DISPLAY SCREEN EQUIPMENT (DSE) PROCEDURE – RMPG07 APPENDIX 3

DISPLAY SCREEN EQUIPMENT SELF-ASSESSMENT FORM Guidance: Please use block capitals throughout

Guidance: Please write yes, no or N/A in the far right column.

Guidance: Answer if DSE self-assessment is referring to the use of a laptop.

A1 How often is the laptop being used?

A2 Is the laptop being used in conjunction with a docking station?

A3 Is the laptop being used with a riser?

A4 Is the laptop being used with a full size keyboard?

A5 Is the laptop being used with a standalone mouse?

Guidance: Adjust your chair height so that your elbows are roughly the same height as the top of your desk.

B1 Is your chair suitable and stable? (five fixed feet)

B2 Does the swivel mechanism work?

B3 Do the casters or gliders work efficiently? (five casters)

B4 Do the height adjustment controls work?

B5 Do the back adjustment controls work?

B6 Have you adjusted the chair to the correct height and adjusted the back to correctly support your lower back? Guidance: This process is explained in the slide show on the OLM ‘fit-for-work’

B7 Can you sit with your feet flat on the floor without a foot-rest?

B8 Is there an instruction booklet available for your chair?

B9 Is the covering of the chair in good condition?

Guidance: Screens should be directly in front of you if single, equal-spaced if dual and not placed in the curve of curved desks. The screen height should be adjustable and a riser may be required to achieve correct height.

C1 Have you positioned the screen so that it is approximately arm’s length away?

C2 If your screen is height adjustable, have you positioned it so the top is level with your eyes?

C3 Does the screen tilt and swivel?

C4 Does it give clear and stable images with no flickering?

C5 Is your screen free from glare and reflections?

C6 Have the brightness and contrast controls been set to the optimum setting?

C7 Is the text size comfortable to read?

Guidance: Your work surface area should be adequate for you to complete your tasks and organise the essential equipment required for you to undertake your work. Remember the Trust has a clear desk policy.

D1 Is there enough room on your desk for essential papers?

D2 Is your desk surface free from glare and reflection?

User’s name: Location:

Signature: Date: / Telephone: 0

201

I have looked at the slideshow within the ‘fit-for-work’ section of OLM

Workstation or Laptop

SAMPLE - DO NOT USE

Guidance: Your desk should be arranged so that you can carry out your essential tasks without stretching or twisting your body, if frequently used, your keyboard should be centrally placed in front of you, with your mouse positioned just to the right of the large + key; or just to the left of the ‘tab’ key for left-handed people.

E1 Is your keyboard positioned in an easily reached location without tight cables?

E2 Do you have enough space in front of your keyboard? (100mm approx.)

E3 Are your keys all legible and do they all operate correctly?

E4 Does your mouse work properly, is it of the correct hand for you and does it work smoothly and at a suitable speed?

Guidance: Your working environment should be as comfortable as we can reasonably make it for you, this includes air quality and temperature, please remember there is currently no upper limit on temperature.

F1 Do you have enough room to sit comfortably, change position and vary your leg movements?

F2 Is the light coverage in your room adequate and enough for your work?

F3 Do your windows have adjustable blinds or other furnishings?

F4 Is the noise level generally comfortable without excessive noise that affects your concentration?

F5 Is the air quality and temperature acceptable?

F6 Have you checked that your cables (both electrical and IT) are not causing any hazards? (Please check that no daisy-chains are in use).

F7 Is the flooring free from trip hazards, including boxes, papers, handbags, or unevenness etc.?

Guidance: Other items that require your consideration in the execution of your work.

G1 Is the supplied software suitable for you to complete your tasks?

G2 Is the software easy to use and have you had sufficient training in it?

G3 Can you use your telephone without stretching and twisting?

G4 Do you need to input data whilst using the telephone?

G5 Do you take frequent breaks during your computer work?

G6 Are you free from aches and pains in your upper torso, neck, arms, shoulders and hands?

G7 Do you have restrictive joint movement?

G8 Are you free from problems with your vision – headaches, sore eyes or problems focusing?

Staff Member additional comments: Guidance: Allow box to expand if necessary to ensure as much detail is captured as possible.

Guidance: You should now discuss this form with your immediate manager and ask them to sign it and make any comments regarding your DSE; they should try to correct anything in their power (reasonable adjustments). Guidance: If any health issues are identified in the DSE Self-Assessment the Manager should ensure a copy of it is sent to the Occupational Health Department for their review, comment, and / or action dependant on Management/user findings. Guidance: For any other issues that cannot be rectified by the manager, in the first instance, then refer to the Risk Department ensuring the manager’s comments clearly note what they have done to assist the employee concerned.

Manager’s comments:

Manager’s signature:

Date:

SAMPLE - DO NOT USE