Best Practices in Patient Transfer for Health Safety

Understanding Patient-Handling Injuries in Healthcare Settings

Injuries sustained during patient handling, particularly in lifting or transferring scenarios, predominantly affect healthcare workers in areas like the lower back. However, they also pose significant risks to other body parts, including the neck, shoulders, elbows, and wrists. Such injuries often occur in dynamic and unpredictable situations, for instance, when a patient transfer escalates into an emergency lift (e.g., if a patient begins to fall). This sudden shift forces healthcare professionals to bear the full weight of the patient to prevent a fall, significantly increasing injury risk.

The risk of injury is not solely dependent on the weight of the patient being moved. Equally critical is the biomechanics of the healthcare worker's body during the maneuver. For example, holding even a moderate weight of 10 pounds at an arm's length, particularly with an extended back, can exert a force equivalent to 100 pounds on the lower back. This disproportionate force amplification highlights the vulnerability of spinal discs, especially when bending forward, as they support not just the weight being lifted but also the upper body's mass.

Furthermore, it is imperative to recognize that the risk extends beyond back injuries. These patient handling activities can expose healthcare workers to potential injuries in the shoulders, elbows, hips, and knees. The cumulative effect of repetitive lifting and transferring can lead to chronic musculoskeletal disorders, underscoring the need for proper training, ergonomic intervention, and the use of assistive equipment in healthcare settings.

Effective Management of Patient Handling Hazards in Healthcare Facilities

When injuries from lifting and transferring patients are a concern, a systematic and proactive approach is essential:

1. Communication and Escalation: Initially, raise these concerns with your supervisor. If the response is inadequate, bring the matter to your health and safety committee or your local union's executive. These representatives can advocate for changes and, if necessary, involve a health and safety inspector to evaluate and enforce safe practices.

2. In-Depth Hazard Analysis: Conducting a thorough analysis is crucial for understanding the scope of the hazard. This should include the following critical questions:

   • Patient Demographics: What is the total number of patients, and how many require regular lifts or transfers?
   • Equipment Availability: What types of mechanical lifts are available, and are they adequate for the patient needs?
   • Training and Competency: Have workers been adequately trained in safe patient handling techniques?
   • Staffing Levels: What are the staffing levels on each shift, and how do these levels fluctuate? Are there issues with frequent short-staffing?
   • Environmental Assessment: Do the rooms and passageways in the facility accommodate safe patient movement with lifts?
   • Patient Behavior Assessment: Are there patients with a history of violent behavior that could pose additional risks during handling?

3. Comparative Analysis of Needs and Resources: After identifying the needs, compare these with the existing resources in the facility. This comparison should help in determining the requirement for additional equipment, staffing, or training.

4. Review and Adaptation of Procedures: Evaluate existing procedures and compare them to current practices and expectations of both management and staff. It’s crucial to ensure that the policies are not only well-crafted but also supported with adequate resources for effective implementation.

5. Management and Staff Alignment: A successful policy requires commitment from both management and staff. Management must provide the necessary resources, while staff should be encouraged to adhere to the safe practices outlined in the policy.

6. Ongoing Evaluation and Feedback Loop: Establish a feedback loop where staff can report concerns and suggestions. Regularly review and update the practices based on this feedback, new research, and evolving best practices in patient handling.

Implementing Best Practices in Patient Handling for Enhanced Safety and Efficiency

In healthcare facilities, adopting a comprehensive strategy for patient handling is crucial for ensuring the safety of both workers and patients. This approach not only enhances workplace safety but also presents significant benefits for employers.

1. Optimal Transfer Plans: Designing a transfer plan that includes a sufficient number of trained staff and mechanical lifts is fundamental. Such planning ensures that every transfer is conducted safely and efficiently.

2. Advocating a No-Lift Policy: The best practice in patient handling is to establish a no-lift policy, where manual lifts without mechanical support are strictly prohibited. This policy mandates the use of mechanical lifts for every transfer, adhering to the recommendations of the lift manufacturer regarding staff numbers.

3. Investing in Permanent Lift Equipment: Ceiling-mounted lifts offer the highest level of safety for both patients and healthcare workers. These devices provide stability and ease of use. However, in older buildings where permanent installations are not feasible, portable lift equipment serves as a viable alternative. While not as convenient for horizontal moves, these units are effective for vertical transfers.

4. Utilizing Transfer Belts and Adjustable Beds: Transfer belts worn by patients help reduce the strain on caregivers during positioning and assisting movements. These belts should be adjustable, comfortable, and equipped with multiple handholds. Additionally, adjustable beds that align with the height of transferring surfaces greatly reduce the risk of back injuries for workers.

5. Incorporating Slider Sheets: Slider sheets are essential for reducing friction and facilitating the safe repositioning of patients on beds. Proper training in their use is vital to ensure safety and effectiveness.

6. Formation of Specialized Lift Teams: In scenarios where mechanical lifts are not feasible, the formation of specially trained lift teams is a viable solution. These teams, composed of personnel trained in team lifting techniques, should be the last resort due to the residual risks involved. The inclusion of appropriate lifting aids is recommended even in these scenarios.

7. Advantages and Commitment to Change: Implementing these lift policies not only creates a safer working environment but also offers tangible benefits for employers, such as reduced workers' compensation costs. Successful implementation requires commitment from all parties in the workplace, emphasizing the development and adherence to policies that minimize risks to both workers and patients.