Operating room nurses hurt themselves more often than laborers, movers and truck drivers, according to the Bureau of Labor Statistics. The cause of so many on-the-job injuries? Repositioning, moving and lifting patients. The possible cure? Patient handling equipment. Here's a review of the types of transfer-assist devices and tips on selecting the equipment that'll work for you. You can group patient handling equipment into 4 main categories, each of which offer specific capabilities and operate under particular conditions.

1. Friction-reducing lateral transfer devices. These easy-sliding sheets are designed for shifting patients between stretchers and OR tables or for turning and repositioning them, making them ideal for surgery, imaging and PACU. While clinicians find them easy to use, exercise caution to ensure patient comfort, especially among sedated patients who may not be able to express discomfort with a rough transfer. These comparatively inexpensive options are available in single-use or reusable options.

2. Air-assisted lateral transfer devices. These devices also assist in the slide, but they're made up of 2 components: an electrically powered, forced-air pump and a reusable, inflatable cushion. Placed under patients, they can enable lateral transfers with less effort, and can also remain beneath patients, uninflated, throughout the perioperative process for later reinflation to assist in positioning. This equipment isn't just intended for overweight or bariatric patients. It also stands to increase the quality of care when handling patients suffering the pain of compression or hip fractures, and to decrease the need for pain medications (and the subsequent confusion or loss of cognition they may cause).

3. Sit-to-stand devices. These include mobile floor equipment that use slings, site-specific chairs that slowly lift patients or any device designed to help patients out of chairs or wheelchairs. Their use requires some cooperation on the patient's part, so the patient must have physical control over his torso and be able to bear weight on at least one leg as he follows the operator's directions. As a result, hip- and knee-replacement and spine patients must be handled carefully.

4. Total body lifts. The heavy machinery of patient handling equipment, ceiling-mounted and mobile floor-based lifts and their component slings — available in washable and disposable versions — can help transfer patients laterally and between stretchers and chairs, position and reposition them in bed or on the OR table, and even help them in and out of automobiles. While a ceiling-mounted lift, which requires installation during new construction or retrofitting through renovation, is more likely to be seen in intensive care units and other inpatient sites where highly dependent patients are treated, ambulatory facilities may find use for ceiling or floor lifts in staging areas, where patients are first put onto stretchers.

Assessing the need
To determine what patient handling equipment you'll need, identify the patient handling risks in your facility. Studying your workers' compensation data will tell you what kind of injuries are occurring, where they're occurring and to whom. The frequency of, reasons for, and direct and indirect costs of injuries will help you locate the highest risk situations or departments.

Consider the specifics of your cases. What types of surgery does your facility host? What is the average size and weight of your patient population? The changes in a patient's level of cognition between pre-op, surgery and PACU will likely affect his dependence on clinical staff and his ability to cooperate. And the setup of your clinical environment may affect what patient handling is needed.

In addition to examining this objective data, observe your staff at work in patient handling tasks. Interview them on the physical demands that their jobs impose on them throughout the surgical day, the ergonomics of what they have to work with, and how the tasks and schedule of the workflow affect the situation. What would be the ideal situation?

Testing the methods
You'll want to know how effective and safe patient handling equipment is in transferring patients, as well as whether its use truly improves working conditions and reduces the threat of staff injuries.

Networking with peers and visiting their facilities is one way to see and interface with patient handling equipment in person. This is especially advisable if the equipment represents a sizable capital investment or installation, such as with ceiling-mounted lifts. The exhibit halls of professional conferences are another good bet. The University of South Florida's annual Safe Patient Handling and Movement Conference (www.cme.hsc.usf.edu/sphm) focuses exclusively on the subject.

Alternatively, you can contact vendors and distributors to host your own vendor fair, or at least trial equipment possibilities one at a time in your own daily work flow.

Seek your staff's input on how easy the equipment is to use, how ergonomically effective it is in decreasing the stress of lifting and repositioning patients and, in the case of devices powered by electrical components, how intuitive its controls are.

Weight ratings and measurements against average patient sizes will help to determine whether a piece of equipment adequately addresses the needs of your patient population. And make sure that some of your staff members are transferred and lifted themselves with the equipment you're considering, so that you get a firsthand report of its comfort from the patient's perspective.

In the case of mechanical lifting equipment, particularly the mobile floor models, ensure that it's safely stable in any position and, as with stretchers and convertible stretcher-chairs (some of which feature mechanically assisted lateral transfer capabilities), how many staff members it takes to safely move. In terms of dimensions, besides its storage and operation space requirements, determine whether its lifting clearance is sufficient to your stretchers and tables and whether its wheelbase fits beneath them.

While a lift that operates entirely electrically with no manual effort required takes the burden off your staff, make sure that the equipment offers overriding options, such as a battery backup or manual functioning, that let your staff operate the device in the event of a power failure — especially if the power fails in mid-lift. When trialing lifting equipment, you'll want more than just your clinical staff's input. You'll also want to consult with your biomed staff, safety or risk management expert and facilities manager (especially if, as with ceiling lifts, there will be installation involved).

Encouraging successful use
Just because your facility purchases patient handling equipment doesn't mean all your staff will automatically and routinely use it. You've got to keep it conveniently accessible, stored in accordance with fire and safety codes but where staff can easily reach it. Let's face it, no one's going to regularly dig through IV poles to the back of the closet or open 2 locked doors to get to it, even if it does mean a safer working environment.

Adopt a safe patient handling policy to guarantee the efficient, effective use of these transfer assist devices, especially if your state has not yet enacted legislation on the issue. This policy should include initial and ongoing training on the equipment's proper use and ergonomic practices — perhaps with the cooperation of the equipment's vendors — for all staff, with the possibility of disciplinary action and retraining if an injury occurs while safety equipment is available. Without a program to back this purchase up, you run the risk that your safety efforts will sit idle.

AirPal Patient Transfer Systems
AirPal Platform
(800) 633-4725
www.airpal.com
List price: Starting at $3,510 for complete system, including transfer pad, air supply and reusable protective liner.
FYI: The AirPal Platform inflates to a semi-rigid surface for horizontal patient transfers or positioning. Excess air escaping through perforations on the bottom of the device creates a frictionless surface — a cushion of air — that lets you move the device with little effort and move the patient comfortably, safely and fully supported.

AliMed
No-Lift Booster
(800) 225-2610
www.alimed.com
List price: $69.25
FYI: This flat tube of soft fabric with a virtually frictionless interior surface glides patients up to the headboard without the drag and shear associated with conventional draw sheets that present risks to patients' skin. The company describes it as an effortless method for moving a patient on a bed while preventing back strain. Available in standard and bariatric sizes, machine-washable and disinfectant-safe.

Angelica Corporation
Angel Slider
(678) 823-4100
www.angelica.com/angel-sliders.html
List price: not disclosed
FYI: Generously sized for maximum support, thin enough not to interfere with the performance of pressure-reduction mattresses and made with a breathable microfiber backing to prevent heat buildup beneath patients, this product can remain beneath patients for safer, easier repositioning throughout the perioperative process.

Graham-Field Health Products
Lumex Easy Lift Patient Lifting System (LF1050)
(800) 347-5678
www.grahamfield.com
List price: $2,500
FYI: With a 400-lb. weight capacity and constructed of heavy-gauge steel, this mobile lift features a quiet, smooth, 24-volt DC motor, easy-grip handles for smooth maneuvering, a warning beep if its battery is running low or its weight capacity is exceeded, an easily accessible emergency stop button, an emergency manual lowering device and an optional digital scale.

HoverTech International
HoverMatt Air Transfer System
(800) 471-2776
www.hovermatt.com
List price: not disclosed
FYI: Available in 4 sizes and with varied fabric treatments for durability, this product reduces the amount of force required to move a patient. When inflated, it and the patient float on a cushion of air, letting caregivers laterally transfer patients without lifting or straining for a safer and more comfortable transfer.

Liko, a Hill-Rom company
Golvo Universal Lift
(888) 545-6671
www.liko.com
List price: not disclosed
FYI: This mobile lift, which accommodates up to 440 lbs., lets even a lone caregiver handle a wide variety of patient handling and repositioning tasks, including assistance in ambulation and transfers into and out of vehicles. Uses a telescoping mast and retractable lifting strap instead of the up-and-down lifting motion of conventional lifts, permitting even such difficult transfers as retrieving recumbent patients from a car's back seat.

McAuley Medical
Rollbord
(888) 399-7287
www.mcauleymedical.com
List price: $495 to $1,295, depending on size and model. Volume discounts available.
FYI: A no-lift lateral transfer device with a soft foam core and no metal rollers, this lightweight device employs a conveyor-belt action powered by a gentle push or pull to move patients without the risk of skin injury and without the noise of forced-air options. Anti-static, antimicrobial and available with optional disposable plastic covers, it folds compactly for easy storage on a wall hook. Various sizes, each backed with a 3-year warranty, are available.

Medcare Products
625 Ceiling Lift
(800) 695-4479
www.medcarelifts.com
List price: $3,958 to $5,259, plus track and installation fees
FYI: With a 625-lb. weight capacity, this battery-powered, single-caregiver operated ceiling lift is powerful enough to lift the vast majority of patients, yet small enough to be inconspicuous and out of the way when not in use, says the company. Lightweight and easy to carry, it can easily be moved from one track location to another for multi-room use.

NK Medical Products
Power Patient Lift
(800) 274-2742
www.nkmedicalproducts.com
List price: $5,150
FYI: Requires only one staff member to elevate or lower a patient to meet a stretcher's surface. Its quiet mechanism operates on low-voltage, 24-volt DC power with an on-board charging system that plugs into any 115-volt standard AC wall outlet (with remote charging available on request) and is controlled by a simple handset. Its wheelbase is adjustable to fit around different-sized beds and stretchers.

RoMedic
ReTurn 7500
(888) 625-4343
www.romedic.com
List price: $1,678
FYI: This stand-assist device helps patients who are able to cooperate achieve a standing posture when transferring to or from a bed, wheelchair or commode, freeing your staff from hoisting them up by hand. The device rolls easily and is available with the optional ReTurn belt for additional support and security during the transfer.

Sloan Medical
ezGlide Patient Transfer Sheet
(800) 782-3742
www.sloanco.com
List price: $180 for case of 90 sheets
FYI: Designed by a surgical nurse, the single-use, plastic patient transfer sheet reduces friction to let staff slide patients between beds, stretchers and tables, eliminating the hassle and strain of lifting patients. As a disposable supply, it also supports infection prevention efforts by reducing the risk of hospital-acquired infections among patients.

Smart Medical Technology
Liftaem Patient Transfer Device
(800) 605-9868
www.smartmedtechnology.com
List price: not disclosed
FYI: Suitable for use in any medical unit, this device laterally transfers patients from one surface to another, safely and effortlessly, to minimize injuries. Its latex-free, 1,000-lb. capacity, radiolucent and single-use inflatable mats minimize cross-contamination, says the company.

TechniMotion Medical
Proxi-Motion Patient Lift
(512) 464-1252
www.technimotion.com
List price: $4,995
FYI: Getting patients into a car after surgery is swift, safe and easy with this lift, says the company. At bedside, the equipment is an over-bed table that can handle patient lifting. At curbside, it can insert and extract patients simply and without the need for turns, twists or acrobatic maneuvers.

Wright Products
Slipp Patient Mover
(800) 356-6911
www.wrightproductsinc.com
List price: $195, with volume discounts available
FYI: Designed to reduce friction to a minimum, this patient-moving device makes patient transfers and repositioning easier for both patients and caregivers, regardless of the patient's weight, by sliding patients across a surface of sealed fluid. The comfortable surface includes nothing that would pull or abrade delicate skin. Available in 3 sizes.

Wy'East Medical
Pink Slip Transfer System
(800) 255-3126
www.wyeastmed.com
List price: $75 for package of 10
FYI: These anti-friction slide tubes glide against themselves to make patient transfers and repositioning easier for caregivers and more comfortable for patients. Individually packaged and designed for single-patient use, they eliminate the time and cost of cleaning and the risk of cross-contamination.