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Vol. 2 - No. 1 - January 10, 2007
Editor's note
Dear Subscriber,
Welcome to the first issue of Safe Lifting News for 2007. This pro bono e-newsletter is designed to help you keep abreast of what's happening in the world of safe patient lifting and caregiver injury prevention. If you'd like to make suggestions for topics to be covered in the future, please take a moment to fill out the "Comments" form at the end of the newsletter. And, if you've got a question, just "Ask the Lift Doctor" in the link below. As always, we look forward to hearing from you!
Warm regards,
Melissa Nowitz
Editor, Safe Lifting News
e-mail: melissa.nowitz@hill-rom.com
Headlines in the news...
Do YOU need Nursing Educational Credits??
A key editorial mission of the ANA’s new publication, American Nurse Today, is to provide high-quality, relevant continuing education to nurses. The December issue of the journal carried a 6-page article entitled, "Taking the pain out of patient handling." This article was authored by Jan DuBose, RN, Liko’s Director of Education, and Terry Donahue, RN, president of Safe Patient Moves. Please note: The American Nurses Association is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.
ANA is approved by the California Board of Registered Nursing, Provider Number CEP6178.
Generic version of Patient Lifting "Infomercial" now available
Several institutions have requested generic versions of the patient safe lifting "infomercial" offered in the last issue of this newsletter. The video informs the patient about your institution's policies regarding safe lifting and is designed to be shown to patients who are unwilling or otherwise resistant to being lifted by an assistive device such as a floor lift or ceiling lift. In response, a 4-minute generic version of the infomercial is now available. You can view this free patient informercial by visiting www.safeliftingportal.com/gettingstarted/infomercial-generic.html. You might also be interested in visiting the new "Patients" tab in the Getting Started section of the Safe Lifting Portal.
Legislative Roundup
State legislatures across the country continue to make progress toward passing laws on safe patient handling and caregiver injury prevention. Click here to view this continuously updated list: www.safeliftingportal.com/gettingstarted/legislative-and-regulatory.html.
"Getting Started" section of Portal addresses needs of many readers.
Following nearly a year of publishing the safe lifting newsletter, editors have determined that one of the most popular topics is "how to get a safe lifting program started." Consequently, the section formerly known as "achieving buy-in" has been revised, updated and given a new name. Visit the new section at www.safeliftingportal.com/gettingstarted.
The Reading Room
Following are several suggested publications for background reading on topics related to safe lifting.
- "Tales of Uplift" - Read about how Integris Health's risk management organization confronted the problem employee injuries. "Back and shoulder injuries are our loss leaders, and not just from a money viewpoint. Perhaps even more important, injured people can lose their careers." Visit http://www.riskandinsurance.com/061101_choice2.asp.
- "Giving Care/Taking Care"
- That's the title of a PowerPoint presentation given by Susan Blitz, MD MPH, of the University of Michigan Health Care System. If you'd like to review an exceptionally informative and insightful presentation on the topic of ergonomics and healthcare injuries, click here to download a pdf file.
- NIOSH "Comment"
- For a comprehensive summary of injury statistics and the need for national legislation on safe patient handling programs, refer to the "Comments" column under the NORA (National Occupational Research Agenda) page of the NIOSH website. The commentary, by Rachael Kwapniewski, RN, provides yet another call for legislative action on a national level. Visit http://www2a.cdc.gov/niosh-comments/nora-comments/
noracmtsdetail.asp?area=HSA&id=595&rcdid=87
- Handle with Care: Patient Handling and the Application of Ergonomics (MSI) Requirements
- This 126-page publication contains valuable details on how to implement a "No Lift" approach to patient handling in the health care sector.
Source: WCB of B.C. Click here to download a pdf file or visit http://healthcare.healthandsafetycentre.org
/s/Musculoskeletal.asp.
- "Job Stress May Lead to Back Injury for Some People, Study Finds."
- The Ohio State University Research News. Online: http://www.osu.edu/units/research/archive/strsback.htm. Contact: William Marras, 614-292-6670, marras.1@osu.edu. Catherine Heaney, 614-293-5837, heaney.1@osu.edu. ("We found that psychological stress seems to amplify the physical demands of lifting for certain personality types.")
- "Nurses and Preventable Back Injuries"
- This brief but informative guest editorial provides a useful summary of statistics and lifting concerns that you could use to justify a commitment to safe lifting. Available online from a back issue of the American Journal of Critical Care. http://ajcc.aacnjournals.org/cgi/content/full/12/5/400.
NEW
Reader Poll - Nursing Resistance
Click here to take the Nursing Resistance Reader Poll.
(Results will be published in next issue.)
Ask the Lift Doctor...
Ask the Lift Doctor - Operating Room Transfers
"What is the best way to transfer a patient from operating table to bed if the patient is anesthetized?"
Denise Warczinsky
Huron Medical Center
Bad Axe, Michigan
Dear Ms Warczinsky:
Thanks for your question.
Transferring an anesthetized patient requires special care, and transfer of a patient following surgery requires yet another dimension in care and special preparation. The surgical patient's situation may become more complex as a result of the presence of IV tubing, intubation tubing, and possibly wound-related precautionary measures. Assuming you have taken those precautions into consideration and protected the patient against risk of additional injury, in general you will want to select a full body sling or lift sheet that provides maximum support to the patient's entire body including the head. Log roll the patient into position to enable placement of the sling or transfer sheet per the manufacturer's instructions. When the lift begins, perform a "pre-lift" test by partially lifting the patient. Once the straps are taut, but while the patient's weight is still on the surface of the bed, check all connections as well as placement of the sling at all points of the patient's body. Complete the lift and move the patient into position over the bed as gently as possible. Lower the patient into position on the bed and log roll to allow removal of the sling.
Stay safe.
The Lift Doctor.
Ask the Lift Doctor - OT/PT versus FIM Standard
"How do you address issues of nursing staff using patient lift equipment on an inpatient rehab unit? Are there articles or information available? Also, how does the use of patient lift equipment by the nursing staff affect the FIM (functional independence measure)? These concerns are from the therapy department."
Denise McGowen
Providence Health System, Alaska
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
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