1. Equipment Options for Safe Patient Handling - A Hands On Approach 58 th Annual Governor’s Industrial Safety & Health Conference October 7-8, 2009

2. 2 Presenters Jeannette Murphy, OTR/L, CEA –Ergonomist, Injury Prevention Specialist –St. Luke’s Rehabilitation, Spokane WA Leslie Pickett, PT –Ergonomics and Injury Prevention Specialist –Swedish Medical Center, Seattle WA Lynn LaSalle, MOT –Ergonomist, Ergonomic Coordinator –MultiCare Health System (MHS), Tacoma WA

3. 3 Participants will… Understand how to choose the right equipment for the right patient at the right time Understand some of the challenges and solutions for safe patient handling of the bariatric patient Understand the different levels of patient handling equipment and what to consider when choosing equipment Have the opportunity to handle and use common safe patient handling equipment.

4. 4 Why Safe Patient Handling? Protect staff and patients –It’s the “right thing” to do Enable experienced health care professionals to work longer –It’s the necessary thing to do. Comply with Washington’s Safe Patient Handling Law –It’s the law!

5. 5 NACs RNs

6. 6 NACs

7. 7 Washington State Safe Patient Handling Law March 8, 2006 – Signed into law Goal – Reduce injuries among patients and health care workers by manually lifting, moving and repositioning patients. “Safe Patient Handling” – The use of engineering controls, lifting and transfer aids or assistive devices by staff instead of manually lifting to perform the acts of lifting, transferring and repositioning patients.

8. 8 Washington State Safe Patient Handling Law Components –Committee – develop by February 1, 2007 –Program – develop by December 1, 2007 –Equipment – minimum purchase by January 30, 2010 –Employees’ Right to Refuse Policy – develop by January 2010 –Tax Credits – Must be claimed before December 30, 2010 –L&I Lower Risk Classification for hospitals with SPH programs –Program Evaluation required

9. 9 Frequently Asked Questions Regarding WA State Safe Patient Handling Law

10. 10 Guidelines for Choosing Equipment The right equipment for the right patient at the right time –Patient centered –Assess patient each and every time he/she is moved –Use equipment when needing to lift more than 35 lbs of the patient’s weight –Use least restrictive equipment to allow patient to help The patient will only be safe when the health care worker is safe

11. 11 Equipment Options High tech –Dependent Low Tech –More ability Total patients lifts Sit-to-stand lifts Hovermatt Hoverjack Glide/slide sheets Transfer boards/slides Pivot discs Sheet as hip sling Walking belts Gait belts

12. 12 Assessment of the Patient’s Transfer and Mobility Status 1.Level of assistance – What the pt does, not how much you do for them 2.Weight bearing capability 3.Upper extremity strength 4.Balance 5.Level of cooperation and comprehension 6.Weight/height 7.Precautions/modifiers affecting transfers

13. 13 1 – Level of Assistance Functional Independence Measures (FIM TM ) 7. Complete independenceNo setup, cues or touching 6. Modified independenceAdaptive equipment, longer time needed, safety considerations 5. Standby assistance/supervisionSet-up, cues, coaxing, within one arm’s reach of patient 4. Minimal assistance/contact guardPt does 75% or more, any touching 3. Moderate assistancePt does 50-74% of work, more help than touching, any lifting 2. Maximal assistancePt does 25-49% of work 1. Total assistance/dependentPt does <25% of work, automatically a total assist with 2 people assisting

14. 14 2 – Weight-Bearing Capability Bridging – test hip and leg strength Not acceptable

15. 15 2 – Weight-Bearing Capability Straight leg raising Not acceptable Straight leg raising – test hip and leg strength

16. 16 3 – Upper Extremity Strength Observe if/how the patient uses arm(s) for … –Bed mobility –Come to sitting –Support self when sitting –Wheelchair mobility –Feeding –Grooming –Bathing –Toileting

17. 17 4 – Balance Can the pt sit on the side of the bed without support? Can the pt sit forward in the chair without help? Not acceptable

18. 18 5 – Cooperation and Comprehension If the pt cannot follow verbal instruction/gestures to bridge, straight leg raise, or demonstrate good balance… –DO NOT MANUALLY TRANSFER –Use a mechanical lift or assistive device

19. 19 6 – Weight/Height Is the pt’s weight/height within the limits of the equipment? If more than 35 lbs. is being lifted during a manual transfer, then lift equipment, transfer aids or assistive devices should be used instead.

20. 20 7 – Precautions/Modifiers Does pt have any behaviors or characteristics that make transfers inconsistent or especially difficult –Pusher, leaner, impulsive, unpredictable, excessive tone, contractures, fear of falling –Bariatrics If so, lift equipment should be used.