Download Attachment EP30f, Safe Patient Handling

EP30f, Safe Patient Handling.pdf
University of California Irvine HealthCare
Policy and Procedure Manual
SAFE PATIENT HANDLING
PATIENT CARE RELATED
Date Written: 08/07
Date Reviewed/Revised: 04/08
Page No. 1 of 5
I.
PURPOSE
To provide an environment of safe patient handling which promotes the well-being of our
patients by decreasing risk for skin breakdown, risk of falls, and complications of
immobility, while maintaining a safe work environment for the patient care provider. .
II.
BACKGROUND
Immobility can be caused by illness or injury which may result in a number of
complications and prolong hospitalization or result in further medical complications and
debilitation. Progressive mobility incorporates a plan to mobilize a patient, starting at
repositioning and regular turning schedules for bedrest patients, up to independent
ambulation. These activities are essential to the total well-being of the patient.
However, in the implementation of progressive mobility activities the possibility of
unintentional harm to the patient or healthcare provider exists. These risks may be
minimized through the use of safe patient handling techniques and tools.
The Medical Center’s goal is to create a culture of safety for all patient care staff, through
the services of a Lift Team and appropriate utilization of lift and transfer equipment,
thereby creating a safer environment for the patient.
III.
POLICY
Safe patient handling techniques will be utilized for all patient lifts, transfers, and
repositioning.
Nursing care staff (RN/SHA) are responsible for implementing routine Q2 hour turning
and repositioning of all patients who are unable to perform these tasks independently.
MaxiSlides (non-friction surface sheets) will be utilized by nursing staff for all repositioning and turning of patients who require assistance to prevent skin breakdown due
to shearing forces, to promote patient comfort, and to decrease risk of injury to the care
provider. Drawsheets will not be used for the transfer and repositioning of patients.
Transfer tubes or MaxiSlides will be used by all nursing staff in the transfer of patients
who require assistance between bed surfaces (guerney, OR tables, bed).
Patient care staff will utilize mechanical lift equipment and transfer devices for all
transfers or lifts requiring any assistance, except in the event of an emergency. (Please
see “Service Plan for Safe Patient Handling and Movement”, to determine most
appropriate equipment to use).
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The Acute Rehabilitation Unit and Physical Medicine & Rehabilitation staff will utilize
lift and transfer equipment as appropriate to their patients’ individual needs as the goal of
this service is to promote the return of the patient to a community level of care, which
may not include the use of assistive devices.
The Lift Team shall be called for the transfer or lift of the non-complex patient whenever
the safety of the patient or healthcare provider is at risk should their assistance not be
utilized
The Lift Team shall be called whenever possible for the transfer and lift of all complex
patients, i.e. multiple lines, traction, ventilators, or bariatric patients.
The Lift Team utilizes the SBAR hand-off (see “SBAR Lift Team Report”) with the
oncoming shift to promote continuity of service to patients identified as requiring lift
services.
The Lift Team shall make routine rounds on each patient care unit at least twice a shift,
for updates on specific patient needs for assistance.
The Lift Team is available for staff education and training in the appropriate use of lift
equipment and transfer devices..
IV.
PROCEDURES
A.
B.
C.
D.
E.
Upon admission, and with each change in status, the RN will assess patient for
level of assistance necessary for patient handling during lifts, turns, and
repositioning.
Re- assessment should be completed by the RN prior to each lift, turn, or
repositioning task if the patient has varying levels of ability to assist due to medical
reasons, fatigue, medications, etc. When in doubt, the nurse will assume the patient
cannot assist with the patient movement and requires full assistance.
Nurse communicates with the Lift Team members during routine rounds to identify
patients requiring left team assistance for scheduled or planned transfers or patient
movement.
Nurse calls the Lift Team for urgent or unplanned patient transfers or lifts, via the
group paging system for assistance with patients requiring full assistance or
complex lifts..
The Lift Team determines the lift/transfer needs for the patient in conjunction with
nursing staff to determine the safest mode of transfer (See “Service Plan for Safe
Patient Handling and Movement”). The Lift Team members will always utilize
assistive devices or lift equipment for patient handling, except in the case of an
emergency.
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F.
G.
H.
I.
V.
The unit nursing staff (Registered Nurse or Hospital Assistant) shall remain with
the lift team until completion of the patient movement task to provide patient
specific information pertinent to patient handling.
Lift Team members perform hand hygiene and appropriate infection control
practices prior to, during, and after all patient contact, including equipment
disinfection.
Lift Team, in collaboration with the patient care provider, shall perform lift or
patient movement utilizing safe patient handling practices and good body
mechanics.
Lift Team activity is documented and maintained in the Lift Call binder, stored in
the Lift Team office.
REFERENCES
American Nurses Association (2003). Position statement on Elimination of Manual
Patient Handling to Prevent Work-Related Musculoskeletal Disorders.
http://www.nursingworld.org/readroom/position/workplac/pathand.pdf
Standards of Care: Progressive Mobility Protocol
Author:
Terri Donly, RN
Carlos Torres, LVN
Jennifer Bailey, PT
Approvals:
Nursing Standards Committee
Nursing Leadership
Policy Review Committee
Performance Improvement Committee
Med Exec Committee
Governing Body
04/2008
07/2008
08/19/2008
October 8, 2008
October 20, 2008
October 20, 2008
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UC Irvine Medical Center
Lift Team
Service Plan for Safe Patient Handling and Movement
Date/Time:__________________ Nursing Unit/Room No:________ RN:_______________ Assessed
by:_______________
I. Diagnosis:_________________________ Isolation: No_____ Yes_____ Type:__________________
II. Weight:___________
Height:____________
III. Weight Bearing Capability: Full_______ Partial_______ No_______
IV. Upper Extremity Strength: Yes______ No______
V. Patient’s Level of Comprehension and Cooperation:
_____Cooperative (able to follow simple commands)
_____Unpredictable (frequent behavior changes, restraints)
VI. Conditions that may affect transfer / repositioning (Check all that apply)
_____Respiratory compromise
_____History of falls
_____Postural hypotension
_____Severe Osteoporosis
_____Severe edema
_____Fractures
_____Paralysis/paresis
_____Urinary / fecal stoma
_____Amputation
_____Severe pain
_____Splints / traction
_____Tubes (IV, chest, gastric, etc.)
_____Contractures/spasm
_____Incontinence
_____Unstable spine
_____Wounds affecting transfer / repositioning
_____Hip / knee replacement
_____Fragile skin / decubitus ulcer
VII. Service Plan (Circle all that apply)
Patient Profile
Patient requires assistance to move up in bed or turning or
lateral transfers or pt with decubitus ulcer.
Patient requires assistance to move up in bed or turning or
lateral transfers or pt with decubitus ulcer (Heavy weight-over
300 lbs).
Patient weighs less than 265 lbs & able to pull self into
standing position.
Patient able to bear weight on at least one leg, & able to
follow simple instructions, & able to grip with at least one
hand or a 2nd staff member able to assist, and able to undergo
moderate pressure to the mid or lower back.
Patient can undergo a semi-inclined position
Patient ABCs normal, not able to bear weight or pull self into
sitting position.
Task
Transfer to & from: Bed to
bed or bed to gurney,
cardiac chair, exam table.
Transfer to & from: Bed to
bed or bed to gurney,
cardiac chair, exam table.
Transfer to & from: Bed to
chair, wheelchair, toilet or
shower.
Transfer to & from: Bed to
chair, wheelchair or toilet.
Transfer to & from: Bed to
wheelchair, gurney,
cardiac chair, exam table.
Transfer up from floor to
bed, chair, wheelchair,
gurney.
Lift
Device/Equipment
Maxi Slides/tubes
Hover Matt
Stedy
Sara Plus (pt wt less
than 420 lbs)
Sara 3000 (pt wt less
than 440 lbs)
Maxi Move (pt wt less
than 500 lbs)
Tenor (pt wt 501 - 704
lbs)
Maxi Move (pt wt less
than 500 lbs)
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SBAR Lift Team Report
Report
Shift:
Report
Shift:
S
B
A
R
given by: __________________
Date: ______________Time: ______________
____________
received by: _________________
____________
Situation:
Patient Nursing Unit/Room No: ______________________
Male
Female
Gender:
Diagnosis: _______________________________________
Nurse: ________________________________________
Yes
No
Infection Control/ Isolation:
Contact
Droplet
Airborne
Isolation Types:
Background:
None
Latex
Other
Allergies:
Full
DNR
Code status:
Language:____________________________
Developmental issues:___________________________
Assessment:
Yes
No
Type:
Restraints:
___________________________
Mental Status:
Alert and oriented x4
Cooperative
Unpredictable
Cardiopulmonary Status:
IV
Oxygen
Pulse Ox
Telemetry
SCD
Trache
GI/GU Status:
NG
GT
JT
Tubes:
Foley
Fecal stoma
Drains:
Musculoskeletal status: ______________________________
Arm & leg strength
Motor & function coordination
Activity:
Recommendation:
Equipment needs:
Hover Matt
Maxi Move
Maxi Slide/transfer tubes
Sara Plus/Encore
Sara 3000
Stedy
Tenor
Trixie
Service plan for continuing safe patient handling and movement
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
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