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Musculoskeletal Injury Prevention ACUTE

Workplace injuries can be prevented — whether you work in a lab, move boxes, or spend hours working at a computer. This module is intended to help you reduce your risk of suffering musculoskeletal injuries (MSIs).


What are the greatest MSI risks for Mohammed and Sandra?

Case Study 1

Mohammed is a patient care aide at VCH. He spends the day transferring and mobilizing patients/residents.

Case Study 2

Sandra is a nurse at VCH. She spends her day attending and treating patients.


The most important information I need to know.

5 Risk Factors

Signs & Symptoms

3 Stages of MSI


Awkward Posture


EXAMPLE: Mohammed’s job entails work in awkward postures transferring and mobilizing patients/residents. Other examples of awkward posture at VCH are:

  • Dressing patients
  • Retrieving linen from a shelf or bin
  • Assisting a patient to roll

FACT: Neutral posture reduces the strain on working muscles and joints, and keeps the blood circulating, which enhances the body’s ability to remove toxins.




EXAMPLE: Mohammed’s work involves force during tasks such as manually rolling a patient. Other examples of force at VCH are:

  • Transferring a patient
  • Repositioning a patient in bed or wheelchair
  • Pushing/pulling bed stretchers and carts

FACT: Small forces that seem manageable can nevertheless increase the risk for MSI when the task is repetitive or if applied in an awkward posture.




EXAMPLE: Sandra spends some of her day repeatedly tearing IV bags. Other examples of repetition at VCH are:

  • Crushing pills
  • Accessioning in the lab
  • Connecting and disconnecting lines

FACT: All risk factors become even riskier when combined. The effects of repetition can be amplified when high forces and/or awkward posture are also at play.


Static Posture


EXAMPLE: Sandra spends part of her day in a static posture holding a limb for a dressing change. Other examples of static posture at VCH are:

  • Assisting with breastfeeding
  • Standing at a workstation

FACT: Joints and muscles get their nutrition and eliminate waste products by moving.


Contact Stress


EXAMPLE: Sandra experiences some contact stress in her day leaning her wrist against the edge of the desk while using the computer mouse. Other examples of contact stress at VCH are:

  • Leaning forearms against a counter top
  • Pushing on cart handles
  • Leaning against bed rails (e.g. during a dressing change, bed care tasks)

FACT: The effect of contact stress can be aggravated by holding the position for a long time.


MSIs are injuries that affect the human body’s movement or musculoskeletal system (i.e. muscles, tendons, ligaments, nerves, discs, blood vessels, etc.).

MSI can worsen over time. Early recognition is critical for timely  intervention and treatment.

It is also important to recognize the signs and symptoms so that they can be reported to your Supervisor.


Signs are things you can see such as:

  • redness
  • swelling


Symptoms are things you can feel such as:

  • numbness
  • tingling
  • spasms
  • stiffness
  • reduced range of motion

Early Stage

  • Ache/fatigue may be present during work but lessens or disappears with rest
  • No effect noticed on work performance
  • This stage may last weeks or months

Middle Stage

  • Ache/fatigue/pain may be present both at work and at home
  • Visible signs of MSI may be present
  • This stage may last several months

Late Stage

  • Ache/fatigue/pain may be present even when resting
  • Work performance and sleep are significantly affected
  • This stage may last for months or years


Tips to help me take care and stay safe.

Identify workplace risk factors

The first step to reducing MSI is to recognize risk factors and report them to your supervisor.

Problem solve

Discuss ways to minimize identified risk factors with your supervisor and peers. If you feel the onset of MSI, consult with your health care practitioner. Early intervention is key to recovery. Report to Workplace Health Call Centre: 1 (866) 922-9464.

Point of care risk assessment

  • Do I have the skills?
  • Am I in the right frame of mind?
T – Task
  • Do I know how the patient does the task?
  • Has the care plan changed? Kardex? Report?
E – Environment
  • Is the area safe?
  • Proper equipment and set-up?
P – Patient/Resident/Client
  • Is the patient safe to do the planned task?
  • Has the patient changed?
  • Is this the right time for the patient?
  • If transferring: “S.A.F.E. Pre-transfer Check”

Pre-transfer check

Use it to assess if a manual transfer is safe to do at a point in time.  There are 5 steps.

  • Step 1: Can the patient follow simple instructions and cooperate?
  • Step 2: When in bed, can they lift their hips up (bridge) or shift hips (scoot) to the side?
  • Step 3: In sitting, can they sit upright independently, and lean forward and back?
  • Step 4: Can they start to stand by leaning forward and lifting their bottom off the seat?
  • Step 5: In standing, can they move their feet (step on the spot or shuffle their feet side to side)?

The patient must be able to complete all steps to continue with a manual transfer safely.

If the task is unsafe:
  • Follow your worksite’s standard procedure for when unsafe work conditions are identified
  • Make sure the patient is safe and ask for supervisor input on an alternative plan
  • Understand your Right to Refuse Unsafe Work (Occupational Health and Safety Regulation). Refer to Refusal of Unsafe Work Process — the Occupational Health and Safety Agency for health care in BC.
  • Familiarize yourself with examples of immediate actions and follow up actions

Correct body mechanics

Correct body mechanics help you position and move your body in a safe and efficient way. They may help reduce muscle fatigue and injury risk.

Apply them in all situations – whether doing patient handling tasks (such as transfers, toileting, bathing) manually or using patient lifts, and when handling materials or other equipment.

Follow these principles of correct body mechanics:

Before you move / lift:

  • Assess the work or load
  • Get close to the object/person before you move
  • Place your feet shoulder width apart in standing or wider if shifting your weight
  • Keep your back neutral/straight – Avoid awkward postures
  • Do not twist or overreach


During the move / lift:

  • Pull your stomach in
  • Lift with large leg muscles
  • Weight shift using your legs to move
  • Lift or move in a controlled way


Know your equipment and tasks

Ask about any Safe Work Procedures (SWP) in your unit/work-area. There are often several different ways to do the same task or activity, and some of these will be safer than others. Review helpful resources on safe use of equipment.


Checking my confidence in this subject.


Identify risk factors in your new work environment and prepare to discuss problem solving methods when you meet your supervisor and peers in person.

Click here to access & complete the required MSIP quiz.

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