Rehab patients gain from safe lifts

Improve functional independence

Safe patient handling has been a hallmark of employee health. But perhaps it should also be a rallying point for patient safety advocates.

When it is easier to get patients out of bed, their rehabilitation improves, says Margaret Arnold, PT, CEES, coordinator of rehabilitative services at Bay Regional Medical Center in Bay City, MI.

A recent study of 94 stroke patients at Bay Regional provides evidence of that. Patients who received their rehabilitation while therapists and caregivers used safe patient handling equipment and protocols had overall higher functional independence measure ratings compared with patients who were treated before the medical center adopted a comprehensive safe patient handling program.1

"Some [physical therapists] said using the equipment was going to make patients more dependent, but ... the patients with strokes did slightly better using the equipment," Arnold says. At the same time, employee injuries declined by almost 80% hospital-wide. Before implementing safe patient handling, Bay Regional had about 80 or 90 injuries related to patient handling each year. In the eight months of 2011, there were just 10.

Unpublished data also show a reduction in pressure ulcers when there is a safe patient handling program, says Stephanie Radawiec, PT, DPT, MHS, MBA, a clinical consultant with Diligent, an equipment manufacturer based in Addison, IL. That is an increasingly important outcome for hospitals because pressure ulcers are a "never event" that isn't covered by Medicare, she says.

'One of the myths'

Still, convincing physical therapists and others in rehab care to use safe lifting equipment can be a challenge. "It's surprising how much resistance there is to the change," says Arnold.

Often, the therapists are concerned that patients will become too dependent on lift equipment, Radawiec says. "[That] is one of the myths we work with," she says.

Some physical therapists don't realize the wide range of equipment that is available, including lifts that can help partially dependent patients ambulate, such as a sit-to-stand lift. Meanwhile, as patients are heavier, they need for lift assistance is even greater. For example, ceiling lifts with ambulation slings can be used to protect patients from falling.

"Once the staff member understands what the equipment can do for them a light goes on. They get it," she says.

Bay Regional has focused on education to promote safe patient handling and works to make therapists comfortable with the equipment, says Arnold. Safe patient handling coaches are available on every shift in every unit to help employees and encourage them to use the equipment.

The safe patient handling committee meets monthly to review progress. If someone is injured during patient handling, the committee conducts a root cause analysis to determine whether changes are needed.

Meanwhile, Arnold emphasizes the benefits to patients when she talks to her colleagues. Working with a sore back will make it even more difficult to help patients in their rehabilitation, she tells them. "If we're not at our best, we can't give our patients our best," she says.

Senior administrators are supportive. In fact, they often ask employees about the lift equipment when they conduct rounds, says Arnold. "They will ask staff, 'Show me how to use this piece of equipment,' and 'Which patients are you using this with?'" says Arnold. "It really lets the staff know this is an important issue."

Reference

1. Arnold M, Radawiec S, Campo M, and Wright LR. Changes in functional independence measure ratings associated with a safe patient handling and movement program. Rehabil Nurs 2011; 36:138-144.