Seeing the Forest for the Trees

One of the numerous occupational health mailing lists that I subscribe to has a discussion going on about dealing with the implementation of Safe Patient Handling protocols within facilities. The discussion was started with a search for patient transfer devices to help reduce friction to help make patient transfers easier. The problem becomes that as some people focus on the use of machines, such as lifts, to help reduce the incidence of lower back injuries among medical personnel (don't get me wrong, this is incredibly important, we've lost track of the people performing the jobs.

Number one, as shown by the fact that a representative for a health care facility is seeking sources for devices to decrease friction during transfers, there is still a physical demand to performing patient transfers even when using an assistive device. You still need to be able to get the harness for the lift underneath the patient. Even in the video for the Sandel Z-Slider, there is still a need to be able to manipulate the patient to get the Z-Slider film underneath - but once you have it underneath, it does an amazing job of reducing the required forces.

Number two, the patients still need to be moved around the facility. In health care facilities that we have performed on-site assessments for the purpose of post-offer pre-employment testing and functional capacity evaluations, an initiation force for pulling or pushing of 60 pounds is required to move a hospital bed with a patient. This force can be as great as 80 pounds or more when transitting ramps that connect uneven floors between buildings. One commenter on the above mentioned thread talked about using powered gurneys that can transition among many different uses in order to not require a person to be able to physically push the patient from area to area.

Number three, in the event of unforeseen circumstances that requires large numbers of patients to be moved quickly from one area of a facility to another there may not be enough devices and/or time to permit "Safe Patient Handling" to be performed within the time constraints of the situation. This is not to say that proper biomechanics shouldn't be used in these situations.

So where does that bring us? All attempts should be made to make "Safe Patient Handling" a part of all facilities. But, we need to make sure we still see the forest for the trees. We need to take a look at the individuals that are hired. Are they strong enough to facilitate the placement of harnesses and/or other devices that are used in safe patient handling? Do they have the physical strength to push/pull hospital beds that require 60 pounds of initiation force on a frequent basis? Does the facility provide high quality training in proper lifting techniques to their employees? Are proper lifting techniques emphasized routinely through the year whether through routine assessment or refresher training?

If your facility is not answering yes to these questions, give Biokinetics a call at (732) 741-5085 so that we can help you with this process.