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Vol. 3 - No. 2 - March 6, 2008
Editor's note
Dear Subscriber,
Welcome to the latest issue of Safe Lifting News, a pro bono electronic newsletter designed to keep you abreast of what’s happening in the world of safe patient lifting and caregiver injury prevention. Please check our new "Safe Lifters" forum in the Help Desk section, and why not consider contributing a question to our "Ask the Lift Doctor" section using the link below.
Warm regards,
Melissa Nowitz
Editor, Safe Lifting News
e-mail: melissa.nowitz@hill-rom.com
Reader Poll
Do you think adoption of a "National Healthcare Safe Lifting Day" would help to focus attention on prevention of lifting injuries in healthcare? Click here to complete the reader poll.
Readers ask... "Who is the Lift Doctor?"
The Lift Doctor is actually a panel of Liko specialists who have a wealth of experience in the safe lifting and transfer of patients. They include a highly skilled clinician, a sling application expert, an educator, an ergonomist, a bariatric specialist, several RNs, a lift system design consultant, a former EMS worker, a physical therapist, a researcher, a labor and delivery nurse, an ex nursing manager, a risk management professional, a site analyst, a CNA, an infection control specialist, an architect, an overhead installation designer, a safety director, an OT, a clinical instructor, an administrator, and many other dedicated individuals. The Lift Doctor is why Liko sponsors the Safe Lifting Portal and other safe lifting initiatives... it’s our way of promoting injury prevention and saying "Thank You" to our many loyal customers and healthcare associates around the world. Stay safe. If you are attending the SPHM conference next week, be sure to pick up your copy of the Lift Doctor Booklet in the Liko booth.
The "Lift Doctor" gets published.
In response to reader requests, we’ve decided to publish a booklet entitled Ask the Lift Doctor – Real-world Questions and Answers about Safe Lifting. Over the past two years, our newsletter readers have sent The Lift Doctor questions on dozens of wide-ranging topics, and now you’ll be able to obtain a hard copy of indexed questions and answers…in fact, you might want to circulate this useful information among your colleagues. Simply fill out this form to obtain a copy.
"Safe Lifting Practices for Nurses" -- 16-Page Reprint Now Available
A 5-part series of safe lifting articles reprinted from American Nurse Today is now available in hard copy format. Sponsored by Liko, the articles include sections on assessing patients, selecting lifts for patients with special needs, infection control, and how to calculate return-on-investment. Click here to request a copy.
A Contributed Anecdote...just what IS an emergency??
This true story was submitted by one of our readers who requested that his identity be kept anonymous.
"I am no longer in healthcare but as the founder of Lift Teams at two different medical centers, I like to keep up with this area and I am glad to see it is growing.
One accident investigation I did early in the implementation of a lift team at one major hospital involved the Term "Emergency." I was asking an INJURED nurse why she didn’t wait for the Lift Team to move her patient (our average response at the time was less than 4 minutes) and she said it was an "Emergency."
Nurse: "It was an Emergency."
Safety Professional: "What Kind of Emergency? The Room was on fire? Incoming Mortar Rounds? Sniper fire?" (I was...still am ... a bit of a smart aleck)
Nurse: "Radiology called and said they had a CT opening for my patient and that I had to get him down to them within 5 minutes for him to be fit in."
Safety Professional: "And what was it about the patient’s condition that meant he had to have a CT in the next 5 minutes? Suspected aneurism or something like that?"
Nurse: "No, nothing life threatening, but he had been waiting all day and... (insert lame excuse here ...I can’t remember the exact issue but it was not important enough for a nurse to herniated a disk over.)
Safety Professional: "You are on the 8th floor in a different wing of the hospital...how long would it take you to push the patient to CT even if you didn’t have to transfer him?"
Nurse: "About 15 minutes"...
Safety Professional: "So it was an impossible goal to begin with...."
In this case, an experienced and dedicated nurse incurred an injury that likely ended her career as a floor nurse because Radiology scheduling created what I call an "Artificial Emergency," a situation where a dedicated care provider sacrifices his or her health because they feel that they must in order to provide quality care to the patient.
So...just what IS a "Lifting Emergency"?
From the Reading Room
- New Lift Systems Begin to Pay Off - Staff members at Eden Medical Center's campuses in both Castro Valley and San Leandro are being trained to use new lift equipment and follow guidelines for their Get A Lift! program which is designed to eliminate the need for nurses and other hospital personnel to manually lift patients into beds, onto gurneys, or out of wheelchairs. Nurses, X-ray technicians, respiratory therapists and other staff each use the new lifting equipment and guidelines to avoid injuries to themselves and their patients. To read about their experiences, click here.
- Effectiveness of an Evidence-Based Curriculum Module in Nursing Schools Targeting Safe Patient Handling and Movement - In this research study, nurse educators at 26 nursing schools received proposed new curricular materials and training; nursing students received the evidence-based curriculum module, and the study found that nurse educator and student knowledge improved significantly at intervention schools, as did intention to use mechanical lifting devices in the near future. It concluded that the curriculum module is ready for wide dissemination across nursing schools to reduce the risk of MSDs among nurses. Click here for more information.
- The Victorian Nurses Back Injury Prevention Project -This authoritative study includes a cost-benefit analysis of the intervention using three different models, showing that facilities stand to gain significant financial benefits/cost savings by implementing back injury prevention programs based on No Lifting principles. Results included:
- A 24% reduction in the rate of standard back injury claims by nurses in public health service agencies in Victoria.
- A 41% reduction in the rate of working days lost associated with standard back injury claims by nurses in public health service agencies in Victoria.
- The mean working days lost per claim was reduced from 100 days per claim in the pre-implementation period to 77 days in the post-implementation period, a reduction of 23%.
To review the Victoria report, click here.
- Patient Lifts Prevent Injuries at Naval Medical Center - In the past, half of all occupational back injuries at National Naval Medical Center in Bethesda, MD, were related to lifting and transferring patients. A typical lifting task was the manual transfer of a patient from a bed to a chair, where caregivers often bent forward or twisted their upper bodies during the lift. Read how the introduction of patient lifts lowers injury rates by clicking here.
Ask the Lift Doctor...
Lift Doctor Question 1
Question: I provide risk control service to a large nursing home that is looking to replace their 100+ crank beds with electric beds. This particular facility has had several workers’ compensation claims resulting from resident (bed) transfer. I suspect that some of these may be due to the C.N.A. not taking the time to crank the bed up or down prior to the resident transfer. The CFO wants a cost/benefit analysis done prior to committing to this expenditure. Do you have any case studies that support replacing crank beds with electric beds?
Patty Soppe
Company: PMA Insurance Group
Dear Patty,
Your question gives us an opportunity to answer by summarizing at least three different topics of interest from previous Lift Doctor columns.
- The TIME issue – Often nurses and CNAs will use Time as an excuse for not using a piece of equipment, or in this case for not cranking up the bed. The resulting injuries have placed a tremendous burden on our healthcare system and have caused untold, needless pain and suffering to those nurses who injury themselves. They need to be educated regarding the importance of taking the time to perform their tasks in a safe and efficient manner.The Program issue – In order to educate your personnel on the dangers of manual resident transfers, you should consider introducing some type of training or safety program. Why not start with some of the free tools available on safeliftingportal.com?
The Cost/Benefit issue – Check out the "return on investment" calculator here.
The Lift Doctor believes your existing injury statistics can be entered into the calculator and will provide a close estimate of the savings that will be achieved on an annual basis. While it’s not designed precisely for electric beds, the calculator does embody many of the direct and indirect savings that will "roll up" into a realistic cost/benefit summary.
Good luck in addressing this issue with the CFO.
Stay safe,
The Lift Doctor
Lift Doctor Question 2
Priscilla Anderson
NHTI
Question: I am using a manual lift (company x) to transfer my husband who has MS from his bed to the toilet. This lift does not have a toileting sling that I can remove, so he is always sliding off the toilet seat. I have been denied an electrical lift with the use of a toileting sling from my insurance company. Do you have any supportive documentation that I can use to convince them of our need? Or do you have any other suggestions that I can use? He has limited upper body balance. I already have a back injury from repetitive transfers for the past 18 years. Thank you for your help.
Dear Priscilla Anderson,
You may wish to have your insurance company review the following document, "An Overview of Home Care Lifts and Reimbursement Issues" (Email hillromathome@hill-rom.com for a copy ). In this article from Disease Management Digest the author covers the issue of Hydraulic vs. Electric lifts as well as provides a summary of alternative reimbursement options, some of which might be available to you. These options include Medicare, State Medicaid, workers’ comp, governmental agencies, vocational rehabilitation grants, and local/regional funding sources such as church groups and fraternal organizations. I hope you are successful in your much-deserved quest.
Stay safe,
The Lift Doctor
Lift Doctor Question 3
Larry Wilcox
SD Veterans Home
Question: Where can you buy a whirlpool Bath System that will handle a person up to 600lbs?
Dear Larry,
In general The Lift Doctor tries to avoid making recommendations of products from any specific manufacturer. However, in this instance I would simply advise you to utilize existing search engine technology to locate appropriate suppliers of bariatric whirlpool tubs. As an example, click on the following site, http://www.usatubs.com/TheBig-BatherModel.html , which we located via a quick Google search. It lists large whirlpool tubs from several different manufacturers.
Stay safe,
The Lift Doctor
Lift Doctor Question 4
Paul Shannon
NSUH C.E.M.S
Question: I am part of an EMS group trying to develop stretching programs for personnel while on ambulance duty. Are there any ergonomics or stretching programs for personnel to use while on duty, prior to a call, or simply using the ambulance for stretching?
Dear Paul,
We hope every EMS tech understands the value of being physically fit in order to prevent work-related injuries and avoid the risk of early retirement due to musculoskeletal disorders. Stretching exercises in your workout will help you remain more flexible whenever heavy lifting is required. Thus proper stretching should be part of your warm-up routine and is an important part of remaining fit and preventing injuries. You may wish to obtain a copy of the book entitled Stretching by Bob Anderson for specific stretching routines.
However, here's a word of caution from the Lift Doctor: Please also be aware that dozens of studies over many years have disproved conclusively the myth that healthcare workers can avoid injuries by being physically fit. Lifting patients is probably the main reason EMS personnel are ranked among the top ten most dangerous professions! Furthermore, patients are getting heavier and heavier, thus new lifting processes and equipment must be considered to protect both patients and EMS personnel against lifting and transferring injuries. The bottom line is, EMS personnel are NOT immune to injuries, thus they must begin to utilize similar assistive equipment and techniques currently being mandated in hospitals and nursing homes worldwide. Protecting your back protects your working longevity.
Stay safe,
The Lift Doctor
Lift Doctor Question 5
Deanna Janes
David Thompson Health Region
Question: I need to reposition a patient from supine to prone for dressing changes. What lifts & slings would you recommend?
Dear Deanna,
Before answering, let me qualify the situation for our readers as follows: In many instances it is possible to accomplish dressing changes in a side-lying position (which would only require the caregiver to use MultiStraps, a RepoSheet or a slide sheet to log-roll the patient into a side-lying position. The decision regarding which of the preceding aids to select depends on the weight and functional capability of the patient). However, I am assuming by your question that in this case the patient must be placed into a full prone position for some reason.
In order to turn the patient from supine to full prone on a standard size bed, I would recommend a combination of a RepoSheet and a SlidingTube. Ideally two caregivers would participate, one on each side of the bed. The RepoSheet would first be placed under the patient. The SlidingTube would then be placed under the RepoSheet. Next the lift would be attached to the RepoSheet and the lift would then be used to log-roll the patient over to a full prone position on the SlidingTube. During the log-roll the caregivers would use the SlidingTube to keep the patient centered in the bed. Note: Care must be taken not to allow the patient to be rolled too close to the edge of the bed. The same basic procedure would then be used to turn the patient back into a supine position.
Regarding a specific type of lift: Ideally you would choose an overhead solution but the procedure will also work with mobile lifts that are capable of lifting to a sufficient height. For example, either Liko’s Viking XL (M,L) or Golvo 7007 should provide sufficient lifting height to successfully complete the maneuver.
Stay safe,
The Lift Doctor
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