Sue Unger, OTR/L, Medcare’s on-staff safety expert, provides practical information for avoiding injury in medical facilities.

For further information, contact Medcare or email Sue at safety@medcarelifts.com

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ZERO LIFT PATIENT HANDLING GUIDELINES

When developing zero or low lift policies in health care facilities the most important guidelines are those that relate to how the health care staff will move a patient or resident. This month, I would like to focus on what should be included in these guidelines. The most important factor should be that the policies should reflect how to reduce the risk of injury to both worker and patient. In workers the risk is related to eliminating Musculosketal Injuries (MSI) or Cumulative Trauma Disorders (CTD).

1. Patient handling policies should outline a process that will eliminate foreseeable problems. Some areas to consider are:
2. Eliminate all unnecessary manual patient handling tasks.¹
3. Staff should encourage the patient assist in their own transfer as much as they are safely able to. Keep in mind that this may vary because of the patient’s fluctuating physical or cognitive abilities.¹
4. Install appropriate patient assistive devices such as grab bars or rails in hallways, bathrooms, dining areas, etc. These devices encourage the patient to be more independent.¹
5. Use mechanical lifting devices to move patients. These would include ceiling lifts, patient moving devices and motorized carts/gurneys. Each device should be clearly defined and outlined for staff handling.¹ The following are examples of what should be included in the policy: 
   • Each patient moving device should indicate the minimum number of staff required to complete the transfer.
   • Equipment should have written instructions attached to it describing how it is used. It is especially important to describe how a patient should be correctly positioned in sling or belt. Sling sizes should be identified according to patient weight. Staff should know how to check for the condition of the sling and any moving parts on the machine.
   • Battery information such as location, how to charge and replace it should be on the equipment. Also, the staff should know how to check the battery level and what to do if the battery fails in the middle of a transfer.
   • Equipment contraindications should be written into the policy.
6. Use electronic beds to eliminate patient handling procedures such as sitting the patient up in bed.²
7. Write into the policy that the patient should not be moved if a safe solution is not available. Outline alternative work methods that may be performed until a safe solution is provided. For example, a health care worker may have to care for the patient in bed until the appropriate piece of equipment is located.²
8. Outline transfer situations that may require more spotters. For example if the patient has multiple lines or tubes to watch.
9. Indicate how the health care worker should communicate with staff and the patient. Include who should coordinate the patient lift in various situations.
10. Have a procedure in place to report to the next caregiver of the patient what went well and what might not have gone so well. This information should be given in both written and oral forms.

Submitted by: Sue Unger OTR/L

References:
¹WorkSafeBC Publications (2006). Handle with Care: Patient Handling and the Application of Ergonomics (MSI) Requirements, Part 6, 54-56.

²American Nurses Association. The Online Journal of Issues in Nursing. Handle with Care. Castro A.B. (September, 2004). The American Nurses Association’s Campaign to Address Work Related Musculoskeletal Disorders. http://www.nursingworld.org/readroom/position/workplac/pathand.pdf.

 

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Sue Unger, OTR/L Sue is an Occupational Therapist with 25 years of experience. From 1989 – 2002 she worked in the field of industrial rehabilitation treating injured workers in a hospital setting. Since 2002 she has worked in a hospital based Employee Occupational Health Services department doing preventive ergonomic work site analysis and ergonomic consulting. Her specialties are ergonomics, injury prevention training and job site analysis. Sue does ergonomic education and training with injured and non-injured individuals and also with groups of employee in various departments. She has worked as an ergonomic consultant in both hospital and other work settings. Currently, she teaches hospital nurses and other health care workers Safe Patient Moving and Correct Patient Handling Techniques both with and without mechanical patient moving aids. Sue has presented at both state and national conferences on ergonomics.           Page updated Sunday, January 27, 2008   |   ©2006 Medcare Products, Inc.