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Vol. 2 - No. 4 - May 2, 2007
Editor's note
Dear Subscriber,
Welcome to the current issue of Safe Lifting News. This "pro bono" e-newsletter is designed to keep you 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 you want covered in the future, please email melissa.nowitz@liko.com. We also encourage you to share your success stories with us by Clicking Here. 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@liko.com
Headlines in the news...
Legislative Update - Great News: 2 new states join
the growing list
- Maryland - HAS PASSED House Bill 1137 which requires that each hospital establish a safe patient lifting committee by Dec. 1, 2007 and a safe patient lifting policy to reduce injuries associated with patient lifting by July 1, 2008. Click here to view the bill.
- Michigan - Senate Bill 0377 would require establishment of a safe patient handling committee and program in hospitals by Sept. 1, 2008, plus equipment and training by Dec. 31, 2011. Click here to view the bill (click PDF for wording).
To review the entire list of legislative initiatives, visit the
legislative section of safeliftingportal.com.
4 Safe Lifting CREDIT HOURS for Nurses
A six-part series of articles that appeared during 2006 in CareManagement magazine is now available as a 4-Credit-Hour course for nurses. The series, reprinted as a 20-page booklet entitled "Patient Lifting," is FREE to members on the Academy of Certified Case Managers. If you are a nurse but are not a member of the Academy, you may submit a CEU application with a check for $ 15 for each certificate, payable to ACCM. The course is particularly well suited to situations where you need to provide advice and assistance to patients who are returning home and who need to acquire a patient lift. Even if you do not pursue the credit hours, the booklet can be a useful resource for your training program. Click here to request the course booklet. For ACCM membership information call (203) 454-1333.
"Patient Infomercials" - now available En Espanol
Last month, several readers reminded us of the need to provide our Safe Lifting infomercial messages in Spanish as well as English. If you haven’t yet had an opportunity to view these free video messages, now you can see them in three different versions for Hospitals, Nursing Homes, and in Spanish.
Click here to view the infomercials in Spanish, or simply visit the "Getting Started" section of SafeLiftingPortal.com. The Infomercials are located under the "Patients" tab. As a reminder, these infomercials are designed to inform patients about your facility’s safe lifting policies and can either be shown to patients upon admission or can be shown on your in-house video system.
FAQs on Safe Lifting
From time to time we receive questions about the breadth of acceptance and effectiveness of the Safe Lifting Environment program and workplace decals. This convenient FAQ Sheet will help answer many of those questions and may also assist with your internal communications activities. View document.
Visit our new "Share Your Story" Section
If your facility is presently using Safe Lifting decals or other components of the campaign, please consider sharing your story with the remainder of our readers. The more we share ideas and results about programs, the more nursing injuries we will prevent. Perhaps a few minutes of your time will help to initiate a program at another facility, whether next door or half way around the world. To view a success story from Children's Hospital in Minneapolis, click here. If you are interested in sharing your story, click here.
The Reading Room
Following are several suggested publications and Web links to background reading on topics related to safe lifting.
- "High-Risk Manual Handling of Patients in Healthcare"
- This useful and informative guidebook provides documentation on MANUAL patient handling techniques. In particular, it reviews common lifting, transferring, and repositioning tasks and provides a "Musculoskeletal Injury Risk Factor" (Moderate or High) for each task. You might want to share this with members of your staff, including any who are resistant to use of assistive devices. Source: "WorkSafe BC" - The Workers’ Compensation Board of British Columbia. To review the guidebook, visit
www.worksafebc.com/publications/health_and_safety/
by_topic/assets/pdf/handling_patients_bk97.pdf
- "Patient Handling in Small Facilities"
- Due to their size and lack of resources, small facilities often lack the ability to have a formal joint health and safety committee or a designated MSI spokesperson. This handbook outlines a process for small healthcare facilities to minimize or eliminate MSI risks to workers. While targeted at the health care sector in British Columbia, the handbook provides valuable insight and a number of useful tools that you can adapt to your individual situation. Source: "WorkSafe BC" - The Workers’ Compensation Board of British Columbia. To read the full article, visit
www.worksafebc.com/publications/
high_resolution_publications/
assets/pdf/bk100.pdf
- "Treating the Bariatric Patient"
- Whether in long term care or in an acute-care facility, rehab specialists work to
help obese patients become more mobile and functional in order to get them ready for discharge
or into a facility that can manage their condition. This brief benchmark article explains
that there are cost-effective ways to get bariatric patients mobile and that equipment exists
that can make their lives easier.
Visit
http://www.bariatricrehab.com/coverstory02.html
Results of Last Month’s "Who should be responsible?" Reader Poll
Following are results of the reader poll on "who should be responsible for administering a safe patient handling program"
that appeared in the March issue of Safe Lifting News.
Click here to view the results and comments.
Ask the Lift Doctor...
Ask the Lift Doctor - Leaving lateral transfer aids under patients during x-ray
"Are there any lateral transfer devices like the Slipp that can be left under a patient on an x-ray table."
Mary Irzyk
Froedtert Hospital
Dear Mary:
One of your first considerations should be whether the x-ray is being used to examine the skeletal structure or whether soft tissue is the object for examination. The answer may affect whether the sling or transfer sheet can be left under the patient. Here’s why.
Slings and lateral transferring devices can be radiolucent to varying degrees, depending on the specific material of construction used. The appearance of the fabric on a radiograph may be immaterial if skeletal structures are being examined (a common example would be shooting through a cast to observe a fracture site). However, when soft tissue is the object for evaluation, such as a chest x-ray, the appearance of fabric or a fabric weave pattern may have a negative effect (no pun intended). Of importance, the lower the density of the fabric, the less visible it is on the film. For example, cotton is less dense than polyester and would thus be less visible on the x-ray. You will also find that net polyester and plastic coated net will create a mesh pattern at certain energy and exposures and not others.
To summarize, if your sling or transfer sheet is cotton or a cotton/poly blend, you can probably leave it in place and not cause a problem, even when taking soft tissue x-rays. For example, it is not uncommon to shoot through an ER stretcher back support or several layers of cotton/poly bed linen. On the other hand, if your sling or sheet is high density poly material, it should be removed unless you are taking a skeletal series. To avoid the possibility of negative effects, you should always attempt to use a transfer or repositioning sheet made of a lower density fabric such as cotton or cotton/polyester blend.
Best Regards,
The Lift Doctor.
Ask the Lift Doctor - for Repositioning patients in bed
"I am currently in charge of the hospital's zero lift program. I have been asked to look for something to assist with repositioning residents or patients in bed. What do you recommend?"
Loree Pauls
Lincoln Hospital
Dear Loree:
Repositioning is a potentially dangerous operation and is often repeated many times each day by nurses and caregivers worldwide. Luckily, there are some aids that, if used properly, can make repositioning easier.
There are two basic types of repositioning aids available -- manual and mechanical -- and you need to consider the features, advantages, and benefits of both in each individual situation.
1) Manual Aids: There are a number of manual friction reducing devices on the market, often called transfer or repositioning sheets, and you need to carefully consider both patient and caregiver safety when selecting a product to use. Their advantages are low cost and easy availability, while disadvantages are the need for multiple caregivers and the risk of caregiver injury.
In 1993, a NIOSH Lifting Equation set the maximum recommended manual lifting limit at 51 lbs. This is for a vertical lift and does not take into account shearing and rotational forces applied to the human spine during repositioning tasks. The Patient Safety Center of Inquiry of the Veterans Administration, in its October 2001 publication of lifting algorithms, recommended the following for Repositioning in Bed: Side-to-Side, Up in Bed; "If patient is > 200 pounds: Use friction reducing device and 2-3 caregivers."
2) Mechanical Aids: Many kinds of mechanical aids are available to assist you during repositioning operations. Mechanical lifts can be either mobile floor based models or ceiling-mounted overhead systems. When using a specially designed repositioning sheet together with a mechanical lift, the patient can easily be moved to a better position in the bed. The patient can also be turned in the bed, with virtually no strain on the patient or the caregiver. Turning is usually popular since it facilitates washing and dressing the patient as well as changing bed linens. It can also help prevent bed sores.
Remember to select only repositioning sheets designed to be used with mechanical lifts, and pay particular attention to recommended weight limitations when using them with heavy patients.
Best Regards,
The Lift Doctor
Ask the Lift Doctor - Crossing the straps of a hygiene sling
"We use the hygine slings quite a bit in the nursing home. I do the training on proper use of slings and Liko lifts. I have noticed that the employees like to improvise quite a bit. I found the Aides not crossing the leg portion of the hygine sling (one strap through the other) after placing the strap under the legs. I am sure I was trained to always cross the leg straps and then hook the strap to the lift bar. I am concerned we might drop someone out of the hygiene sling due to improper placement of the straps."
Loree Pauls
Lincoln Hospital
Dear Loree:
As this is your second question this month, you must be an avid reader of Safe Lifting News !!
An individually fitted sling is always recommended in order to provide the best possible safety, function and comfort during the lift. Regarding crossing or not crossing the leg supports, it’s generally safer to cross the leg supports before attaching them to the slingbar.
Note: One reason you may elect NOT to cross the leg supports may be to provide better access during perineal care. If you choose NOT to cross the leg supports, you should be aware that you may be incurring increased risk, thus you should select a sling that provides extra safety. For example, you could select a sling equipped with a belt and safety buckle to enhance safety, or a sling equipped with a "safety belt," including Liko’s Hygiene Sling Models 45 and 46, or Hygiene Sling Models 50 and 55. The Safety Belt provides dynamic tightening which enhances safety. Bear in mind that a Velcro fastening system can easily be opened by mistake and does not provide the same degree of safety.
A narrower slingbar, for example 350 mm wide, is more suitable for safe and comfortable lifts when the leg supports are uncrossed. The narrow slingbar holds the patient’s legs together better, and the upper part of the sling supports the patient’s body better during the lift.
General recommendations can also be found in sling instruction guides - and Liko’s can be downloaded free of charge at www.liko.com.
Stay safe,
The Lift Doctor
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