SOUTH WEST HEALTHCARE CLINICAL POLICY AND PROCEDURE PATIENT MANUAL HANDLING ‘NO LIFT’ POLICY 2016

Document Name: / MANUAL HANDLING PROCEDURES: NO LIFT /
Prepared by: / Manual Handling Working Party
Authorised by: / Issued: / 7/02 11/07
11/11 3/12, / Due for review:
Restrictions: / Review No: / 5 / Risk rating: / H
Description
Objective: / The South West Healthcare (SWH) Manual handling no liftprocedures provides for a safer approach to patient/client handling whereby the manual lifting of patients/clients is eliminated or minimised wherever possible.
To provide a safe work environment for employees of South West Healthcare through:
  • identification of, and risk management of unsafe or dangerous manual handling tasks,
  • education and training of staff in the correct use of equipment,
  • and for healthcare professionals that patient assessment is performed accurately to identify the needs re manual handling of patients, within the community and clinical environments.

Contents
/ This policy contains the following information
Topic / See Page
definitions, objective, / 1
Roles and Responsibilities, / 2
Compliance / 2
Risk management and identification
Equipment
Equipment maintenance
Appendix: Safe Working Procedures
  1. Moving Patient’s on Equipment with Castors
  2. Moving a patient using a mechanical hoist with castors
  3. Moving a patient using a ceiling hoist
  4. Moving a patient using slide sheets
  5. Moving a patient off the floor

Appendix 5: O’Shea Patient Risk Control Form / 20
ROLES &/ RESPONSIBILITIES
No Lift Co-ordinator
/ The role of the No Lift Co-ordinator is to:
  • Plan and coordinate the education and training of safe manual handling programs within South West Healthcare, and evaluate program outcomes.
  • Identify learning needs for staff and volunteers and provide annual education/refresher programs;
  • Monitor staff compliance with manual handling policies and procedures;
  • Participate in all OH&Sand risk management programs and activities involving manual handling;
  • Function as a resource person and provide consultation and problem solving assistance with Department Managers and Supervisors;
  • Provide advice to Wards and Departments regarding appropriate manual handling equipment and co-ordinate clinical education sessions regarding new manual handling equipment, products and techniques introduced.
  • Participate in consultative working parties;
  • Initiate the development of safe manual handling policies and procedures and ensure that they are relevant and up-to-date.
  • To liaise with Biomedical Engineering and Supply to ensure all manual handling equipment purchased has been through an extensive trial; there is a standardization of preferred equipment and a database records equipment and ongoing project management requirements.
  • responsible for monitoring, auditing and surveillance of staff manual handling injuries; data collection and data analysis, risk identification and risk mitigation early and preventing risk to staff.

Employees: / All employees have a responsibility and duty to:
  • Adhere to the manual handling policy and safe working practices
  • Participate in hazard identification, risk assessment and control when requested;
  • Comply withany information, training and instruction received;
  • Use equipment provided for manual handling tasks;
  • Report any hazards, faulty equipment and or any injuries; and
  • Perform day to day care of equipment provided for manual handling.

COMPLIANCE
Checks and Audits / Random checks may be carried out by the No Lift Co-ordinator to ensure compliance with policy and documented risk assessments.
Reporting of accidents, incidents and near misses: / All adverse events, including, related to manual handling to be reported using the Riskman electronic database, or associated hard copy incident forms.
Any occurrence of an injury or ailments possibly associated with manual handling should be reported and investigated by the manager of the department in consultation with the Safety and Security Manager and the Employee Health and Wellbeing Manager. It is also important to record the number of days / hours absent from work if the person affected is a member of staff.
RISK
Manual Handling Risk Assessment: Patients
/ Risk assessment of manual handling tasks must always be based on what is safest for the nurse, most appropriate for the patient, and most suitable for the environment in which the care is being provided by:
Assessment of the manual handling needs of the patient should[JS1] be carried out by the person involved in the care of that patient, in conjunction with a physiotherapist when necessary, to ensure that staff are not placed at unacceptable risk.
The manual handling needs of the patients should be assessed and documented prior to admission or, as soon as possible after admission, as well as continuous assessments thought-out admission. This assessment should include risk factors to the staff member including:
Step / Action
1 / Formal patient risk assessment on admission, including ability to assist
  • Cognitive signs i.e. confusion, dementia
  • Physical signs i.e. impairments, weight (BMI)
  • Behavioral signs i.e. aggression
  • Clinical constraints i.e. medications, drainage products.
  • persons previous history of falls
  • assist in their own transfers by being able tomanoeuvre their own weight, weight bear, stand with or without a gait aide
Physical environment:
  • Furniture i.e. beds, chairs
  • Space i.e. single/double/4 bedroom/bathrooms
  • Equipment i.e. hoists, mobility aids, medical equipment.
Work practices:
  • Training i.e. manual handling, using aids
  • Adequate staff numbers i.e. minimum 2 staff for hoists, 4 staff for bariatric patients
  • Work hours i.e. end of shifts, working multiple days/nights.

2 / Any change to a patient’s condition or environment that may result in added risk factors will require further assessment of patient’s ability to assist with manual handling tasks
3 / Planned interventions and equipment needs are documented in:
  • care plans,
  • patient’s progress notes and
  • Risk assessment forms.
  • On communication boards in patient’s room

Other factors to consider
4 / Continual handling of patients: Daily work includes long periods of various manual handling tasks – for 30 minutes at a time or 2 hours total per shift.
5 / Patient behavioural or cognitive variables; are resistive, unpredictable, uncooperative
6 / Patient physical variables or constraints; e.g. obese, frail, rigid, contractures, fatigue
7 / Clinical constraints or contraindications; e.g. pain, unable to lay flat, IV lines, drainage bags, intubations, frames.
IDENTIFYING RISKS IN THE WORKPLACE
/ The following is a guide forstaff to assess factors that contribute to hazardous manual handling tasks that must be controlled as far as is reasonably practicable.
RISK FACTOR
/ WHAT TO LOOK FOR
Awkward postures
/ Prolonged or repeated postures e.g. bending forward or sideways, twisting, working at or below knee level.
Exerting high force
/ Staff find the effort difficult e.g. holding, restraining, pushing, fast forceful movements or with loads not equal for both sides of the body.
Reaching
/ Reaching away from the body of over shoulder height for long periods or while exerting force.
Poor environment design
/ Limited space and access to working areas, equipment not easily movable, narrow doorways, clutter, carpets, ramps or changes of level at lifts, slippery floors, poor lighting.
Inappropriate furniture and fittings
/ Wind-up or manual adjust beds, low baths, low patient bedside chairs, and no grab rails in bathrooms, toilets or corridors.
Inadequate or insufficient patient handling aids
/ Inadequate numbers, not readily accessible, poorly designed, not maintained.
Staffing
Factors
/ Inadequate staff numbers for safe handling, staff inexperienced, inadequately trained, unfamiliar with patients, and working long hours.

RISK ASSESSMENT

FORMS SWH

O’Shea Patient risk assessment form

Bariatric Rapid impact risk assessment

CURRENT EQUIPMENT USED IN PATIENT CARE
/ Proper use of equipment to assist in completing manual handling tasks should be used, at all times to minimise or eliminate staff injury and protect the patient. The following equipment is currently available throughout South West Healthcare: -
Bed mechanics / All electric beds have controls to raise or lower the bed to a safe working height, allow the back rest to be raised to assist patient out of bed as well as slightly tilt bedhead down when moving patient up the bed on slide sheets
Slide Sheets / Are used to move and reposition patient/residents for on bed tasks. Two slide sheets may be used, depending on the patients’ ability to assist.
NB Continence sheets (pinkies) are not to be used as slide sheets. This constitutes non-compliance & disciplinary action will be taken.
Foot/Leg Lifters / Can be used by the patient to assist the staff member in transferring their legs onto the bed. Often used in conjunction with a slide sheet.
Linen Bag Supports / Are a detachable support used on linen skips to prevent overfilling, ensuring easier removal of the bag from the skip.
Monkey Bars/Tiger Tails/Bed sticks / May be used by the patient to assist them to sit up in bed or to the side of the bed.
Turning Sheets / Used to assist in turning patients >100kgs as these can be used with mechanical devices.
Electric wheelchairs / Two electric wheelchairs with attendant driver controls are now available, 1 is regular, size safe working limit -(SWL) 225kg, the second is a larger wheelchair – (SWL) 290kgs
Recliner or tub chairs / Most recliner or ‘tub’ chairs have casters or wheels, which allows the patient to be maneuvered safely in their environment. At least 2 staff will work together to gain momentum of the chair and upon movement, one staff member will walk besides the chair to assist in direction while the other staff member continues pushing.
Sling Hoists
Jordan Frame
Stand Transfer Hoists
Overhead Tracking / The following safety measures must be adhered to when using hoists to move patients: -
  • 2 nurses must be in attendance, one to maneuver the hoist, the other nurse to guide the patient
  • Only use slings that are recommended by the manufacturer.

  • Operators of the equipment must know the weight capacity and the emergency release device.
  • Note hoists are not for the transport of patients from one area to another, only for the transfer of patient from bed to chair, bed to trolley, chair to bed etc.
  • Disposable slings are available and are for use with the Voyager Overhead Tracking. The slings are for single patient use only and are to be discarded if they become damp/wet. Available from Infection control Co-Ordinator
Day slings are available for the Jumbuck Hoist, and can be left under the patient whilst sitting in a chair, as they are made of soft material to eliminate patient discomfort and occurrence of pressure areas.
STAMINA LIFT BED MOVER / The Stamina Lift bed mover via a motorized unit that allows one person to effortlessly move heavy beds, with or without a patient. The Stamina Lift bed mover should be used, with all bed transfers to eliminate or reduce staff injury.
Staff are to undertake training & show competence with safe operational use before using the Stamina Lift

Air-Assisted

Patient Transfersystems / The Air Matts/ Hover Matts are a lateral patient transfer system consisting of an air supply, air hose, air mattress, protective sheet, a bridge and carrying bag. They are a unique, ergonomically designed devices with small laser cut holes in the bottom which allows air to continually flow through the bottom of the mattress.
EQUIPMENT AND MAINTENANCE PROGRAM
COMMUNITY
EQUIPMENT
CHECKLIST
Cleaning of Slings / The organisation’s equipment needs will be assessed and equipment purchased to ensure staff are able to carry out the appropriate patient handling techniques by the Safety and Security Manager and No Lift Co-Ordinator. All patient handling equipment such as beds, trolleys, wheelchairs, hygiene chairs and mechanical hoists should be regularly maintained.
Staff are responsible for reporting the following to the Engineering Department: -
•Equipment failure or breakage.
•Equipment requiring urgent maintenance.
•Tagging of equipment for repair stating ward, date, time and what problems exist with the equipment.
Staff are responsible for reporting maintenance requisitions of any damaged equipment or equipment failure to their Manager and the Engineering Department (MAPPs 5.04) Maintenance tags should be used for any requisitions, filled out correctly including equipment type, serial or i.d. number, date, time, location and a brief description of problem.
In the community, it is the client’s responsibility to maintain their equipment unless they have a Case manager who will take responsibility for this.
Staff are responsible for tagging and documenting in regard to:
  • Equipment failure or breakage
  • Equipment requiring urgent maintenance
  • Equipment for repair.
If the equipment is supplied from an external program, staff are to contact that source for repair.
STEP / ACTION
1 / Examine for damage/fraying to sling, straps and clips.
2 / Visually check exposed surfaces for damage or sharp edges, especially where contact is made by either patient or staff
3 / Visually check sling attachment points
4 / Make sure all labels are attached e.g. safe working load
5 / Check to make sure the handgrips are secure
6 / Check that the lifter functions through it’s full range
7 / Visually check the handset and cable for damage
8 / Check operation of the Stop/Reset, system lower override device
9 / Check batteries for leakage and/or deterioration
10 / Make sure all fixings, screws, nuts are secure/tight
11 / Check all castor wheels for wear
12 / Check all covers fit correctly and are not damaged
13 / Check for evidence of corrosion to metal parts
Slings should be regularly laundered by Linen Services, not on the Ward or clinical area.

OPERATING

THEATREAll patient equipment e.g. patient trolleys, operating tables and slide sheets, should be regularly checked and maintained as part of the weekly staff clean up.

Staff are responsible for reporting damaged slide sheets and regular audits wil determine the need to purchase additional sheets.

All patients should have an appropriate slide sheet underneath them before being transferred from one position to another.

A minimum of three handlers are necessary to transfer patients, however more may be required.

CARDIAC ARREST/COLLAPSE

In the event where a patient collapses / arrests whilst sitting out of bed, the nurse to call for help, and commence CPR. When help arrives, lower patient to the floor and continue with resuscitation. Patient will be returned to bed when resuscitation is finished, and equipment is available to safely carry out this procedure.

Outcome Statement

/
  • Compliance with Occupational Health & Safety Legislation.
  • Improved patient care through continuous identification and risk assessment of new and potential hazards and the implementation of appropriate controls.
  • Reduction in staff injuries related to manual handling tasks evidenced by reduced Workcover claims and decrease in the number of reported staff incidents.
  • Ongoing commitment to upgrade and maintain equipment.
• All staff are competent Basic manual handling policies and procedures, Nursing in No Lift System, Allie health Professionals in Smart move techniques.

KEY DOCUMENTS

Safe Working Procedures

  • Occupational Health and Safety Act 2004,
  • Occupational Health and Safety Regulation 2007, and the
  • National Standard & National Code of Practice for Manual Handling 2005 (1990).
  • Manual handling risk, Assessing and controlling (PDF 234kb) Work safe Victoria
  • BARIATRIC PATIENTS - CARE OF

AIR ASSISTED PATIENT TRANSFER SYSTEMS

Smart Moves:Allied hEALTH

References

/ Cobden District Health Service: Safe Working Procedures
Code of practice, Manual Handling (No. 25, 2000).
Lyndoch Living: Safe Working Practices
Manual Handling Regulations 1999
Norwich Trust NHS Manual Handling policy August 2005
O’Shea, L. “No Lift” System of Manual Handling.
Occupational Health & Safety – Manual Handling Code of Practice 2000
OccupationalHealthSafetyAct (2004)
Workcover NSW (2005) ‘Manual Handling for Nurses’.
Worksafe Victoria (2009) Transferring People Safely.

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[JS1]For consistency of language is it patient, client or person/