Stop Turning Nurses into Patients! Safe Patient Handling

Brian S. · Oct 17, 2018

What is safe patient handling?

Safe patient handling uses mechanical or manual equipment to lift and move patients. This can help all nurses and care providers reduce their risk of overexertion injuries by replacing manual patient handling with safer methods. At the same time, it also maximizes the safety and comfort of the patient during handling.

Lifting Weight Limit & Risks

The National Institute for Occupational Safety and Health has suggested a 35 lb. maximum lifting weight, based on the patient being cooperative and unlikely to move suddenly during the task.

But in reality, you know that during a transfer, a patient may experience a muscle spasm or become combative. These movements put staff at a higher risk and change the 35 lb. maximum lifting equation, making lifting equipment necessary to keep you and your patients safe.

Even when you practice the best ergonomics and lifting techniques, several movements put you at risk for injury, including lifting:

With extended arms
When near the floor
When sitting or kneeling
With the trunk twisted or the load off to the side of the body
With one hand
In a restricted space
During a shift lasting longer than eight hours

Adding lifting equipment can keep you safe and prevent injuries. Lifts and aids are an important part of protecting your health, your career, and your patients.

Benefits for Hospitals and Clinics

Talk to your employer about the benefits of having a safe patient handling program, including:

A reduction in annual employee injuries
A reduction in lost and restricted work days
An increase in patient referrals (patients feel more dignified and safe)
An increase in employee satisfaction.

It can be challenging to change the way everyone thinks and performs patient handling. But it's important that everyone receives appropriate training on the equipment and that management encourages its use. Nurses have the right to a safe and secure workplace so they can provide quality patient care.

The goal of safe patient handling programs should be to eliminate all manual lifting when possible. Some hospitals, including Baptist Health System in Florida and medical centers in the Department of Veterans Affairs, have reduced lifting injuries by 80% by using machines and intensive training.

The use of mechanical lifting devices, training programs for these devices, and incorporating space and construction design for mechanical lifting, will help to reduce employee injuries. It is necessary to accept that this is no longer an exception to care, but is the expectation of care.

What should I use to transfer patients safely?

There are several pieces of equipment that can help you move and lift patients - from small assistive aids for more mobile patients, like gait belts, to larger pieces of equipment for lifting immobile patients. The best equipment for you will depend on the type of movement you're doing and what your facility has available.

Types of Patient Movement and Lifting

Lateral transfers: Moving patients sideways (bed to stretcher)
Transfers involving sitting positions: Bed to chair, chair to chair, chair to toilet
Repositioning: Pulling patients up in bed, moving them side to side in bed, or pulling patients up in chairs
Floor: Moving patients who have fallen on the floor back into bed

Be sure to follow Safe Patient Handling Techniques when using equipment, too:

Maintain a wide, stable base with your feet
Try to keep the work directly in front of you to avoid rotating your spine
Adjust the bed to the correct height (waist level when providing care and hip level when moving a patient)
Keep the patient as close to you as possible to minimize reaching or overstretching
Keep the load centered to reduce the stress on your back

What aids and equipment are available for safe patient handling?

Basic Equipment for More Mobile Patients

Mechanical lifts are ideal because they reduce the most stress on your body, but due to budgets, space constraints, and other factors, they might not always be available. These more economical options still help reduce your risk of injury while moving and transferring patients.

Gait or Transfer Belt

Helps with mobile patients who are fall risks, but can bear their own weight
Aid ambulatory patients in keeping their balance without injuring your back

Transfer Swivel

Assists patients in turning while seated, can be used on a chair or in a car to help rotate the patient's pelvis and trunk
When used in bed, can help turn a patient from a seated position to a lying position

Transfer Board

Makes it easier to move patients from wheelchair to chair, shower bench, or bed
Commode transfer boards help transfer patients to a commode or toilet without the need to remove the board

Transfer Disc

Easily move patients from one location to another while standing, including those who can't pivot
Aid patient in standing on portable disc and help them turn without lots of exertion - take steps and turn with the patient, don't twist your spine!

Patient Slide Tube

Helps transfer patients from stretcher to bed with less effort
Also use to slide patient toward the headboard or help turn patient without lifting

Advanced Mechanical Lifting Equipment

44% of all worker-reported injuries in the healthcare industry are due to overexertion. For the safest patient handling, the goal should be a no-lift or minimal-lift policy. The ANA supports the elimination of manual patient handling to prevent musculoskeletal disorders.

There are several mechanical aids available to help accomplish this goal depending on the patient's mobility level. Here's a brief overview of common equipment that you may use when safely lifting your patients.

Transfer Aid

Great for bed to wheelchair transfers or wheelchair to toilet transfers
How it works: Patient actively pulls themselves up to a standing position while you easily rotate the device so the patient can sit back down

Standing Aid

Used to transfer a patient from one sitting position to another, without the need for a wheelchair and slide or pivot transfer
How it works: Patient steps onto footplate then sits on flip-down seat support during transfer

Sit-to-Stand Lifts

For use with patients that have some mobility but need assistance when standing from a bed, chair, wheelchair, or commode
How it works: A special sling goes around the patient's torso and under the arms, the lift raises the patient into a standing position

Floor Lifts

Also known as full body lifts or Hoyerâ„¢ lifts, used with a patient that has limited to no mobility
How it works: Move patient onto the sling, then use the lift to raise and move the patient

Ceiling Lifts

Designed for patients with limited mobility or little to no weight bearing capabilities
How it works: Tracks are installed into the ceiling in patient rooms around the bed and into the bathroom, so the system is always accessible (and frees up floor space in small rooms!)

Nursing is one of the most dangerous jobs in America, due to the high number of back injuries from lifting and moving patients. Relying on modern technology (rather than your back) can help reduce injuries and enable you to do your job safely.

The goal should be for nurses to provide healthcare to their patients, and for proper mechanical devices to provide the lifting. This helps protect both you and the patient from injury.

References

American Nurses Association. (2008). Elimination of Manual Patient Handling to Prevent Work-Related Musculoskeletal Disorders. Retrieved from Elimination of Manual Patient Handling to Prevent Work-Related Musculoskeletal Disorders

Harwood, S. (n.d.) Safe Patient Handling. Retrieved from https://bit.ly/2qZZSEi

Wallis, L. (2015). OSHA Gets Serious About Workplace Safety for Nurses. Retrieved from OSHA Gets Serious About Workplace Safety for Nurses : AJN The American Journal of Nursing

Zwerdling, D. (2015). Hospitals Fail To Protect Nursing Staff From Becoming Patients. Retrieved from Hospitals Fail To Protect Nursing Staff From Becoming Patients : NPR