Safe Patient Handling 2015 update march 2015

Safe Patient HandlingEED/NTDD

2015Lisa Affatato, MSN, RN-BC

Maureen Ibrahim MS, RN, CCRN, CEN

At the end of this class the learner will be able to :

• Define safe patient handling.• List the benefits of safe patient

handling and mobility technology.• Describe why manual handling of

patients causes injuries.

Crit Care Nurs Clin N Am 19 (2007) 213-222

In 2004, Nelson & Baptiste stated:

• “Nursing can no longer afford the “human sacrifice” approach to patient handling defined as replacing the steady stream of injured nurses with newly recruited nurses.”

Did You Know?• 52% of RN’s complain of chronic back pain lasting >2 weeks

within past 6 months• 12% of RN’s have left profession due to back pain• Nurses Aids & RN’s suffered highest prevalence 16.6% of

work-related back pain involving lost work days• In 2005 Texas was first state to implement legislation

requiring HCF to implement SPH programs to protect HCW’s from preventable injuries from manual patient lifting

• 49% reduction in falls in one study R/T use of lifting equipment

Risk:• The single greatest risk factor for

musculoskeletal disorders (MSD) in Health Care Worker is manual handling of patients (lifting, repositioning, & transferring)!• Risk of injury can be significantly reduced

or eliminated through use of assistive devices and equipment.

Exercise: Use of SPH Equipment

Employee Resistance Regarding Use of SPH Equipment

Employee comments What would you say?

1. “I’ve been a healthcare worker for 25 years and I’ve never injured my back yet. I don’t see why I have to start doing things differently now.”

*Back pain reoccurrence rate 90%

2. “I’m in good shape. I don’t need that fancy equipment to do this.”

3. “This patient has already been through quite a lot. I don’t want to burden him any further. Let’s skip the lifter-you and I can just lift him together.”

4. “I find it takes a lot longer to use this piece of equipment even when it’s readily accessible.”

5. “I don’t use that piece of equipment enough to remember how exactly it works so it’s easier to just do a manual lift.”

6. “I don’t have enough time to hunt for the equipment.”

05/02/2023 Educational Enrichment Day 2015

LEVEL OF RISK

WorkerEducation and trainingIndividual capabilities

Physical readiness/ posture

EnvironmentRoom size and layout

EquipmentFurniture

Workspace

TaskTypes of care tasks

Task pacingTask variety/ repetition

Mobility CooperationSize AggressionWeight BalancePredictability DiagnosesCognition

Patient

RISK FACTORS:

05/02/2023

Why Caregivers Get Hurt:

• Always lifting, moving & turning patients which tires your muscles putting you at risk for injury

• Patients can’t be held close to body like a box• Patients are bulky • Patients don’t have handles• Don’t always know if patient can help• You can’t predict!!!

Risk- Load Increasing:

• OBESITY is a growing population• In 1983 one in 200 people had a BMI > 40• In 2000 one in 50 people had a BMI > 40• In 2010 one third of all Americans have a BMI > 40 • One study found < 10% of patient census was

bariatric patients & patient-handling injuries accounted for 29.8% of staff-reported injuries

Risk- Repetition:

• 1995 study at one hospital• Found nursing staff pulled patients up in their

bed an average of 9.9 times/shift.

Safe Patient Handling:

• Definition: Use of engineering controls, lifting and transfer aids, or devices to perform acts of lifting, transferring and repositioning patients

NYS Safe Patient Handling Act NY SB 6914

• Public interest for Health Care Facility (HCF) to implement safe patient handling policies

• Caregivers will reduce risk of injury• Safe Patient Handling Workgroup to develop policy

& training materials; submit report by July 1, 2015• Each HCF will have a SPH Committee by January 1,

2016• Program must be implemented by January 1, 2017

National Institute of Occupational Safety & Health (NIOSH)

• Calculates maximum load for manual lifting, pushing, pulling and carrying using a range of variables

• Maximum load for a box with handles is 51 pounds (23 kg.) – load is lower if lifter has to reach, lift near the floor or undertake an awkward position

• 35 pounds (15 kg) safe patient- lifting limit for HCW’s

Safe Patient Handling & Mobility:

• For lifts above the SPH limit, there is no such thing as “Safe Lifting” using our bodies as the lifting mechanism

• Body Mechanics – important, but again if load is above the SPH limit, injuries will occur

• We must change our mindset!• Get in habit of using Safe Patient Handling & Mobility

(SPHM) technology• This will keep both our patients & ourselves safe from

harm!

Ergonomics

• Design of workplace or equipment• Those factors or qualities in the design of

something, especially a workplace or equipment used by people at work, that contribute to comfort, efficiency, safety, and ease of use

• Greek word; Ergon = work, Nomos = Laws;• “laws of work”• Fit the task to the worker – not fitting the worker

to the task

Equipment available at Huntington Hospital:

• Lift – Invacare (2 North), Prism (Med/Surg) & Golvo (CCU/ICU)–For Prism; reusable sling is blue,

disposable sling is white–Slings are par leveled on every unit

• Transfer boards

Slipper Slide Sheets

Transfer Board

Transfer Board

Safe Patient Handling: Equipment

• https://www.youtube.com/watch?v=3lTA1ZoBh_w

Culture Change: Never Lift Alone

• https://www.youtube.com/watch?v=9v3CYuQnxok

Benefits of SPH:• Reduced injuries• Less re-injury • Pregnant/Older workers can work longer• Reduced workman's compensation medical and insurance

costs• Reduction of lost days worked• Improved recruitment and retention• Improved employee satisfaction• Increased patient referrals; feel more dignified

transferring with use of equipment

Benefits of Safe Patient Handling

WHAT CAN IT DO FOR YOU?

Reduce injury to healthcare

workers

Increase quality of care

for patients

Decrease patient injury

during transfers and

handling during care

Lower workers compensation and insurance

costs

Reduce lost work days

Increase in nursing

retention

Lower Hospital and Nursing Home costs

Return on investment in

1-3 years

What Should be Looked At:• Is the patient dependent?• Is the patient minimally to moderately dependent?• Is the patient independent?• Weight-bearing capability?• Upper extremity strength?• Level of cooperation and comprehension?• Medications?• Other conditions; stoma, fractures, severe edema or joint

replacement?• Equipment i.e. foley, oxygen mask, IV

Communication of Patient’s Mobility Status:

• Handoffs• After procedures• Administration of medication or medication

changes

ANA Recommendations:

Suggestions?

• Have you worked with equipment elsewhere that you think would be beneficial for us to trial?

• Send suggestions to:– Lisa Affatato RN, Nurse Manager, 2 Southwest– Kevin M. Cerrone, DPT, MHA, MS, CSCS Director Physical Therapy & Orthopedics

References• Cadmus, E., Brigley, P. & Pearson, M. (2011). Safe patient handling:Is your

facility ready for a culture change? Nursing Management. Retrieved from www.nursingmanagement.com

• Fitzpatrick, M.A. (2014). Safe patient handling and mobility: A call to action. Current Topics in Safe Patient Handling and Mobility.

• Gallagher, S. (2013). Implementation guide to the safe patient handling and mobility interprofessional national standards. ANA: Silver Springs, MD

• Garcia, A. Standards to protect nurses from handling and mobility injuries. Current Topics in Safe Patient Handling and Mobility.

• Kumpar, D. (2014). Prepare to care for patients of size. Current Topics in Safe Patient Handling and Mobility.

• Ryan, L. (2014). Safe patient handling leadership briefing. Greater New York Hospital Association.

References• Stenger, K., Montgomery, L.A. & Briesemeister, E. (2007). Creating a culture of

change through implementation of a safe patient handling program. Crit Care Nurs Clin N Am 19 (2007) 213-222

• U.S. Bureau of Labor Statistics, U.S. Department of Labor. (2014). http://www.bls.gov/news.release/osh2.t01.htm

• U.S. Bureau of Labor Statistics, U.S. Department of Labor. (2014).http://www.bls.gov/iif/oshwc/osh/os/osch0052.pdf

• Zitkus, B.S. (2010). Obesity management workbook. Retrieved from http://www.zitkus.com