Development of the Patient Lifting Status Indicator

In an effort to reduce patient handling injuries, I started by trying to update our patient handling policy which was last revised in 2003. I presented the new policy to the Patient Safety Committee in the fall of 2007 and they immediately shot it down. They thought it was too long; no one has time to read this, etc. Next I went back to the drawing boards and redid the policy completely by using algorithms with a brief explanation of each algorithm. Back to the Committee I went, and back I came with another rejection. They were not impressed. They wanted something simple.

Their request for something simple was because our present system was not working. Patient assessments were documented on a marker board or “white board.” But when investigating caregiver injuries, employees indicated they usually didn’t look at the board for this information because there was so much data written…they couldn’t take the time to review it all.

As a result, I formed a Patient Safety Task Force to address the issue. First we discussed colored magnets, colored squares to hang on a hook, etc. The problem with these ideas is that most of these types of material will eventually disappear and nobody will take the time to replace them. Then I thought of an indicator panel or “control panel” that would be mounted on each patient’s white board. We decided to use colored squares that had the advantage of quick recognition and easy recall. Since there were no standards for what color designates what, I came up with my own version. The first indicators had only 3 squares: 1 caregiver, 2 caregivers, and lift. Working closely with the nursing staff, they wanted a way to indicate when the patient was independent. This meant we added a green square and a Capital I. Next we ran into the issue of what to do if the patient was not able to be moved. This required the addition of the red square with a patient in bed to indicate no movement allowed. As time went on I started receiving suggestions from the staff that they needed a way to determine if assessments had been done. As a result, I added a sixth square with the “Assessment Needed” designation. To make sure the indicator is “reset,” I have our housekeeping staff turn the indicator to the Assessment Needed square when they are done cleaning a room.

To verify its effectiveness, I sent out an evaluation questionnaire to the department that was trialing the patient lifting status indicator.

The results were:

1. appearance, design, ease of use; 33% exceeds expectations, 67% meets expectations,
2. established clear objectives and expectations; 33% exceeds expectations, 67% meets expectations,
3. accuracy compared to previous method; 59% exceeds expectations, 41% meets expectations;
4. builds positive communication relationship with staff; 33% exceeds expectations, 67% meets expectations.
5. promotes patient and staff safety; 67% exceeds expectations, 33% meets expectations.
6. overall effectiveness; 33% exceeds expectations, 67% meets expectations.

100% indicated they would continue to use the indicator.

I am in the process now of incorporating the patient lifting status indicator into our new patient handling policy. I am also going to refer to the Morse Fall Assessment Guidelines that all departments are required to do for every shift. We will be modifying this program to address the lifting needs of the patient which will be documented on the indicator. Of significance, this information will be available to all departments. For example, if the patient needs to be taken to Radiology, their department staff can review the patient assessment and see that the patient requires 2 caregivers for any transfer. Not only does this help the staff on the floor but also any department that has contact with the patient. Again, each patient lifting status indicator will be updated at least once per shift based upon the Fall Assessment Guidelines.

If you would like information on how to procure sample copies of this convenient assessment indicator, please contact Randy Chamberlain, rchamberl@frhs.org or 402-644-7655.