Safe Lifting and Moving in Health
Care:
Equipment Selection Process
Lisa Murphy, RN
Jesse Brown VAMC
Safe Patient Handling Facility Coordinator
312-569-7896
[email protected]
Equipment Selection Process
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Where to Start?
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Equipment Selection Process
Determine high risk activities by caregivers.
What equipment will be most useful?
Who, what, where, when, how……..
 Who provides most of the physical care?
 What types of lifting, repositioning, and
moving activities do they provide?
 Where do these activities happen?
 When is the care provided?
 How often do they engage in each activity?
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Equipment Selection Process
 WHO??????
Provides most of the care.
Talk directly to the caregiver(s)
Others can only speculate
Equipment Selection Process
• What specifically are the high risk activities?
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Pushing/pulling
Lateral transfers
Lifting
Repositioning
Equipment Selection Process
Where is the care provided?
Equipment Selection Process
When is the care provided?
Equipment Selection Process
How often are the tasks required?
 Knowing frequency assists in the purchase
process.
 How many Stand Aids do you need?
 Staff and Residents find it difficult to wait at
times for equipment.
Equipment Selection Process
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Now what ??????
Structure follows function!
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What are my resources?
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Do I have limited space(storage)?
What construction is required?
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What do I really need?
Equipment Selection Process
Lateral Transfer Devices
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Air mattresses
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Rollboards
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Slide sheets
. Resources
. Task
- How many do I need?
- Where am I going to store it?
- How will I clean it? (reusable vs single patient use)
Equipment Selection Process
Standing and Raising Aids
Active lifting – consumer participates
Motorized raising with slings -All have legs that open
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Ability to bear some weight.
Follow directions and cooperate.
Ability to grasp with one hand.
Un-motorized raising with/without slings
Some have legs that open
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Ability to bear some weight.
Follow directions and cooperate.
Pull self to a standing position.
Equipment Selection Process
Passive Lifters
Ceiling lifts
Gantry Lifts
Floor Based Lifts
How do I choose???
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Is the ceiling /construction conducive to lift installation?
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?
Equipment Selection Process
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What else is available?
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Can the equipment serve dual purposes?
•Specialized
slings
•No-slip chair seats
•Turning discs
•Helping hands poles
•Liftseats
•Motorized stretchers
•Inflatable chairs/mattresses
•Wheelchair lifters
•Hygiene/shower lifts
•Shower trolleys
•Wheelchair movers
•Automobile lifts!
Equipment Selection Process
What’s next???
Now that I have equipment…..
how do I choose what is appropriate
for each situation?
Equipment Selection Process
Safe Patient Handling
Clinical Guidelines & Algorithms
Equipment Selection Process
Assessment
Completed on anyone needing
assistance (per licensure and facility protocol).
 Includes…
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 Individual
Characteristics
 Medical Condition/s
Equipment Selection Process
Assessment
Includes items such as:
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Ability of the person to provide
assistance
Ability of the person to bear weight
Ability of the person to cooperate and
follow instructions
Height and weight
Special Medical/Physical
Considerations
Equipment Selection Process
Algorithms
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Based on Specific Characteristics (from
Assessment)
Considers the task to be completed
Assists caregivers in selecting safest
Equipment
Advises # of staff needed
What tasks do the
Algorithms cover?
1.
2.
3.
4.
5.
6.
Transfer To and From: Bed to Chair, Chair
to Toilet, Chair to Chair, or Car to Chair
Lateral Transfer To and From: Bed to
Stretcher, Trolley
Transfer To and From: Chair to Stretcher,
Chair to Chair, or Chair to Exam Table
Reposition in Bed: Side to Side, Up in Bed
Reposition in Chair: Wheelchair or
Dependency Chair
Transfer a Patient Up from the Floor
Patient Assessment and Algorithms
for Safe Lifting and Moving.
The Assessment and Algorithms go hand
in hand...
1.
2.
3.
4.
What is the task to accomplish?
Assess the Patient.
Use Algorithms to determine
equipment and # of staff needed for
each high risk task.
Don’t’ forget space needs
Plan your move!
How Do We Lift
This Resident?
Let’s assess CLC resident:
May Flowers
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75 year old resident of a CLC (Continuous living center) who
was at home with her family but her condition
deteriorated. May has MS, progressive dementia, and has
fallen a couple of times the past week.
She is in the hospital for rehab and restorative care.
Weight: 156 lbs. Height: 5’ 8”
Some days May is cooperative. Other days she is
combative and fearful.
When she is cooperative, she can bear weight and
ambulate on occasion. Otherwise, she resists standing.
May has upper body strength & can grasp with both
hands.
She has daily rehab and is to be out of bed every day in a
chair.
Ergonomic Algorithm 1: Transfer to and from:
Bed to Chair, Chair to Toilet, Chair to Chair, or
Car to Chair
Start
Here
yCare giver assistance not needed: Stand by for safety.
Fully
IIs the patient
cooperative?
Is the
patient Is
No
Can the
patient bear
weight?
Partially
No
yes
Use ceiling lift/floor based
lift with sitting sling and 2
or more staff.
-To remove patient from car, select lifter designed for
that purpose.
-Utilize motorized Standing and raising aid or nonpowered 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.
Motorized Standing and
raising aid or non-powered
stand aid if patient has
upper body strength with
1 caregiver.
Take a few minutes and complete a
Patient Lifting Plan for May
Flowers.
(Refer to handout)
Know When Algorithms
Should be Used
Use the Algorithms for every patient who needs help
moving
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Remember….
 The Algorithms provide general
direction
 Caregiver must use their professional
judgment in applying Algorithms
Know When Algorithms
Should be Used
Use varies by clinical settings and present circumstances!
Evaluate on initial admission
 Re-evaluate frequently in clinical situations
where patients status can change daily.
 Re-evaluate weekly/monthly when similar status
exists in longer term situations.
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Example……………
• May ambulates periodically during the day but after
rehab is too tired to walk to the bathroom or get out of
the chair on her own.
Know When Algorithms
Should be Used
Use varies by clinical settings
 SBAR/Care
Plan updates not feasible in
some clinical settings where status
changes quickly
• Attach algorithms to lifts for easy
access
• Post algorithms in patient rooms
Equipment Selection Process
Summary
1.
Evaluate high risk tasks and the environment
(ask the users)!
2.
Consider resources, site prep costs, storage,
maintenance, as well as who will utilize and care
for the equipment before purchasing.
3.
How many and what types of devices do I need?
Can the equipment serve dual purposes?
4.
Who will determine what is used?
5.
How will we standardize this so everyone is
consistent, (what process, documentation and
transfer of information will be utilized)?
Equipment Selection Process
Thank you!
Safe lifting & moving -
NOT