SPECIFIC
- Do not manually lift a patient from the floor. Use SPHM technology.
- Medical precautions or stabilization do not require manual lifting. A Back Board can be lifted with a repositioning or supine sling or with straps built to connect back board to lift. Some lifts have stretcher attachments to keep a patient flat.
- Do not allow patient to lean on caregiver for support.
- Lift straps must go low enough to reach sling connections (loops or clips) without pulling patient up manually to attach.
- Friction reducing devices aid in transferring a patient onto lifting devices, back boards or slings.
- If patient falls in a difficult to access area, consider inserting air assisted lifting and/or lateral transfer device or lift sling under patient to facilitate pulling patient out of hard to access area. Sling or air assistive device can then be used to lift the patient.
- Preserve dignity by facilitating privacy for fall rescue when possible.
GENERAL
- NEVER manually lift patients except under emergency situations such as during an active patient code.
- NEVER catch a falling patient! A caregiver probably cannot stop a patient from falling. Quickly remove obstacles out of the way that may injure the patient’s head.
- Prior to starting task, CONFIRM patient handling equipment, slings, and destination locations (bed, commode, wheelchair, etc.) meet WEIGHT, WIDTH, AND HEIGHT requirements of patient.
- Do not allow patient to lean or pull/grab on caregiver for support in movements.
- Allow and encourage patients to move on their own as much as it is safe to do so.
- Ask patient what steps can be taken to facilitate ease and comfort in their movement and mobility as they typically understand their strengths and weaknesses.
- Avoid shearing forces especially for patients with delicate skin or pressure ulcers.
- Increase ease in inserting slings by using friction reducing device or lateral transfer device.
- Verify equipment is locked prior to transfer/movement.
- During any patient task, under the best of circumstances (no lines, tubes, contractures, etc.), a caregiver may lift no more than 35 pounds of a patient’s weight (body, head, appendages). If tubes, lines and other patient items or conditions influencing patient handling are present, or staff must bend, twist or reach, the permissible lifting weight is decreased. If weight limit is exceeded, assistive devices must be used if possible.
- Conditions likely to affect transfer/repositioning techniques.
- Hip/Knee/Shoulder Replacements
- Respiratory/Cardiac Compromise
- Fractures
- History of Falls
- Wounds Affecting Transfer/Positioning
- Splints/Traction
- Paralysis/Paresis
- Amputation
- Severe Osteoporosis
- Unstable Spine
- Urinary/Fecal Stoma
- Severe Pain/Discomfort
- Severe Edema
- Contractures/Spasms
- Postural Hypotension
- Very Fragile Skin
- Tubes (IV, Chest, etc.)
BARIATRIC
- For patient handling purposes, any patient that weighs more than 300 pounds, or 100 pounds over ideal weight, or who has a BMI or over 40 is considered a patient that increases the risk for caregivers while performing patient handling. Waist circumference is also used to identify bariatric patients. Weight, height, waist diameter, waist circumference should be collected on these patients in order to provide safe care and select appropriate equipment, beds, stretchers, wheelchairs, lifts, and other devices.
- Elevate head with pillow prior to moving patient to facilitate patient comfort and ease in breathing.
- If using air assisted lifting and lateral transfer devices, consider placing seated, supine, or repositioning sling on top of air assisted lateral transfer device prior to placement under patient.
- Fall rescue will require three or more caregivers to help pick patient up from the floor using lifting devices. Identify a leader when performing tasks with multiple caregivers in order to synchronize efforts and increase safety.
- A friction reducing device will facilitate insertion and removal of a sling under a bariatric patient.
- Inserting sling from head to toe or toe to head rather than log rolling may make sling placement easier.
- A multidisciplinary team should problem solve these tasks, communicate to all caregivers, refine as needed and perform consistently.