Safety: Help With Heavy Lifting

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Proper lateral transfers of obese patients prevent staff injuries.

Transferring patients between stretchers and surgical tables presents plenty of challenges for members of the surgical team. Nurses and support staff are at risk of suffering muscular injuries caused by lifting or straining, and patients can suffer skin friction or shearing. The difficulty of the task increases when obese patients are involved, especially if physical limitations prevent them from providing minimal support preoperatively and the effects of anesthesia cause members of the surgical team to handle the full weight of the patient.

AIR APPARENT Members of the surgical team can inflate the transfer device   |  Joyce Stengel

Moving obese patients between two lateral surfaces therefore requires time, proper equipment and properly trained staff. Our perioperative team elected to trial an inflatable lateral transfer device to assist in the safe transfer of patients with a BMI over 40. The mats have an air-assisted device with a hose feature that fills them up in seconds. The air pushes out of small holes in the mat’s surface, allowing staff to glide patients across surfaces rather than lifting them without assistance or moving them uncomfortably using a roller board. Another bonus? We typically need only two to three staff members to assist in the transfer, as opposed to four or five, which can make the patient feel uncomfortable or embarrassed.

Members of a multidisciplinary team consisting of surgical support associates, nurses, physicians and perioperative leaders met to discuss the implementation of using a transfer device for all patients with a BMI over 40. Here are a few of the effective policies they developed to promote safe lateral transfers:

  • Ask and assess. Interview members of the surgical staff to find out if barriers prevent them from using a lateral transfer device. For example, we discovered members of the surgical team and clinical support team simply forget to use the mat or believe they can move patients without mechanical assistance. We also discovered that although a few of these devices were previously available in the department, staff often moved patients without the devices because defined protocols and procedures for their use were lacking. Confer with staff in other procedure areas where the devices are routinely used to understand how the process was enculturated into their practice and implement similar practices in the surgical department.
  • Educate and encourage. Schedule simulation training on the proper use of the lateral transfer device with staff volunteers playing the role of the patient. Also conduct one-on-one educational sessions with nurses, surgeons and anesthesiologists on when and why the device should be used during patient transfers.
  • Plan and prepare. Create a communication plan to ensure the mats are available for all patients with a BMI over 40 and disseminate the plan to all stakeholders. The plan should include an electronic document — ours is called a Safe Patient Handling Report — that’s emailed each night to perioperative supervisors, leaders, nurse managers and coordinators — to alert them of patients for whom staff will need to use the lateral transfer device. The report should note the patient’s name, medical record number, number of the OR where the procedure will be performed, surgeon name, procedure, scheduled time, last recorded BMI and patient weight. Also announce the rooms where the procedures will take place during safety huddles with the surgical team each morning. Make sure the surgical support and nursing staffs communicate constantly to increase mat usage in the operating rooms. In addition, throughout the day, clinical managers should keep tabs on where the devices are currently being used, which surgical teams will need the devices next and ensure the mats are delivered on time.

Constant attention

Implementing a safe patient transfer protocol requires oversight and tracking of your staff’s performance. We tracked the utilization of the transfer mats for approximately six months and the results were very promising: Data showed staff utilized the mats 79% of the time for eligible patients. It’s important to conduct ongoing training and education for all team members who use the mats, so they continue to prevent staff injuries related to lateral patient transfers. Transferring patients without lifting or straining supports employee and staff safety, and should always be a top priority for all surgical facilities. OSM

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