SPECIFIC:
- Vehicle transfer will be hazardous whenever the patient is combative. Use more staff and minimize contact with the patient.
- NEVER use a gait belt to lift or transfer a patient.
- For seated transfer aid, chair must have arms that recess or are removable.
- Verify equipment is locked prior to transfer/movement.
- Always transfer towards stronger side, if 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. May insert sling from head to toe or toe to head to ease sling placement.
- 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.
- Bariatric size chairs and powered stretchers need to be wide enough to accommodate patient’s width and height for patient safety and comfort.
- Keep patient’s head elevated during transfer and transport.
- If coordinating transport, verify transport vehicle is large enough to accommodate patient, staff, and patient handling equipment.
- Keep repositioning sling or air transfer device under patient to facilitate lateral transfers if allowed and appropriate.
- Pre-plan route to minimize transport risks over rough terrain or up or down inclines.
- Bariatric patients require more caregivers. 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.