Department Focus: Quality--Safe Travels

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As the population ages—and gets heavier—lifting patients is becoming more hazardous for caregivers and patients alike. Some hospitals have developed a straightforward solution: Don't do it.

When you're in charge of quality and patient safety, it's easy to get caught up in infection control, medical reconciliation, and patient satisfaction scores. But when you're thinking about providing quality healthcare to patients, you also must think about the care of your employees.

America's nursing population is aging, and as patients get larger and sicker, there's more of a risk of injury to both patients and employees, says Mary Godwin, RN, MSN, program manager, training and development, employee health and infection control for Alamance Regional Medical Center in Burlington, NC.

Employees can injure their shoulders and backs when moving and lifting patients, and patients often report sore joints or torn skin as a result of being moved by staff members. If an employee with an injury is moving and lifting patients, there's an increased chance that the patient will be dropped or fall during transport.

"We're seeing a patient now that we've never seen before. They're older. They're living longer, and they're living with more health problems," Godwin says. "They may be large, and with so many comorbidity factors, it's a challenge for patients, families, and healthcare providers."

That's why 238-licensed-bed Alamance Regional developed the Safe Patient Handling and Moving Program more than three years ago. The program teaches caregivers the importance of using mechanical lifts to assist them in moving patients to a chair, a bed, or the restroom—regardless of their size.

"We should never be lifting patients is our philosophy," Godwin says. "Even though that patient may weigh only 100 pounds, if we lift a patient, we can harm the patient." That perspective is a significant change from what many of today's nurses were taught in nursing school, she says.

"Historically, you were always taught about body mechanics—knees bent, back straight when you lift a box," says Godwin. "But patients are not boxes. When you pick a patient up they're limp, they move, and their weight is not equally distributed."

Body mechanics can't always prevent an injury, but during the past three years, Alamance's program has led to a significant reduction in the number of employee injuries, Godwin says.

Highland Hospital, a 261-staffed-bed affiliate of the University of Rochester (NY) Medical Center, has seen similar results since implementing a no-lift policy last year, says Karen DesJardin, RN, assistant manager for perioperative services and chair of the hospital's safe patient handling committee.

"About a year ago we had a staff nurse who developed a no-lift protocol for her unit," DesJardin says. "We saw great results … and thought there was no reason not to implement this throughout the hospital."

Since instituting the no-lift policy, DesJardin says the hospital has seen fewer injuries to both patients and staff members in that unit, and because the process is easier on both employees and patients, patients are actually moved more often, which goes a long way toward preventing pressure ulcers—one of those "never events" that the Centers for Medicare & Medicaid Services won't pay for after Oct. 1 of this year.

"If staff members aren't using the proper lifting equipment, there's always a chance for injury to patients, so this is an added plus for them," she says. "And when staffs feel comfortable moving somebody, patients are going to get moved more frequently."

If your hospital doesn't yet have a safe lifting policy, Godwin says today's healthcare climate will soon require it.

"All hospitals will have to have it—not just for the patient that is larger—but for the sheer fact that healthcare providers are older," she says. "We need to protect nurses, orderlies, and physical therapists. Part of that is keeping them from having to lift heavy loads."

—Maureen Larkin

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