Safe Lifting and Moving in Health Care: Equipment Selection Process Safe Lifting and Moving in Health Care: Equipment Selection Process Lisa Murphy, RN

Safe Lifting and Moving in Health Safe Lifting and Moving in Health Care:Care:

Equipment Selection Process Equipment Selection Process

Safe Lifting and Moving in Health Safe Lifting and Moving in Health Care:Care:


Lisa Murphy, RNLisa Murphy, RNJesse Brown VAMCJesse Brown VAMC

Safe Patient Handling Facility CoordinatorSafe Patient Handling Facility Coordinator312-569-7896312-569-7896

[email protected]

Equipment Selection ProcessEquipment Selection Process

Where to Start?Where to Start?

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Determine high risk activities by caregivers.Determine high risk activities by caregivers.

What equipment will be most useful?What equipment will be most useful?

Who, what, where, when, how……..Who, what, where, when, how…….. Who provides most of the physical care?Who provides most of the physical care? What types of lifting, repositioning, and What types of lifting, repositioning, and

moving activities do they provide?moving activities do they provide? Where do these activities happen?Where do these activities happen? When is the care provided?When is the care provided? How often do they engage in each activity?How often do they engage in each activity?


WHO?????? Provides most of the care. WHO?????? Provides most of the care.

Talk directly to the caregiver(s)Talk directly to the caregiver(s)

Others can only speculate Others can only speculate


• What specifically are the high risk activities?What specifically are the high risk activities?

• Pushing/pullingPushing/pulling• Lateral transfers Lateral transfers • Lifting Lifting • RepositioningRepositioning


Where is the care provided?Where is the care provided?


When is the care provided?When is the care provided?


How often are the tasks required?How often are the tasks required? Knowing frequency assists in the purchase Knowing frequency assists in the purchase

process. process. How many Stand Aids do you need? How many Stand Aids do you need? Staff and Residents find it difficult to wait Staff and Residents find it difficult to wait

at times for equipment. at times for equipment.


Now what ?????? Now what ?????? Structure follows function!Structure follows function! What are my resources?What are my resources? Do I have limited space(storage)?Do I have limited space(storage)? What construction is required?What construction is required?

What do I really need?What do I really need?


Lateral Transfer DevicesLateral Transfer Devices

Air mattresses Air mattresses

RollboardsRollboards

Slide sheetsSlide sheets

. Resources . Resources

. Task . Task - How many do I need?How many do I need?- Where am I going to store it?Where am I going to store it?- How will I clean it? (reusable vs single patient How will I clean it? (reusable vs single patient

use)use)


Standing and Raising Aids Standing and Raising Aids

Active lifting – consumer participatesActive lifting – consumer participatesMotorized raising with slings -Motorized raising with slings -All have legs that openAll have legs that open Ability to bear some weight.Ability to bear some weight. Follow directions and cooperate. Follow directions and cooperate. Ability to grasp with one hand. Ability to grasp with one hand.

Un-motorized raising Un-motorized raising with/without slings with/without slings

Some have legs that openSome have legs that open Ability to bear some weight. Ability to bear some weight. Follow directions and cooperate.Follow directions and cooperate. Pull self to a standing position. Pull self to a standing position.


Passive LiftersPassive Lifters

Ceiling lifts Ceiling lifts

Gantry LiftsGantry Lifts

Floor Based LiftsFloor Based Lifts

How do I choose???How do I choose???- Is the ceiling /construction conducive to lift installation?Is the ceiling /construction conducive to lift installation?- Do I have enough funds for many lifts or is a floor lift more useful?Do I have enough funds for many lifts or is a floor lift more useful?- Where can I store a floor based lift and how many would I need?Where can I store a floor based lift and how many would I need?

Equipment Selection Process

- What else is available?

- Can the equipment serve dual purposes?

Equipment Selection Process

- What else is available?

- Can the equipment serve dual purposes?

•Specialized slingsSpecialized slings•No-slip chair seatsNo-slip chair seats•Turning discsTurning discs•Helping hands poles Helping hands poles •LiftseatsLiftseats•Motorized stretchersMotorized stretchers•Inflatable chairs/mattressesInflatable chairs/mattresses•Wheelchair liftersWheelchair lifters•Hygiene/shower liftsHygiene/shower lifts•Shower trolleysShower trolleys•Wheelchair movers Wheelchair movers •Automobile lifts! Automobile lifts!


What’s next???What’s next???Now that I have equipment…..Now that I have equipment…..

how do I choose what is appropriatehow do I choose what is appropriate

for each situation?for each situation?


Safe Patient Handling Safe Patient Handling

Clinical Guidelines & AlgorithmsClinical Guidelines & Algorithms


AssessmentAssessment

Completed on anyone needing Completed on anyone needing assistance assistance (per licensure and facility (per licensure and facility protocol).protocol).

Includes…Includes… Individual Characteristics Individual Characteristics Medical Condition/sMedical Condition/s


AssessmentAssessment

Includes items such as: Includes items such as: Ability of the person to provide Ability of the person to provide

assistanceassistance Ability of the person to bear weightAbility of the person to bear weight Ability of the person to cooperate Ability of the person to cooperate

and follow instructionsand follow instructions Height and weight Height and weight Special Medical/Physical Special Medical/Physical

ConsiderationsConsiderations


AlgorithmsAlgorithms Based on Specific Characteristics Based on Specific Characteristics

(from Assessment)(from Assessment) Considers the task to be completedConsiders the task to be completed Assists caregivers in selecting safest Assists caregivers in selecting safest

Equipment Equipment Advises Advises # of staff# of staff needed needed

What tasks do the Algorithms cover?What tasks do the Algorithms cover?

1.1. Transfer To and From: Bed to Chair, Chair to Transfer To and From: Bed to Chair, Chair to Toilet, Chair to Chair, or Car to ChairToilet, Chair to Chair, or Car to Chair

2.2. Lateral Transfer To and From: Bed to Lateral Transfer To and From: Bed to Stretcher, TrolleyStretcher, Trolley

3.3. Transfer To and From: Chair to Stretcher, Transfer To and From: Chair to Stretcher, Chair to Chair, or Chair to Exam TableChair to Chair, or Chair to Exam Table

4.4. Reposition in Bed: Side to Side, Up in BedReposition in Bed: Side to Side, Up in Bed5.5. Reposition in Chair: Wheelchair or Reposition in Chair: Wheelchair or

Dependency ChairDependency Chair6.6. Transfer a Patient Up from the FloorTransfer a Patient Up from the Floor

Patient Assessment and Algorithms for Safe Lifting and

Moving.

Patient Assessment and Algorithms for Safe Lifting and

Moving.

The Assessment and Algorithms go hand The Assessment and Algorithms go hand in hand...in hand...

1.1. What is the task to accomplish?What is the task to accomplish?

2.2. Assess the Patient.Assess the Patient.

3.3. Use Algorithms to determine Use Algorithms to determine equipmentequipment and and # of staff# of staff needed needed for each high risk task.for each high risk task.

4.4. Don’t’ forget space needs Don’t’ forget space needs

Plan your move!Plan your move!

How Do We Lift This Resident? How Do We Lift This Resident?

Let’s assess CLC resident: May Flowers

Let’s assess CLC resident: May Flowers

75 year old resident of a CLC 75 year old resident of a CLC (Continuous living center) (Continuous living center) who was at home with her family but her condition who was at home with her family but her condition deteriorated. May has MS, progressive dementia, deteriorated. May has MS, progressive dementia, and has fallen a couple of times the past week.and has fallen a couple of times the past week.

She is in the hospital for rehab and restorative care.She is in the hospital for rehab and restorative care. Weight: 156 lbs. Height: 5’ 8”Weight: 156 lbs. Height: 5’ 8” Some days May is cooperative. Other days she is Some days May is cooperative. Other days she is

combative and fearful. combative and fearful. When she is cooperative, she can bear weight and When she is cooperative, she can bear weight and

ambulate on occasion. Otherwise, she resists ambulate on occasion. Otherwise, she resists standing. standing.

May has upper body strength & can grasp with both May has upper body strength & can grasp with both hands.hands.

She has daily rehab and is to be out of bed every day She has daily rehab and is to be out of bed every day in a chair. in a chair.

Ergonomic Algorithm 1: Transfer to and from: Bed to Chair, Chair to Toilet, Chair to Chair, or

Car to Chair

Start

Can the patient bear

weight?

yCare giver assistance not needed: Stand by for safety.

Motorized Standing and raising aid or non-powered stand aid if patient has upper body strength with 1 caregiver.

Use ceiling lift/floor based Use ceiling lift/floor based lift with sitting sling and 2 lift with sitting sling and 2 or more staff. or more staff.

Is the patient Is

-To remove patient from car, select lifter designed for that purpose.-Utilize motorized Standing and raising aid or non-powered Stand Aid for transfers for toileting as appropriate.-If exam /procedural table or stretcher can be positioned to a low level, utilize Standing and raising aid. If not use Ceiling lift or floor based fully body lift.-Patient to utilize transfer board if trained by Rehab Service and board is available.

yesyes

IIIs the patient Is the patient cooperative?cooperative?

NoNo

PartiallyPartially

HereHere

FullyFully

NoNo

Take a few minutes and complete Take a few minutes and complete a Patient Lifting Plan for May a Patient Lifting Plan for May Flowers.Flowers.

(Refer to handout)(Refer to handout)

Know When Algorithms Should be Used Know When Algorithms Should be Used

Use the Algorithms for every patient who needs help Use the Algorithms for every patient who needs help movingmoving

Remember….Remember…. The Algorithms provide The Algorithms provide generalgeneral

directiondirection Caregiver must use theirCaregiver must use their

professional judgmentprofessional judgment in applying in applying AlgorithmsAlgorithms

Know When Algorithms Should be UsedKnow When Algorithms Should be Used

Use varies by clinical settings and present circumstances!Use varies by clinical settings and present circumstances! Evaluate on initial admissionEvaluate on initial admission Re-evaluate frequently in clinical situations Re-evaluate frequently in clinical situations

where patients status can change daily.where patients status can change daily. Re-evaluate weekly/monthly when similar Re-evaluate weekly/monthly when similar

status exists in longer term situations.status exists in longer term situations.

Example……………Example……………• May ambulates periodically during the day but after May ambulates periodically during the day but after

rehab is too tired to walk to the bathroom or get rehab is too tired to walk to the bathroom or get out of the chair on her own.out of the chair on her own.

Know When Algorithms Should be UsedKnow When Algorithms Should be Used

Use varies by clinical settingsUse varies by clinical settings SBAR/Care Plan updates not feasible in SBAR/Care Plan updates not feasible in

some clinical settings where status some clinical settings where status changes quickly changes quickly • Attach algorithms to lifts for easy Attach algorithms to lifts for easy accessaccess• Post algorithms in patient roomsPost algorithms in patient rooms

Equipment Selection ProcessSummary

Equipment Selection ProcessSummary

1.1. Evaluate high risk tasks and the environment Evaluate high risk tasks and the environment (ask the users)!(ask the users)!

2.2. Consider resources, site prep costs, storage, Consider resources, site prep costs, storage, maintenance, as well as who will utilize and care maintenance, as well as who will utilize and care for the equipment before purchasing.for the equipment before purchasing.

3.3. How many and what types of devices do I need? How many and what types of devices do I need? Can the equipment serve dual purposes?Can the equipment serve dual purposes?

4.4. Who will determine what is used?Who will determine what is used?

5.5. How will we standardize this so everyone is How will we standardize this so everyone is consistent, (what process, documentation and consistent, (what process, documentation and transfer of information will be utilized)?transfer of information will be utilized)?


Thank you! Thank you! Safe lifting & moving - NOTSafe lifting & moving - NOT

Documents

Safe Lifting and Moving in Health Care: Equipment Selection Process Safe Lifting and Moving in Health Care: Equipment Selection Process Lisa Murphy, RN