Reader Poll Results

Five Questions regarding Rehab Personnel

• Do you feel physical therapists and occupational therapists are in better physical condition than nurses and other caregivers?
• Do you feel that better conditioning enables handling patients manually with less risk of self-injury than nurses and other caregivers?
• Do you feel the patient thinks less of a PT or OT for using assistive equipment during the course of therapy?
• Do you feel use of mechanical lifting devices detracts from the patient's progress toward full functional status and independence?
• Do you believe the attitude of PTs and OTs is shifting toward greater acceptance of safe patient handling techniques and equipment into daily practice?

Do you feel physical therapists and occupational therapists are in better physical condition than nurses and other caregivers?

Comments:

• In our particular hospital, yes.....may not always be true
• The percentage is about the same
• Number of injuries reported are as high or higher. I also personally know this staff and they are a sample of hospital employees in general at our facility. C.N.A.'s with MORE seniority have bid on the PT aid positions. So we end up with older, arthritic, and many time overweight employees.
• Most, not all.
• Not all, but some
• Not necessarily
• On average PTs and OTs are younger than nurses. Generally speaking, individuals who are attracted to the PT and OT professions value physical ability and physical fitness. Often people who go into nursing are caregivers, sometimes at the expense of their own health. These last two statements are my observations from working at several hospitals, and many exceptions exist.
• This stereotype can actually increase PT/OT staff risk of injury due to a biased expectation of what "we're supposed to be doing."
• The have better lifting techniques and adhere to appropriate body mechanics when they lift and transfer. They take the time to properly position themselves and the clients/patients.
• False sense of security. They do take time to explain process and give instructions, pace at pts tolerance- so often are safer.
• They have a stronger knowledge base related to safe patient handling than nurses do
• While some in-patient therapists are definitely in better physical shape than others, even those who are more physically fit are reporting that handling patients is taking a toll.
• Comparison is at a group level; some Nurses and other Caregivers are in excellent physical condition. As a group, PTs and OTs are generally in better physical condition.
• However, the average age seems to be younger
• PT feel it is an insult to their professional to utilize an assistive device.
• Rehab staff are not necessarily in better shape than nurses, but they are at least very aware of physical conditioning and training.
• I do feel that PTs and OTs get better training in school regarding proper techniques of patient handling

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Do you feel that better conditioning enables handling patients manually with less risk of self-injury than nurses and other caregivers?

Comments:

• No one can predict when a resident / patient may move, lose balance, etc. Therefore although better conditioning helps and may result in less injury, it does not prevent an injury, as would the use of mechanical devices and lifts.
• Being in better conditioning prevents injuries in many ways, but does not alleviate the risk of injury with lifting, moving patients
• We are all vulnerable
• 2 of my 7 PT aids are now dieting and attending aerobic Zumba classes. Directed by a Rehab RN :)
• Even some one in the best shape possible can get injured with improper mechanics. Even with proper mechanics, a patient can do unexpected movements and cause a condition suitable for an injury to occur.
• No matter how conditioned you are, it is not safe handling a large patient.
• Conditioning plays a small role. The ability to facilitate movement, setup for the task, and effective communication play a large role in reducing risk of injury and providing effective therapy.
• Even though you are physically fit; you still risk injury when manually moving a patient
• It creates a false sense of safety. There are, however, benefits to being in shape.
• But only if proper body mechanics are used along with appropriate lifting techniques
• If pt is with it, yes. Communication and accurate/constant pt reassessment are key. Many injuries are with confused/aggressive pts.
• It is the knowledge and safe practice patterns that protects PTs and OTs
• While being in better physical condition is a good thing, it also gives therapists a false sense of safety. National injury data as well as data from our own facilities indicates therapists are at risk, maybe even to the same degree as nurses.
• Better conditioning does protect therapists from some injuries, but it doesn't protect them from risks caused by heavy manual transfers.
• The equipment used for safe patient mobility does not require better conditioning.
• Less risk, but not necessarily safe.
• Physical conditioning does not minimize the risks associated with manual handling.
• More aware of body mechanics though
• Physios seem to be more involved in personal fitness
• Conditioning does not change the fact that you need to do a proper assessment, get proper amount of help, use equipment and good body mechanics.
• I would like to see no manual lifting period. Better conditioning doesn't matter.
• Somewhat - you have to use proper form and body mechanics as well
• Better conditioning lessens the risk regardless of the profession

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Do you feel the patient thinks less of a PT or OT for using assistive equipment during the course of therapy?

Comments:

• I think the understanding from the patient comes when an educational piece is used to explain the process the PT/OT will be using for treatment.
• I believe patients recognize that the devices keep them safer and also keep employee safe
• Maybe, Educating the patient helps reduce this feeling. OT's use adaptive equipment all the time. We explain why. It works.
• As long as proper explanation is given to the patient on why it is necessary to use safe handling equipment.
• Patients do not think less of therapists who use equipment in a manor that increases safety and is focused on functional outcomes. The rationale needs to be communicated with patients.
• I think they will feel safer and then be able to attempt more because they are not worried about falling or being dropped.
• They tend to appreciate the extra level of care.
• PT and OT know when you need to use assistive equipment and when you don't, but things like a standing or tilt table to initiate weight bearing is part of treatment not a transfer method
• But sometimes nursing questions why. In rehab, often therapy will progress off lift but still rec. lift for nsg on off shifts due to pt fatigue/cognition, etc
• It is all in the presentation to the patient
• Initially until they understand the importance to staff and patients.
• With the use of appropriate equipment, patients feel more secure, and can concentrate on their rehab goals without worry of falling or hurting their therapist.
• The pt's perception on the benefits of using equipment is heavily influenced by the therapist's attitude. A positive approach on the therapist's part when using equipment has a positive affect on the pt.
• At long as the OT or PT continues to have physical contact with Pt; and explains that the use of equipment is for the safety of the Pt; it is not a detriment
• Some patients/families think that the therapist (or nurse or other healthcare professional has some 'magical' way of getting people up and moving no matter what the patient's strength, condition or functional ability is.
• It needs to be explained to the patient and family that the PT needs to protect themselves in order to care for the patient
• I would think it would make the patient feel safer.
• But PT/OT does always look at the goal of return to original status and may not want to use equipment if not realistic for pt/family use after discharge
• Depends on how it is presented to the patient.
• But they are often uncomfortable and feel different when lift equipment it used.

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Do you feel use of mechanical lifting devices detracts from the patient's progress toward full functional status and independence?

Comments:

• I have found mechanical lifting devices to be a real support system that enables the patient to become independent. When explained properly to the resident, the mechanical devices are accepted.
• If used only to prevent falls or injury
• At times, it is necessary
• Quite the opposite
• This may occur if there is not simultaneous training occurring that is geared to improve functional movement in a controlled fashion and safe environment
• I do not, but the Therapy Department does have this idea
• It depends how and when they are used. A patient may be transferred with a sit to stand lift, which reinforces an extension sit to stand pattern and does not allow upright standing. This process will assist progress towards independence if the alternative is a hoyer style lift and no weight bearing through the l/e's. If the patient is capable of upright standing, then opportunities for functional gains are being lost.
• They can do more because they are reassured with the safety of the equipment and the therapist can then focus on what the patient needs to work on.
• Yes, some of the lifting equipment can detract or prolong a patient's recovery, but the extra time is justified by the reduced risk of injury.
• Depends on the lift and the client's abilities and goals. If all they ever do is transfer using a hoyer lift or something similar they will look muscle mass, have increased walking/transferring independence) or if they are to be independent in wheelchair contractures and will not receive adequate nor the correct proprioceptive and sensory input through their legs, arms and torso to facilitate weight bearing. Depends if the goals are to weight bear through legs (some
• You can progress full lift to standing lift and then to without lift.
• Making the safe decisions for each patient is what is important - choosing to use a mechanical lift means that it is not safe for a rehab specialist to handle the patient
• Sometimes, if a patient has potential for independence and needs practice with transfers outside of the therapy clinic (the "use it or lose it" principle).
• I'm convinced that when used appropriately, lifts can move patients toward their rehab and independence goals at a faster pace.
• The approach for effective use of equipment is choosing 'the right equipment for the right patient at the right time.'
• If there is not a phased approach to the mobility that aligns to Pt improvement then, yes, it would detract.
• We need to protect staff.
• If not used in the appropriate manner
• If used during their entire rehab and therapy. Safe transfer training still needs to be a part of the therapy sessions. But, for example, if the purpose of the session is LE exercise, it may be safer and more efficient to use a lifting device.
• Basically many therapists agree that if the patient does not do anything themselves during a task, then it has little functional value except perhaps a change in positioning (if that is all they can do, then rehab is not appropriate until they can assist in some way).
• As long as the PT understands the purpose of the device, and uses it to enhance treatment
• Promoting dependence on a lifting device instead of the patient
• I feel it gives patient confidence. The patients aren't worried about falling and hitting the floor.

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Do you believe the attitude of PTs and OTs is shifting toward greater acceptance of safe patient handling techniques and equipment into daily practice?

Comments:

• 50/50 split, Yes and no to this question. I believe that some PT/OTs have a great respect for safe patient handling, while others remain thinking that hands-on is the only way to bring confidence to the patient.
• Not at present
• We are a VA facility and we have the latest in lifting equipment available.
• Slow but sure. I think the lifts that have walking harnesses, that can also be used to help the person with supine to sit, can help this transition. Many therapist believe this is not "hands-on", initially, however.
• I don't believe the attitude of PTs and OTs has been a problem with the use of safe patient handling techniques and equipment--if it has been other places it's not that way here!
• They just need more education
• Maybe in other facilities, but not in mine. My therapists believe that they should continue as always!
• I think therapists are very open to technology and techniques that improve patient function. One example is the use of partial body weight support treadmill training, an approach that has solid research to support it. I use the Liko Sabina and Liko Golvo with the master vest or lift pants when it increases safety and facilitates the movement pattern and outcome that I am working toward. I am advocating for an overhead track system on the rehab unit. I hope that safe patient handling equipment is an a very infancy of it's development. It very effective for moving people. It's use for facilitating recovery of function is limited but growing.
• Yes, but new grads are still attempting to lift patients more than using the lift, which is telling of how PT/OT schools are instructing students to lift patients.
• For nursing and other caregiving staff full lifts are needed to avoid injury. As part of therapy, assistive devices are also often used (and needed - tilt tables, standing tables, arjo walkers etc.) but clients/patients often still require opportunities to weight bear and track lifts and floor lifts don't allow for that....all depends on the clients needs and goals!
• In rehab yes. In acute care- less so. They are on a shorter time frame and more pressure from physicians. I have staff hurt standing new post op joint pts. When the pt transfers to rehab they use the lift!
• By the use of the devices
• I hope so -- as they are more exposed to the concepts and have opportunities to modify their practice
• Although we still have facilities where rehab staff are very resistive to using lifts as part of therapy, this is definitely changing. We have a number of facilities where rehab staff have emb
• Do not know
• Yes... having an OT or PT acting as a 'champion' for equipment is extremely important. It helps to enlist the aid of an OT or PT who has been injured once or twice and knows the risks firsthand... but injury is not necessary!
• This is a cultural shift where we must retain the best of "hands on" and the best of assistive devices to protect both the patient and the caregiver
• Ahead of ortho & PM&R physicians, but behind RNs
• Absolutely!!
• We are already at this mental moment in time. I find nursing staff in general are slowly making changes.
• I think PT feel threatened that if they utilize assistive devices FTI's will be reduced????
• I hope so....we need to be safe with the patient, but also preserve ourselves for a long career!
• I have already seen the use of sit to stand and cardiac chair devices by PT/OT. Most assume vertical lifts and slider sheets are for nursing to use for low level patients who do not assist in movements.
• This is a very slow process

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