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EN12642XL sticker DVSA is responsible for lorry, bus and coach enforcement including: roadworthiness - including both the vehicle and the load it’s carrying traffic enforcement - including drivers’ hours and overloading During 2013, DVSA issued over 2,000 prohibitions to vehicles which presented a road safety risk because of how their load was secured. In the same period, the Highways Agency reported over 22,000 road impact incidents caused by objects falling from vehicles. This is dangerous to all road users. This resulted in the closure of either a single lane or the full carriageway. On average, it takes 20 minutes to deal with each incident. This places a significant financial burden on the UK economy from: This guidance has been produced by DVSA and representatives from the transport industry. The subject matters chosen were the areas causing the greatest industry concern. This document does not replace the more extensive guidance available in: the European best practices guidelines on cargo securing see here for road transport These more comprehensive documents underpin the current approach to enforcement and should be familiar to anybody involved in the movement of goods via the road network. For the benefit of this guidance any reference to a vehicle should be read as any vehicle, trailer or combination unless specified otherwise. The load securing systems you use should be appropriate for both: 2.2 Make sure the vehicle is fit for purpose You should consider the types of loads being carried when buying vehicles. There are aftermarket products which can provide bespoke securing products to adapt vehicles to ensure they’re fit for purpose. There are also specialist companies who can give advice on the right load securing system for your operation and the loads you carry. The relevant trade body for your business may be able to help their members. Stack the load against the headboard with the centre of gravity as low as possible. Make sure it’s stable without lashings to reduce the risk of it falling over during unloading. If the load is not stable by itself, think about how you can support it: put it in a box, stillage or transport frame. If the load is not against the headboard - or items could slide over it - think about other ways you can stop the load from moving forward. You may need extra lashings, sails, chocks or blocking. The headboard is a key part of the load securing system - fix any damage as soon as possible. Whatever method you choose, the load restraint system needs to secure the load to the vehicle chassis and prevent movement. Not all loads or vehicles are the same.


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Author: Sharon Rindsland is moving and handling senior coordinator, East Kent Hospitals University NHS Foundation Trust. This article has been double-blind peer reviewed Scroll down to read the article or download a print-friendly PDF here Click here to see other articles in this series This article is open access and can be freely distributed This article is funded by an unrestricted educational grant from Hillrom Part 1 of this series discussed the benefits of early mobilisation for patients in hospital. Nurses’ involvement in daily care gives them a critical role in mobility assessment and intervention, yet they typically engage only a minority of their patients in efforts to mobilise; in addition, most of these efforts directory are low-level, of short duration and, usually, initiated by patients (Wald et al, 2018). Older patients in hospital who were ambulatory before admission, spend up to 83% of their time in bed rather than seated, standing or ambulating, and over a third are discharged with a significant disability that was not present on admission (Boynton et al, 2020; Wald et al, 2018). A comprehensive mobility assessment can deliver a higher standard of care through safe and effective mobilisation of patients, while also ensuring the safety of caregivers. Mobility should, therefore, be seen as an important measure for routine assessment to help with care and discharge planning, as well as the measurement of hospital care outcomes (Wald et al, 2018). When mobilising patients, healthcare providers and staff have legal responsibilities and guidance to follow – such as that issued by the Health and Safety Executive and the Royal College of Nursing – to minimise moving and handling risks and prevent injury to staff and patients. Employer and employee responsibilities are outlined in Box 1. Regularly assessing patients’ handling and mobility needs Following appropriate systems of work and attending training Avoiding manual handling for tasks that could cause injury when reasonably practicable and using equipment provided Sources: Bit.ly/RCNMoveHandling; Bit.ly/HSEMoveHandling Mobility/patient handling assessments are part of a wider risk assessment to identify where injuries could occur and how to prevent them. The HSE requires employers to instigate two types of moving and handling risk assessment: Generic risk assessments covering workplace needs (such as the type and frequency of moving and handling tasks, staffing and overall equipment needs), balancing employee safety with the needs, safety and rights of patients; Individual risk assessments, which consider patients’ specific moving and handling needs (such as help required, equipment needs, and number of staff needed), should form part of care planning. Mobility assessment and intervention should follow the nursing process of: Functional mobility assessments focus on: Identifying where injuries could occur and how to prevent them. The assessment should be person-centred and, where possible, involve patients in decisions about how their needs are met. It should include: A social assessment – such as the patient’s level of mobility pre admission and how they managed at home; Assessment of communication needs – for example, whether the patient is hard of hearing or visually impaired; A functional assessment to decide the patient’s mobility level and any handling risks and/or needs (Box 2). A comprehensive functional assessment of the patient should include: Height, stature and weight to inform selection of the appropriate aid/equipment Any specialist risk, such as dementia or spinal cord injury, which might affect the patient’s ability to mobilise safely Other constraints or risk factors, such as confusion, pain, weakness, disability, skin lesions/wounds, or risk of falls Physical function, including upper- and lower-body strength, balance and gait Cognitive and behavourial factors, including ability to respond to instruction and cooperation/concordance What the patient is able/unable to do independently, such as repositioning themself/sitting up in a bed or a chair, transferring from a bed to a chair, moving from sit to stand, walking, toileting/washing Assistance needed for each task, including equipment (make, size, type, including bariatric where necessary) and number of staff needed How to reduce the risk/deal with falls if the patient is at risk When the patient should next be reviewed, including if their condition changes Sources: Bit.ly/HSEMoveHandling; All Wales NHS Manual Handling Group (2020); Scottish Government and Health and Safety Executive (2014) Nurses who assess patients need good (verbal and non-verbal) communication and observational skills. Establishing sympathetic eye contact at the patient’s level is a good start, as this can help build rapport. Assessing cognitive and physical function is the first step towards measuring a patient’s mobility needs. Simple exercises (such as asking the patient to put their hand to your palm and push, or instructing a seated patient to raise one knee until it touches your hand) will show if the patient is alert and can follow instructions as well as testing upper and lower body strength. Sometimes the best way of instructing patients is to do the exercises with them; if the patient is visually impaired, ask permission to take their hand/leg and gently lead them through the process. Using the right language is also important; for example, if you describe lifting the leg as ‘like dancing the can-can’, patients are more likely to lead with the knee, instead of swinging their whole leg up. The can-can analogy is also useful in helping seated patients to move to the edge of the chair, knees over toes, in a safe position to stand. Staff must also be skilled in safer handling, and ward managers should monitor the management of patients and seek specialist advice for any specific moving and handling needs, such as from physiotherapists, occupational therapists or manual-handling advisers.