two people for hoyer lift-why?

Long Term Care Columnist / Guide · May 13, 2010

It's for both staff and resident safety. Generally, if you're using a Hoyer it's because the patient/resident is very weak and immobile, and many are obese as well. How are you going to prevent injury if something goes sideways---the patient gets agitated and starts struggling, the sling breaks, the machine stops working? Have you ever had a 300-lb person fall on you? Believe me, it's worth it to have that second person in there, even if only as a "spotter" to help you position the patient correctly over the chair or bed and prevent them from feeling like they're twisting in thin air.

CNA2day · May 13, 2010

We are required to use a lift if we will be lifting over 25lbs. Now sometimes this is a standup lift... are people required to have two people in the room for those also? They are to use the hoyer if they are non weight bearing, amputees, or if they are not able to hold on to the stand up lift.

I have never had a sling break... and our slings are inspected at every washing and repaired if they need it. Never even heard of a sling breaking at our facility.

I also have never had anyone in a sling hoyer fight with me...

On the rare occasion that the machine has stopped working (once) I simply turned on my light and another aide came to help me. Our lifts are all designed to go down, even in the event of a dead battery.

Maybe we have different lifts then some places.... *shrug*

pkuper · May 13, 2010

It is for resident and CNA safety. At our facility, you are required to have two people in a room to operate a hoyer lift. I can possibly see putting a resident in the bed using a hoyer lift alone, however, I think it is impossible to put a resident in a wheelchair using a hoyer alone. It just seems very dangerous, especially with a resident who is overweight or obese. Not to mention, operating a hoyer lift alone (watching the residents feet, and swinging the hoyer lift around and turning/positioning the resident) is a lot of work, and why make work harder on yourself? I would never operate a hoyer alone, if for no other reason than my resident's safety.

Ev1987 · May 13, 2010

I don't see anything wrong with an extra set of arms and eyes to help assist a resident. When I have a co-worker help me with the hoyer, one person controls the remote while the other makes sure the resident is aligned and steady through the transfer. Safety and security is key priority.

CoffeemateCNA · May 13, 2010

As a newbie, I used to do lots of Hoyers by myself.

It is an unsafe practice for a number of reasons.

You can't push the Hoyer safely while steadying the resident. If you don't steady them while moving, they can hit their head on the bar or hit their feet on the "main column" (again, wish we had the ability to draw pictures here!), both of which may result in lacerations, contusions, you name it. Families have been known to sue over such injuries, especially when they result in infections requiring amputations (it does happen).

It IS possible for residents to fall out of the sling. I have had several near-misses, but one aide at a former job wasn't so lucky. She couldn't hold the resident in the sling AND push it back to safety or call for help at the same time, and the resident fell out and hit the hard floor. The aide was terminated.

You may not have had anyone start fighting you while in mid-air, but believe me, things can turn in an instant.

I used to wish that Hoyers would just be a x1 assist, but if the facility is at least decently staffed, why take chances?

Sit-to-stands or stand-up lifts generally only require 1 person to operate. On rare occasions with obese residents, I have seen "sit-to-stand x2 assist" written in to the careplan.

rosey2007cna · May 14, 2010

I agree that 2 people should be in the room when using a hoyer lift. I have had the battery go dead on the machine when trying to get the person into their chair and had to pull the pin on the lift to get it down, but think goodness I had a second person who could go get another battery. Personally, I have also heard of hoyer lifts turning over with the resident in them.

I have also had some scary things happen with the sit to stands as well (but I do not think that there care plan was up to date). Some of my residents where not bearing weight when using this lift and that can be really dangerous as well. Anyway, I notified PT but they did not do much about it or just blow me off. Anyway, I am glad that I do not work there anymore.

CalledtoCare · May 14, 2010

Wait until someone who is diabetic waits until they are on the lift to collapse into one of their limp, shakey, seizure like moments mid lift. When you are trapped trying to lower them to the floor because they are slouching down like a limp noodle in the sling, you will be oh so greatful for that second person.

I know it is not likely to happen. I know it seems like a waste of time. It is one of those safety things though that when things go wrong, they can go really wrong and we have no right to gamble with a pts safety.

eveningsky339, LPN · May 14, 2010

I have never done or even heard of a single CNA using a hoyer lift, because in the state of Maine, anyone who operates a hoyer alone will be enjoying their next few months in jail. It's that serious.

The various safety reasons have already been posted, but let me just say that your facility's lack of a two-person hoyer policy is disturbing in many regards.

juliaann · May 15, 2010

Agreed with eveningsky.

First, I don't think I *could* get a patient up in the hoyer by myself. Any patient that needs a hoyer lift isn't going to be able to help me in getting the sling under them, so I'll need someone to help me roll the patient. Plus, it's good saftey practice for one person to stand next to the patient to comfort them, and watch their head and neck as they're lifted/set down.

Maybe it's because I work in a no-lift hospital, but if a patient is a bedrest X2 assist, I always get another person for pulling up in bed, turning q2, cleaning incontinence, bathing, linen changing, and using the hoyer. I expected help from the other CNAs, and they expected help from me. It works well.

GooeyRN, ADN, BSN, CNA, LPN, RN · May 15, 2010

I have done it alone while I was a CNA. WHAT would you do if the pt started fighting while up in the air and started falling out? WHAT would you do if the lift started tipping over? These things do happen. I know it is a hard rule, but for safety reasons, two people really should be in the room.

Moogie · May 15, 2010

CNA2day said:
I see on here that many people have to have two people in the room to perform a hoyer lift on a resident. I do not understand this. Why do you need two people?
As long as the sling is positioned properly and you are using the right size there is really no risk to the resident that I can see.
Our facility does not have this policy and I can't understand why this is even a policy?
It just seems like a rule that is set up to be broken!
Can someone enlighten me!?

This is why.

http://theblackcordelias.wordpress.com/2009/08/26/state-investigation-of-fr-tim-vakocs-death-finds-negligence-by-nursing-home-staff/

This Army chaplain survived a roadside bomb in Iraq, albeit with severe head injuries that required he receive constant care in a nursing facility. He died due to the negligence of two nursing assistants who improperly used an EZ Lift. He fell on the floor, hit his head, and died as a result of his injury. Here's the story:

Quote
A state investigation has found that two nursing assistants were responsible for the June accident that led to the death of the Rev. Tim Vakoc, a Roman Catholic priest and Army chaplain, at St. Therese nursing home in New Hope.
The two staffers, who were not identified, were attempting to transfer the paralyzed priest from his wheelchair to his bed when he fell to the floor and injured his head on June 20, according to the report, released Tuesday by the state Office of Health Facility Complaints.
According to the investigation, Vakoc fell to the floor and hit his head while he was strapped in a device called an EZ Lift, which is used to move patients who can't stand by themselves.

One nursing assistant told investigators that she was operating the lift when the accident occurred, but did not remember what happened. The other said she turned her back to move his wheelchair and didn't see him fall.
Both told investigators that they had followed proper procedures in strapping him into the lift, and that they "checked the straps to be sure they were secure," according to the report.
However, two other staff members told investigators that when they entered the room moments after the accident, the straps were not attached on the left side of the device. One said she heard "a loud thud," and found the patient lying unconscious, with his head on the floor and his legs suspended in the device.

Your facility is flirting with disaster by not having a policy that requires two people for ANY sort of mechanical lift. If something goes wrong, YOU can be held liable. Moreover, how would you feel if you did something that resulted in the injury or death of a resident? Common sense should override policy and if you can't get another CNA to help you, get the nurse. No one should use a mechanical lift alone. EVER.