Key Takeaways: 2024 Updates to SPHM Guideline

What You Need to Know to Improve Patient & Staff Safety

As periop nurses, we're committed to keeping the care setting safe for patients and staff. But our work is complex, and the OR setting is dynamic. Whether performing a lateral patient transfer or moving equipment, we must work smarter to avoid injuries. That’s where the AORN Guideline for Safe Patient Handling and Movement (SPHM) comes in to help you in your daily practice.

Highlights of What’s New in 2024

Technology and Individualized Plans

New recommendations: use patient lift equipment like ceiling or boom lifts to reduce the physical effort needed to move patients. The facility's product evaluation team should help select this equipment. Also, store this equipment in an easy-to-access location to promote usage. Personnel are more likely to use patient lift equipment when it is readily available for use.

This update includes a section titled “Individualized SPHM and Ergonomic Plan.” It contains an important revision related to safe patient lateral transfers and repositioning a patient. The recommendation does not specify an exact number of personnel needed for these tasks. Instead, the update calls for using enough staff needed to maintain the patient's body alignment, airway, and support extremities.

Every situation may require a different minimum number of periop team members for these tasks. To ensure patient and staff safety consider:

• Patient's weight
• Other physical characteristics
• Clinical condition
• Starting and ending positions

Periop staff should note a new recommendation: During preoperative skin antisepsis or surgery, assess if extra staff or assistive devices are needed to lift or hold an extremity, head, or panniculus.

Moving Equipment and Supplies

A new section on moving equipment and supplies includes updated and previous recommendations. Staff should carry loads close to their bodies and avoid twisting. Carrying loads away from the body increases spinal stress and injury risk. Twisting the torso further raises the risk of lifting injuries.

Another new recommendation is to minimize manual lifting tasks during the workday. This will help prevent lower back injuries. More lifting tasks can increase the total daily low back loading (i.e., force exerted on the spine), resulting in a greater risk of musculoskeletal injury.

Fall Risk and Mobility Assessments

Several new recommendations were added to the newly titled section “Fall Risk and Mobility Assessments.” Classifying a patient's fall risk is the most important step in fall prevention. Patient preoperative evaluations should include fall risk and mobility assessments. These should be evidence-based, comprehensive, and validated for use specific to the patient population.

These types of fall risk assessment tools:

• Engage patients and their families.
• Help with determining specific fall prevention interventions for each patient.
• Support continuity of care.

Additionally, mobility assessment tools:

• Include an evaluation of gait, visual or auditory impairment, and the need for help with mobility.
• Help identify each patient's baseline mobility status preoperatively, which is shared with intraoperative and postoperative personnel.

This updated guideline is available in AORN eGuidelines Plus (available to subscribers).

eGuidelines Plus is an online library of clinical resources for your facility. It provides your team and multiple service lines at your facility with digital access to evidence-based guidelines, customizable implementation tools, and time-saving clinical resources.

With eGuidelines Plus, you can access AORN Guidelines for Perioperative Practice online — plus, you can do so much more:

• Search for and review the latest AORN Guidelines including FAQ topics and Key Takeaways.
• Use AORN’s At a Glance Library with illustrated, step-by-step guides on Skin Prep, Procedures, Instruments, Positioning, Scrub Role, and more.

» Members log in to access Guideline Essentials Key Takeaways, implementation tools, and more.

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Additional Clinical Resources

Guideline Essentials, AORN Guideline Quick View, and Guideline Key Takeaways

• Highlights key elements of the guidelines with practical implementation steps, images, and rationale to promote safety and optimal outcomes for patients undergoing operative and other invasive procedures.
• Access included with AORN membership.

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