Safe Patient Handling. Objectives Ergonomics Risk factors High risk patient care activities Conditions that result in high risk environments

Safe Patient Handling

Objectives

Ergonomics

Risk factors

High risk patient care activities

Conditions that result in high risk environments

Best solutions for moving and handling patients

The Basic Problem

Fundamental ergonomics

The National Institute of Occupational Safety and Health (NIOSH) research:

– Under IDEAL CONDITIONS, 90% of males, and 75% of females can safely lift 23 kilograms (~51 pounds), MAXIMUM.

– Healthcare settings do not provide ideal conditions (straight back, no bending, no twisting, positive grasp, infrequent lifts, etc.)

Conclusion

– One healthcare worker cannot safely lift an adult patient alone, and positioning tasks that require greater than 23Kg of exertion are also hazardous.

What Makes Patients Risky?

They are bulky—adults are > 51 pounds

No handles! (Technical term is “coupling” = good grasp)

The unpredictable occurrence

Possible lack of help from patient

Possible consideration of wounds

Risks of Job Tasks

What factors contribute to a healthcare worker being hurt during patient positioning?

– Awkward postures

– Lifting heavy loads

– Length of lifting (supporting the patient over a period of time)

– Reaching

– Frequency of positioning tasks

OSHA “Regulations” Regarding Patient Positioning

OSHA recommends

minimizing manual

lifting of patients/

residents in all cases

and eliminating lifting

when possible.

Basic Safe Patient-Positioning Process

Identify

– Characteristics of the patient to be positioned

– Type of positioning to be accomplished

– If movement, where the patient is being moved to.

– Task-related Hazards

– Environment/facility-related hazards

– What personnel/equipment will be needed

– How to move or lift the patient.

Possible Risks In Job Environment

Slip, trip, and fall hazards

Uneven work surfaces (bed to stretcher, chairs, toilets)

Space limitations—(i.e. patient fallen in the bathroom)

Equipment hazards (respirators, IV pumps etc.)

Other Risks

Help unavailable when needed (understaffed facility)

Patient handling equipment in poor working order

Combative patients

Others?

Assessing the Patient Before Moving

Always review the patient care plan before attempting to move the patient.

A patient care plan describes a specific patient’s needs, degree of assistance required, special treatments, etc.

Assessing a Patient

Next ask the following questions before moving or transferring the patient.

Can they provide assistance?

Can they bear weight?

Can they cooperate and follow instructions?

How big and heavy is the patient?

Note patient’s wounds, dressings, and any machinery.

Types of Patient Moves and Lifts

Lateral transfers: Moving a patient sideways

Repositioning: Moving a patient up and down or side to side in a bed or chair

Transfers involving sitting position: bed to chair, bed to bed, chair to toilet, car to chair

Floor: Recovering a patient that has fallen on the floor

Why Use Patient Equipment?

When a patient weighs too much for safe manual positioning

Frequent unassisted lifting and movement of patients causes muscle and joint pain/damage.

Patient handling/moving equipment

Sling – for patients that are totally dependent

Lean Stand Assist – for patients that have some lifting ability

Ceiling Mounted Lift Device – for patients that are totally dependent

Patient Assist Devices

Sliding boards (also called back boards)

Slip sheet, roller sheet, or draw sheet

Trapeze lift attached to bed (mostly used on orthopedic patients)

Walking or gait belt

Shower chairs

Toilet seat risers

And many more…

Hospital & Nursing Home Systems

The following are systems utilized by hospitals to decrease the risk of work-related lifting injuries

Color Coding – color coding of patient’s lift requirements for posting at the patient’s bedside. By looking at the displayed color coding system an employee can know what kind of moving assistance the patient will need

Hospital & Nursing Home Systems

Segregation of patients based on need. This will ensure that equipment and staff are appropriately assigned

Staggered Staffing – Provide additional staff for peak periods. This would usually be during the day shift, patient baths, physical therapy etc.

Lifting and Moving Algorithms

What are lifting and moving algorithms?

– They were developed by a group of nursing experts and tested in different patient populations

How do algorithms help you?

– They give you a safe process to accomplish the task you are trying to perform

– Ensure that you and the patient will not get hurt during the move

Now lets look at one example of a lifting and moving algorithm…

Reposition in Bed: Side-to-Side, Up

Resources

Discussion of Nursing Home mechanical lifting program:

http://www.cdc.gov/niosh/docs/2006-117/pdfs/2006-117.pdf

Full discussion and all algorithms:

– OSHA’s Ergonomics Guidelines for Nursing Homes

– http://www.osha.gov/ergonomics/guidelines/nursinghome/final_nh_guidelines.html

Basic Lifting Techniques

Always remember basic safe lifting techniques while performing duties

– Stand as close to the patient as possible

– Keep back straight

– Get a good grip on the patient

– Lift with legs when possible

SUMMARY

Back injuries are among the most costly and disabling of all injuries.

A back injury now could cause pain for a lifetime – it is important to treat the back well.

Always use the proper lifting techniques and systems, doing so will allow a healthy back for tomorrow and years to come.