SPECIFIC
- Appropriate mode and route of transport requires information gathering prior to transport:
- What equipment can receiving environment accommodate? Some areas may require stretcher or chair as opposed to bed.
- What does receiving area require? (i.e., seated patient, patient on air device, specific bed features, etc.)
- Is width/length/weight capacity of devices adequate for patient?
- What is the easiest and safest route to transport patient (even surfaces, no inclines, etc.)?
- If the patient has respiratory distress, the stretcher must be able to maintain a high Fowler’s position.
- If powered devices are not available, use newer transport devices that are meant for transport. Heavy beds (including sand beds) or small wheels will add to difficulty.
- Plan a path to avoid obstacles, narrow doors, slopes, carpet, tight turns, or sudden stops and to ensure bed/stretcher/wheel chair can be accommodated along the pathway.
- Verify equipment is locked prior to transferring patient onto or off of transport device.
- Confirm elevator will accommodate specialty beds and expanded capacity beds/stretchers.
- Caregivers should avoid push or pull forces greater than 20% of their own weight.
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.
- 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.
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.
- Determine if the stretcher/bed is wide enough for patient to reposition self as needed.
- Transport devices should be powered if at all possible. Verify that device is fully charged and ready for use at all times.
- Transport with head in upright or elevated position.
- Pre-plan the route to transport the patient to facilitate patient respect and dignity as well as ease in maneuvering through wider spaces.
- Pre-plan transport to morgue upon end of life, using repositioning sling or lateral air transfer device under body bag to minimize transfer risks.
- Bariatric patients require more caregivers. Identify a leader when performing tasks with multiple caregivers in order to synchronize efforts and increase safety.
- Suggest applying a sticker to all bariatric equipment with ‘EC’ (expanded capacity) and the weight capacity of the equipment.
- A multidisciplinary team should problem solve these tasks, communicate to all caregivers, refine as needed and perform consistently.