October 5, 2009 - By Diane Rogers
As part of Stanford Hospital’s cutting-edge approach to patient transfers, nursing staff members, James Henrion (center) and Susan Hock-Hanson (right) demonstrate how one of the new lifts makes it easier to move someone from a bed to a chair.
Swaddled in a cushy green hammock, the patient began her ascent off the bed. While one nurse regulated the speed of the lifting device, two of his colleagues guided the patient toward a bedside chair. Within seconds, she was securely lowered onto a cushion, and ready to begin rehabilitation exercises.
There was no jiggling and jostling as the patient moved from bed to chair. No sliding or twisting that might tear fragile skin or aggravate pressure ulcers.
“It makes patients feel more comfortable when they see us using a machine to move them because we’re more confident,” said Joan Forte, interim director of nursing at Stanford Hospital & Clinics. “There’s no stress, no concern that they might fall or that moving them might cause some discomfort.”
What’s more, there’s much less risk that a nurse is going to get hurt.
In April, Stanford Hospital will be recognized by the Veterans Administration with the 2010 Best Practice Award for Safe Patient Handling. Forte also discussed the hospital’s success at the West Coast Safe Patient Handling conference at San Francisco’s Hilton Hotel, Sept. 29-30. A co-host of the conference, Stanford Hospital “is the first hospital of our size to put a program like this in place on the West Coast,” Forte noted.
With Ed Hall, senior director of risk management, and Carole Kulik, patient care manager of the cardiac care and surveillance unit, Forte told hundreds of hospital administrators and nurses why Stanford has invested $3 million in technology to better care for patients—and nurses.
That investment has included eight overhead lifts, 24 mobile lifts, one lift for bariatric-surgery patients and 26 air-powered transfer systems for moving patients from, say, a bed to an X-ray table. That investment also covers consultant partnerships and significant staff training..
The program may eventually pay for itself. Forte said the hospital stands to save in worker compensation claims and associated costs.
The need for patient-lifting equipment has grown in recent years. “What is happening nationally is that patients are getting older, sicker and heavier,” Forte said. “Nurses are also getting older, and that places a lot of strain on their backs. Data shows that nursing is second only to construction work in terms of risk for on-the-job injuries.”
American Nurse Today, the journal of the American Nurses Association, notes that the Bureau of Labor Statistics reports more than 200,000 patient-handling injuries every year among employees in nursing and personal care facilities. In a 2001 survey of some 5,000 nurses, 40 percent said they had been injured on the job, and 60 percent cited disabling back injuries as one of the culprits.
Forte likens the adoption of new lifting equipment to the sea change that occurred decades ago when nurses were required to wear gloves when handling body fluids, to protect themselves and patients from infectious diseases such as AIDS and hepatitis. Today, she said, nurses often have micro tears and injuries in their backs and shoulders that result from years of lifting patients.
“This puts us at great risk in even the simplest situations,” Forte said. “Now we understand that it can be the fragile, 100-pound elderly woman who can be the proverbial straw that breaks the nurse’s back.”
Like Forte, all of the hospital’s “super user” specialists in safe patient handling wear green ribbons on their ID badges that read HATS--Handle All Transfers Safely. The ribbon signifies that they have been trained on the lifting devices and can assist in transfers.
“It’s kind of crazy that nurses ever thought that lifting more than 50 pounds was OK,” super user and patient care manager Kulik said. “Airlines and FedEx have weight limits on what employees lift, and dragging a 300-pound person with a lift sheet is not ergonomically smart for me, or for the patient.”
In the D1 coronary care unit where Susan Hock-Hanson, RN, has been working the night shift for 10 years, her patients require “total care.” Intubated and unable to move themselves, they nevertheless must be turned and repositioned every two hours to prevent pressure ulcers, or bedsores.
“Family members are really excited when they see that we’re going to use the Golvo,” Hock-Hanson said, referring to a piece of lifting equipment made by the Swedish manufacturer Liko. “With the Golvo, one nurse can lift and turn a patient, and reposition his pillows.”
Super users Geoffrey Pridham, manager of nursing administration services, and James Henrion, assistant manager of nursing administration services, are on call to demonstrate the lifting equipment. They show nurses how to safely move patients of all ages, weights and conditions.
“Patients often think they’re stronger than they are,” Pridham said. “They could be 30 years old and in good shape, but because they’re on medications, they’re weakened, and they don’t have the muscle strength they think they do.”
Working in tandem, Pridham, Hock-Hanson and Henrion demonstrate the fine points of lifting patients with machines, while they coach nurses in the nuances of safe handling. “If a patient says he’s uncomfortable, you should stop, and then slow down the motion,” Henrion said, repositioning his finger on the remote-control device. “You always want it to be a steady move,” Pridham added.
The Veterans Administration and the American Nurses Association have asked Stanford to help design a template for other hospitals to use in adopting safe-handling equipment and practices. Forte said the hospital also will be doing its own research on both patient and staff safety. “We think the new equipment will help us get patients up and out of bed and mobilized far sooner. And that means becoming independent and going home sooner.”
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