be undertaken. Each practitioner must be knowledgeable in the current legislation for manual handling practices and policies as well as have a basic understanding of the musculoskeletal injury associated with the particular tasks that will be carried out.

There is a considerable amount of legislation that pertains to moving and handling in the workplace. In summary, employers have general health and safety responsibilities where they are required to avoid the need for hazardous manual handling, must assess the risk of injury from any hazardous manual handling and reduce the risk of injury where it is reasonably practicable.

The employee also has a duty to adhere to this legislation. Each employee should avoid manual handling duties as far as is reasonably possible, assess the risk associated with each manual handling task, and must use training and equipment that have been provided for them by the employer.

To work safely, it is necessary to identify what is appropriate for each child, whatever their age, at each specific time. This often entails determining what the task actually is, whether it needs to happen, how many people need to be involved, and what equipment, if any, is necessary. A risk assessment is not about creating huge amounts of paperwork, but rather about identifying sensible measures to control the risks involved in any moving and handling procedure. One form of risk assessment that is commonly used in patient handling is TILE(E).

The spine is the central composition of the skeleton. It consists of 33 vertebrae, each pair with an intervertebral disc between them. The intervertebral disc has four main functions: (1) it acts as a shock absorber; (2) it acts as a spacer between vertebrae; (3) it reduces friction during movement; and (4) it limits excessive movement.

The most commonly injured areas of the spine are the cervical and lumbar regions due to their mobility, position and lack of protection. The disc can be damaged by mechanical changes, it can rupture suddenly (a slipped disc), which can be due to either direct trauma or more commonly a cumulative injury which occurs over time.

The correct posture in any physical activity is one which does the following:

• maintains the natural curvature of the spine;
  
• maintains the balance of the body;
  
• minimizes the level of stress on the spine.

Therefore, when manual handling, think about the following:

• Maintain a natural upright posture wherever possible, keeping your spine in line.
  
• Create a good stable base with your legs and feet, adopt a power position.
  
• Keep any load as close to your centre of gravity as possible.

Here are some basic principles to adopt when considering any moving and handling manoeuvres.

• Is it possible to avoid the activity altogether?
  
• If it is not possible, has a risk assessment been undertaken?
  
• Have suitable safe systems been put in place – number of people and equipment?
  
• Rather than lifting, consider other movements, such as sliding, pushing, pulling or rolling.
  
• Think before lifting and handling.
  
• Keep the load close to the waist.
  
• Adopt a stable position.
  
• Get a good hold.
  
• Start in a good posture.
  
• Don’t flex the back any further while lifting.
  
• Avoid twisting the back or leaning sideways.
  
• Keep the head up when handling.
  
• Move smoothly.
  
• Don’t lift or handle more than can easily be managed.

Equipment should be used to reduce the load on staff, should be easy to operate and should be in good condition through regular maintenance. Where equipment is provided for manual handling, operators must be trained in its use.