HOME & COMMUNITY Policy No.: PM-3-260

HOME & COMMUNITY Policy No.: PM-3-260

SUPPORT SERVICES New: Dec. 2013 -©-OF GREY-BRUCE-©-

Page: 1 of 7

SECTION: PROGRAM MANUAL

TOPIC: DAY AWAY PROGRAM

POLICY TITLE: CLIENT LIFTS AND TRANSFERS

POLICY STATEMENT

The purpose of this policy is to ensure all staff considers proper body mechanics when assisting clients with lifts and transfers. This policy applies to all Adult Day Program staff. All client transfers will be provided in a safe and appropriate manner. Staff members are trained annually in the safe use of site specific mechanical lifts as well body mechanics. At a minimum each Adult Day Program is provided with a mechanical lift. Staff will use lift systems only with the assistance of a second staff member or trained volunteer. Any specific concerns regarding a client’s ambulation or need for assistance with transfers can be found documented in the client chart and in CIMS. All staff involved with the client’s care must be informed of the person’s condition and directed how to assist when necessary. Clients identified as being unable to weight bear or totally dependent will be transferred by means of lift equipment. Gait/transfer belts may be used where manual assistance is required for ambulation and transfer activities.

PROCEDURE

This procedure applies to all HCSS staff which provides personal care to clients, and outlines HCSS expectations with respect to client lifts, transfers and repositioning.

Definitions:

Lift: Procedure used to lift or carry the entire weight of a person.

Transfer: Procedure used to assist a person who can bear weight through one leg or both arms to move from one surface to another.

Reposition: Procedure used to move a client to a different position on same surface.

Risk Factor: Something that increases the likelihood of physical or mental harm to worker or client.

Hazard: Any real or potential condition that previously caused or could be expected to cause personal or property damage.

Repetition: Repeated movement of the body or body parts. Cycle time of less than 30 seconds, where the cycle time is the time it takes to do repetition.

Musculoskeletal Injuries or illness of muscles, tendons, ligaments, bursa, nerves, joints,

Injury: bones and supporting blood vessels in either upper or lower extremities or the back.

·  Team Leaders will provide initial and ongoing training on client lifts, transfers and repositioning as part of the orientation process and ongoing for employees including body mechanics, identifying hazards, reporting hazards, reporting injuries, reporting changes in client mobility and consequences of not following procedure.

·  Team Leaders and Programs Directors will ensure ongoing training is provided to staff on client lifts, transfers and repositioning.

·  Team Leaders and Programs Directors will educate employees on completing safety checks on equipment for client lifts, transfers and repositioning prior to use.

·  Team Leaders and Programs Directors will arrange and document client specific training with client and/or lift equipment.

·  Family and Client Care Coordinators will ensure that an appropriate initial and ongoing client mobility (lifts, transfers and repositioning) assessment has been conducted for ALL clients. This may occur as part of the intake process, or as part of the client’s RAI assessment, or at the request of the Team Leader. The assessment will include 4 major factors—the worker, the client, the equipment and the environment. Client mobility concerns will be included in client service plans.

·  All HCSS staff maintains the right to refuse to perform a client lift, transfer and repositioning task which is a violation of HCSS procedures.

·  Family and Client Care Coordinators will contact CCAC to inform them of the HCSS plan if risk is identified in relation to client lifts, transfers and repositioning.

·  Family and Client Care Coordinators will advocate for assessment by Occupational or Physical Therapist if:

o  It appears that equipment is required.

o  Training for employee is required or

o  There is ongoing evaluation of client safety i.e. equipment maintenance needed, danger to other clients or staff, etc.

·  HCSS staff will complete an Incident Report if there are any issues involving lifts, transfers and repositioning. (See Policy ADM 6-50)

·  HCSS Staff will inform the Team Leader if a risk situation related to client lifts, transfers and repositioning cannot be controlled safely and service for client will be affected.

·  HCSS Staff will participate in training and education on prevention of musculoskeletal injuries as required. Front Line Staff will participate in training on client lifts, transfers and repositioning as required as required for a specific client.

·  HCSS Staff will NOT lift non weight bearing clients without a mechanical lift.

·  HCSS Staff will not use a mechanical lift unless they have been trained to do so.

·  HCSS Staff will report to the Team Leader any situation where:

o  Client requires a transfer or lift that has not yet been addressed

o  The environment is non-conducive to using good body mechanics, i.e. small bathroom or bedroom.

o  The client is or can become uncooperative during client lifts, transfers and repositioning.

o  There is an indication of musculoskeletal strain by the worker

·  HCSS Staff will always do a safety check before using equipment they have been trained to use. If employee knows or suspects equipment to be defective, they must not use equipment and will report to the Team Leader. The equipment repaired or replaced before front line staff can use the equipment.

·  If HCSS staff at a Day Away Program encounter an emergency situation where the client’s needs have changed and the client needs to be lifted (i.e. If they have fallen) the staff must keep the client safe; work with the Team to identify appropriate and safe means to address the client’s needs (i.e. Personnel trained to complete two-person lift, or use of available mechanical lift), and acquire help from a paramedic or fire department as necessary.

GUIDELINES

The following guidelines detail the correct way to assist clients:

Proper Body Mechanics

·  the task is planned beforehand

·  assistants never strain themselves, they provide support and balance only

·  the assistant’s feet should be kept apart with one foot slightly ahead of the other

·  the correct grip is achieved with the assistant’s body as close as possible to the client’s body

·  the assistant uses the legs, while bending from the knees, not the waist

·  while assisting clients to stand, a slightly arched back is maintained while the head is kept up

·  the client is assisted to the standing position with one smooth, flowing motion

·  to turn the client, the feet are pivoted or shifted, rather than twisting the back

·  when assisting a client to sit, knees are bent and weight is shifted backwards

To assist with walking

·  Close contact with the client is used. If a gait belt is used, it fits snugly around the person’s waist with the buckle secure. The belt is held while supporting, walking with, or transferring the client

·  always stand on the clients’ weaker side

·  the clients balance is not interfered with while receiving the required amount of assistance

·  only provide assistance when necessary

Using Stairs

·  the client goes up first with the assistant behind

·  the stronger leg goes up first and steps to the middle of the step

·  the weaker leg follows along with the cane if applicable

·  cane is put in the middle of the step directly below the person

·  the weaker leg comes down the middle of the step, followed by the stronger leg.

Using walkers, canes or crutches

·  A cane is used on the client’s weaker side, and placed ahead of the person along with the weaker leg, followed by the stronger leg.

·  The back legs/wheels of a walker are aligned with the front of the person’s toes, then moved ahead. With all four walker legs/wheels stabilized, the weaker leg moves ahead, followed by the stronger leg. The client should walk in close to the walker. The walker should not be used for rising or sitting, unless additional assistance is provided.

To transfer out of a chair or wheelchair

·  first explain to the client how you are going to help

·  ensure the wheelchair wheels are locked

·  stand to the client’s side if assistance is needed

·  ask the client to wiggle to the edge of the seat, or assist if needed

·  legs are aligned with the front of the seat or chair with the stronger leg slightly behind the weaker leg creating a support base

·  the person shifts forward to shift the centre of mass over the support base

·  ask client to push on the arms of the chair/wheelchair to stand

·  If the client required more assistance, place your hand at the small of the back. Prompt the person to stand, and begin to shift your weight back to assist

·  As the person rises, straighten your legs and use them, not your back, to assist.

To pivot transfer to another chair or toilet

·  The client takes small steps until coming into contact with the front of the second chair with the back of the legs. The weaker leg is slightly forward.

·  The client is turned toward the stronger side to reach for the seat, then grasps the arms of the second chair and slowly lowers onto the seat.

·  If assistance is needed when lowering, have the client place his hands on the arms of the chair while you stand firm with one hand on the small of the back and one under the arm. The client is lowered slowly onto the seat as the assistant bends his or her knees.

Using the Sit to Stand Lift—two persons must be present

·  Position the standing sling around the clients torso, just below the shoulder blades and under the arms, making sure the clients arms are outside of the sling edge. Buckle the belt snugly.

·  Position the transport sling by pulling the thigh supports forward and attaching to the lower attachment points, above the kneepad. Attach the top part of the sling to each lift arm

·  Attach the sling to the lift from the outside, using the closest colour coded strap to the client that maintains stability and comfort. Use the same coloured strap on each side and the same attachment point.

·  have the client hold the handgrips and lean back into the sling.

·  make sure the client’s knees are secure against the knee pad when lifting

·  make sure feet are on the footplate

·  brakes are unlocked on the sling base for easy movement

·  make sure the lift legs are in maximum open position and the shift handle is locked in place.

·  the client should be elevated just enough to clear the surface with their weight fully supported by the lift

See instructions attached to lift or refer to operating manual for detailed instructions.

Using the Ceiling Track Lift—two persons must be present

·  position the sling, so that the bottom, is sitting at the base of the tailbone

·  Position the thigh straps according to client need and specific client training for use of the lift

·  use the handheld remote to lift the client and move to the desired location with the lift

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