PROPER PATIENT TRANSPORT AND POSITIONING TECHNIQUES are essential to both the safety of your patients and the physical well-being of your staff. Maneuvering patients can be dangerous; patients are at risk of falling or being dropped, while staff put their backs on the line every time they move a patient. Still, there are almost no laws, standards or regulations to mandate the precise amount of lifting that it's safe to perform. That doesn't mean you should avoid taking precautions to protect your patients and staff.
The American Nurses Association estimates that up to 12 percent of nurses leave the workforce annually due to back injuries and over 50 percent complain of chronic back pain. This has been cited as a contributing factor to the nursing shortage and a perceived lowering of the social value of nursing as a profession. In addition, nurses lose roughly 750,000 working days a year because of back injuries and costs for compensable back injuries ranged between $5,000 and $100,000 for each case.
Investing in patient handling and transport devices can pay off. According to an article in the March 2006 issue of Outpatient Surgery Magazine, Glens Falls Hospital in upstate New York invested $350,000 in equipment when it implemented a minimal-lift program. Over one year, the hospital had a 28 percent reduction in workers' compensation claims, 24 percent reduction in the cost per claim, 45 percent decrease in related comp costs and direct savings of $125,000. Further, the number of OSHA-recordable patient handling injuries was halved (43 in 2001; 23 in 2003).
Ignoring staff's on-the-job injuries can have a long-term impact: increased absenteeism, lost work time, burnout, decreased staff retention, high turnover and threatened recruitment, according to a 2003 position statement by the American Nurses Association.
Problems occur when nurses perform tasks their bodies can't handle. Even if you have ideal physical positioning, holding any posture or object for a long duration is tough on the body. Perhaps your neck is leaning downward for a long period of time. Your arm may be supporting a limb or instrument tray. Prolonged standing contributes as well. Combine static postures with awkward ones and it's a recipe for injury. These tasks are more hazardous when the patient is unconscious, cannot help or has a medical condition that requires special handling. Moreover, patients are often connected to equipment that is not well-designed for movement. There are physical limits to the amount of force that your muscles, soft tissue and bones can tolerate.
A movement is under way to require an absolute no-lift environment for healthcare workers. While some manual patient handling will always be required, it should be limited to assisting patients while using assistive patient-handling equipment.
Does employing specialized lifting and transfer equipment eliminate staff risk completely? No, but the equipment can reduce or eliminate peak exposures. That, in turn, will help keep your patients safe, save you thousands in workers' compensation costs, increase employee satisfaction and retain more staff.
Purchasing patient positioning and transfer equipment is not enough. The devices have to be available in sufficient quantity and convenience to encourage their use, staff needs to be trained on their proper and safe use in accordance with the facility's ergonomic patient handling policy, and sufficient space is needed to use the device properly and safely, avoiding obstacles such as walls and other equipment. The devices also need to be maintained and kept in good repair.
In addition to staff-lifting safety, the needs of bariatric patients are sometimes ignored by facilities; chairs in waiting rooms are too small and stretchers are inadequate for transporting increased weight. So while researching devices that will help protect your staff, check out the products in this section that cater to the specific needs of the obese.
Nurses are oriented toward focusing on patient needs first and foremost, and certainly always before their own needs. Regardless of the equipment you purchase, implementing new devices and practices demands a culture change. Surgical units must consider training, assistance and reinforcement as healthcare workers gain the confidence needed to use the equipment. A comprehensive ergonomics program is required to follow through on the tower of evidence that supports a new approach to patient lifting.
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 Carstone Seating
51100 Series Stackable Bariatric Chairs
Emerald Series Bariatric Chairs
51719 Series Bariatric Chairs
(888) 863-9543
www.carstone.com
List Price: Not provided
Elegant and durable. Carstone released three new bariatric chair models, collectively offering seating options for obese patients in facility waiting rooms or offices. The 511000 Series is a stackable, durable chair that can be moved and stored easily to allow for a completely multi-functional space. Carstone's Emerald Series can hold a static load of 6,000 lbs., the company says, and is fully upholstered with numerous fabric options available. The 51719 Series is also graded to hold a static load of 6,000 lbs., and offers many options, including arms, taller backs and multiple seat widths.
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IRSG
i-Mover
(888) 398-2009
www.irsg.com
List Price: $7,995
A versatile moving unit. A battery powered tug that moves both carts and patient beds, the i-Mover features a maintenance-free drive system and can transport loads up to 2,000 lbs. This tug unit has a battery life of five hours or longer, depending on use, before recharging is needed.
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NK Medical Products
PL1000E Power Transport Lift
(800) 274-2742
www.nkmedicalproducts.com
List Price: Not provided
Less strain on staff. The PL1000E Power Transport Lift from NK Medical Products might be able to reduce personnel costs, save time and help eliminate personnel back strain and injury, the company says. Here's how it works: Place the sheet under the patient, pull the eight straps through the buckles and lift the patient. One person can raise and lower the Power Transport Lift frame with a handset. The wheelbase is adjustable to fit a variety of stretchers or beds. The lift runs on low-voltage 24 VDC power with a charging system that plugs into any standard outlet. The mechanical compartment is fully enclosed; the exterior is durable and provides easy cleaning, the company says. It's rated for up to 400 pounds (bariatric model also available) and is waranteed for five years.
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Steris Corporation
Aquagel pads
www.steris.com
(800) JIT-4-USE
List Price: $45 to $500
Reduce OR table pressure and increase patient comfort. Featuring a dual-layer technology, the Aquagel Pressure Management System reduces patient skin shear and conforms to the patient's anatomy. This redistributes pressure away from bony prominences and nerves to promote tissue health, says Steris.
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Stretchair
Crosstown 1200
(800) 237-1162
www.stretchair.com
List Price: Not provided
Make obese patients more comfortable. To make transporting obese patients throughout your facility easier, Stretchair has introduced the first motorized stretcher-chair with riding platform: the Crosstown 1200. Complimenting the convertible transporter is the Versatile Hygiene-Chair, which is a combined commode, transport and shower chair. The Crosstown 1200 is a self-contained transportation system capable of functioning in both chair and stretcher modes. It has a 1,200-pound weight capacity, 36-inch-wide seat and Tempur-Med pressure management cushions to help make patients more comfortable. Features that can make healthcare workers' tasks easier include an integrated handset controller for all powered functions, including sit-to-stand seat assist; chair-to-stretcher articulation; and independent swing legs and vertical lift.
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Stryker
Trio Mobile Surgery Platform
(800) STRYKER
www.stryker.com
List Price: Not provided
Virtually eliminate patient transfers. Stryker's Trio Mobile accommodates all commonly used surgical positions in ambulatory surgery, says the company. Patients remain on the same platform during pre-op, procedure and post-op periods. The platform's side rails provide patient protection when in use and are able to be retracted during surgery, remaining completely out of the procedure area. Optional foot-end and backrest attachments provide access for head and neck procedures, says Stryker. Other optional features include: universal rail clamp, wheel covers, siderail pads, upright oxygen bottle holder and air delivery/drape support.
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TransMotion Medical
TMM5T Surgi-Chair
(866) 860-8447
www.transmotionmedical.com
List Price: $9,640 to $11,315
Eliminate patient transfers. The TMM5T Surgi-Chair features a safe, motorized, staff-controlled positioning change from chair to fully reclined surgical table, therefore eliminating the need for patient transfers and easing staff workload. Surgi-Chair has a 500-lb. patient capacity and motorized height range of 23 inches to 40 inches, making the device conducive for sitting or standing procedures.
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