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Dear
Denise:
Your Lift Doctor question opens up an enormous new field of inquiry within the Safe Patient Handling movement. We will attempt to provide you a concise response, although in all probability someone could write a book on this topic.
To begin, it is fairly well documented that therapists and nursing staff on rehab units do incur significant numbers of injuries as a result of lifting and supporting their patients. For example, Mierzejewski & Kuman (1997) reported in Disability and Rehabilitation, "Prevalence of low back pain among physical therapists in Edmonton, Canada," that 49 percent of PTs in a survey of 311 PTs reported work-related low back pain. Another study, by Bork et al, reported that in a survey of Iowa PT graduates, 45 percent reported job-related low back pain or injury, 30 percent reported wrist and hand pain, and 25 percent reported having upped back pain, all when looking at a one year timeframe. Numerous other studies corroborate these results.
On the other hand, there is an unwritten understanding in healthcare that therapy staff, and to a lesser extent nurses, are somewhat resistant to using mechanical safe patient handling equipment because of their perceived belief that substituting a mechanical lift for their hands-on assistance will somehow interfere with a patient's progression toward independence. In other words, they have been trained to provide hands-on assistance, yet that very same training is causing significant numbers of PTs to injure themselves. If this sounds like a "Catch 22 situation," then you can see why your staff are asking for articles or other information. Perhaps they are searching for a means of changing their culture.
Because the FIM system is copyrighted by Uniform Data Systems for Medical Rehabilitation, we cannot definitively comment on how use of patient lift equipment might affect a patient's placement within the scale. However, as is happening in the general nursing segment of our industry, it stands to reason that proper selection and use of assistive equipment will improve safety for both the patient and the therapist as well. With increased control and confidence in the equipment, the patient demonstrates less guarding and less resistance to standing, plus less fear. Further, with proper training the therapist can learn to utilize the equipment in a manner that encourages the patient toward independence while still functioning as a safety reinforcement. When assistive devices are used effectively, the PT can better facilitate proper gait training and better approximate loading and unloading of the leg in a proper swing sequence, with better hands-on management of the lower limb.
Of additional consideration, rather than being limited by the individual PT's personal strength and stamina to hold up a patient, the lift-assisted patient may well be able to stand for a longer period of time with greater confidence, saving the PT's back and possibly leading to speedier rehabilitation. Additional studies need to be done on this aspect.
Finally, we wish to thank you for bringing this topic to light. Assisted lifting is a very exciting new concept in therapy, one which therapists will eventually come to rely on both for their own health and for the well-being of their patients.
Stay safe,
The Lift Doctor* |
