Safety Observation-Strain and Sprain Prevention Copy

• Location
  Address

• Department

• Observation Date

  Date

• Observer

• Task

• Employee

• Select New employee < 90 days Returning from injury In job > 5 years Discomfort Disregard safe practice Other

  • New employee < 90 days
  • Returning from injury
  • In job > 5 years
  • Discomfort
  • Disregard safe practice
  • Other

If NO is checked, you must select a reason for the AT RISK BEHAVIOR OR CONDITION and include corrective action on the following page. ST: Safety Training no provided within the last 12 months or documented SP:Safe Practice (Training) Not Followed JD: Job Design

Behavioral Risk Factors

• Use neutral body postures

  Yes

  No

• Select One

  ST

  SP

  JD

• Elbows close to sides, back and head straight, no bending/lifting/twisting trunk, three-point contact and supportive body mechanics used; Awareness training provided to employees

• Details of Observation

• Keeps loads close to body

  Yes

  No

• Select One

  ST

  SP

  JD

• Keeps load close to body; Move close to area where object will be placed

• Details of Observation

• Not carrying/handling objects while climbing ladders/stools

  Yes

  No

• Select One

  ST

  SP

  JD

• Requests assistance from another employee after/ascending and before/descending ladder/stool

• Details of Observation

• Uses available material handling devices (cart, hand truck, etc.)

  Yes

  No

• Select One

  ST

  SP

  JD

• Retrieves proper material handling device for the object before lifting/moving it

• Details of Observation

• Gets help for awkward or heavy objects over 50 lbs

  Yes

  No

• Select One

  ST

  SP

  JD

• Requests assistance and complete lift in one, smooth motion by both employees

• Details of Observation

• Manual handling done within "safe lifting zone" - between shoulders and knees.

  Yes

  No

• Select One

  ST

  SP

  JD

• Keeps heavier objects to be handled stored within the safe lifting zone (between shoulders & knees) Complete simple stretching before starting work requiring lifting, carrying, kneeling, bending, etc

• Details of Observation

• Pushes material handling devices instead of pulling

  Yes

  No

• Select One

  ST

  SP

  JD

• Positions material handling devices so loads can always be pushed using both hands and not pulled

• Details of Observation

Conditions / Environmental Risk Factors

• Material handling device casters or wheels in good condition

  Yes

  No

• Select One

  ST

  SP

  JD

• Inspects caster/wheels before use, removes device from service and notifies supervisor/maintenance for repair

• Details of Observation

• Does not complete task while reaching below waist and above chest height

  Yes

  No

• Select One

  ST

  SP

  JD

• Whenever possible, maintain work heights consistent with employees elbow height

• Details of Observation

• Uses proper type and fit for personal protective equipment

  Yes

  No

• Select One

  ST

  SP

  JD

• Provide choices of PPE for both small and large sizes; poor fit promotes muscle/tendon fatigue and strain injuries

• Details of Observation

• Uses computer workstation with adequate adjustability, lighting, workspace, etc.

  Yes

  No

• Select One

  ST

  SP

  JD

• Chair/keyboard has multiple adjustment features and used correctly; sufficient leg space under desk; computer monitor positioned at right angle to light sources to reduce glare/eye fatigue

• Details of Observation

• Uses neutral body posture, during static sitting tasks, to minimize fatigue in back, arms, neck, and legs

  Yes

  No

• Select One

  ST

  SP

  JD

• Chair and workstation properly adjusted to promote neutral body posture (straight/supported back, forearms and thighs parallel to floors; wrists straight/supported; monitor adjusted/straight neck, etc.)

• Details of Observation

• Works in varying postures (standing/sitting) while performing extended reaching to complete tasks

  Yes

  No

• Select One

  ST

  SP

  JD

• Keeps frequently used items within the 12"-15" forward and sideward reach envelope

• Details of Observations

• Works in varying postures (standing/sitting) while performing repetitive tasks

  Yes

  No

• Select One

  ST

  SP

  JD

• Provides task variety - rotate between tasks that use different muscle groups and postures; make simple adjustments to work environment and body motions used in task

• Details of Observation

• Works in reasonable postures (limited bending at waist, extended reaching/lifting, bent elbow/neck) while performing repetitive tasks

  Yes

  No

• Select One

  ST

  SP

  JD

• Facility task variety - rotate between tasks that use different muscle groups and postures; make simple adjustments to work environment and body motions used in task

• Details of Observation

• Stature allows employee to work in safe postures

  Yes

  No

• Select One

  ST

  SP

  JD

• Design work heights for tall employees and provide platforms for shorter employees; design work reaches for small employees

• Details of Observation

• Comments regarding observations - positive reinforcement or corrective action for At Risk Behaviors and Conditions - ST, SP, JD

• Date of Coaching

  Date

• Employee Initials

  Sign

• Supervisor/Manager Initials

  Sign