Distribute exercise: Responding to Employee Resistance Regarding Use of SPH Equipment
Bariatric patients may fear falling and may be embarrassed by the number of persons needed to lift, move or support them for getting out of bed or toileting.
Texas was first state to pass law on SPH in 2005
Proper body mechanics doesn’t compensate for most patient’s weight. Patients don’t come in simple shapes with handles!!!
There is plenty of evidence that safe lifting programs work. The problem is people need to adhere to the maximum weight allowed, “35lbs for Health care workers. Many sites use this number. The mistake is to think that safe lifting can replace the equipment for weights above 35lbs. We are not going to a no-lift policy. Body mechanics proven invalid is also incorrect. Plenty of research in back injury prevention indicates good body mechanics, which is a key component to safe lifting, reduces injury rates.
Safe lifting and body mechanics for lifts below 35lbs and equipment always for weights
Video = 2.14
Video = 1.59 Sacking Unsafe Patient Lifts
Safe Patient Handling 2015 update march 2015
Lisa Affatato, MSN, RN-BC
Maureen Ibrahim MS, RN, CCRN, CEN
At the end of this class the learner will be able to :
• Define safe patient handling.
• List the benefits of safe patient
handling and mobility technology.
• Describe why manual handling of
patients causes injuries.
In 2004, Nelson & Baptiste stated:
• “Nursing can no longer afford the
“human sacrifice” approach to
patient handling defined as replacing
the steady stream of injured nurses
with newly recruited nurses.”
Crit Care Nurs Clin N Am 19 (2007) 213-222
Did You Know?
• 52% of RN’s complain of chronic back pain lasting >2
weeks within past 6 months
• 12% of RN’s have left profession due to back pain
• Nurses Aids & RN’s suffered highest prevalence 16.6%
of work-related back pain involving lost work days
• In 2005 Texas was first state to implement legislation
requiring HCF to implement SPH programs to protect
HCW’s from preventable injuries from manual patient
• 49% reduction in falls in one study R/T use of lifting
• The single greatest risk factor for
musculoskeletal disorders (MSD) in
Health Care Worker is manual
handling of patients (lifting,
repositioning, & transferring)!
• Risk of injury can be significantly
reduced or eliminated through use
of assistive devices and equipment.
Employee Resistance Regarding Use of SPH Equipment
Employee comments What would you say?
1. “I’ve been a healthcare worker for 25 years
and I’ve never injured my back yet. I don’t
see why I have to start doing things
*Back pain reoccurrence rate 90%
2. “I’m in good shape. I don’t need that fancy
equipment to do this.”
3. “This patient has already been through
quite a lot. I don’t want to burden him any
further. Let’s skip the lifter-you and I can
just lift him together.”
4. “I find it takes a lot longer to use this piece
of equipment even when it’s readily
5. “I don’t use that piece of equipment
enough to remember how exactly it works
so it’s easier to just do a manual lift.”
6. “I don’t have enough time to hunt for the
3/29/2016 Educational Enrichment Day 2015
Why Caregivers Get Hurt:
• Always lifting, moving & turning patients
which tires your muscles putting you at risk for
• Patients can’t be held close to body like a box
• Patients are bulky
• Patients don’t have handles
• Don’t always know if patient can help
• You can’t predict!!!
Risk- Load Increasing:
• OBESITY is a growing population
• In 1983 one in 200 people had a BMI > 40
• In 2000 one in 50 people had a BMI > 40
• In 2010 one third of all Americans
have a BMI > 40
• One study found < 10% of patient census was
bariatric patients & patient-handling injuries
accounted for 29.8% of staff-reported injuries
• 1995 study at one hospital
• Found nursing staff pulled patients up in their
bed an average of 9.9 times/shift.
Safe Patient Handling:
• Definition: Use of engineering controls, lifting
and transfer aids, or devices to perform acts of
lifting, transferring and repositioning patients
NYS Safe Patient Handling Act
NY SB 6914
• Public interest for Health Care Facility (HCF) to
implement safe patient handling policies
• Caregivers will reduce risk of injury
• Safe Patient Handling Workgroup to develop
policy & training materials; submit report by July
• Each HCF will have a SPH Committee by January
• Program must be implemented by January 1,
National Institute of Occupational
Safety & Health (NIOSH)
• Calculates maximum load for manual lifting,
pushing, pulling and carrying using a range of
• Maximum load for a box with handles is 51
pounds (23 kg.) – load is lower if lifter has to
reach, lift near the floor or undertake an
• 35 pounds (15 kg) safe patient-
lifting limit for HCW’s
Safe Patient Handling & Mobility:
• For lifts above the SPH limit, there is no such
thing as “Safe Lifting” using our bodies as the
• Body Mechanics – important, but again if load is
above the SPH limit, injuries will occur
• We must change our mindset!
• Get in habit of using Safe Patient Handling &
Mobility (SPHM) technology
• This will keep both our patients & ourselves safe
• Design of workplace or equipment
• Those factors or qualities in the design of
something, especially a workplace or equipment
used by people at work, that contribute to
comfort, efficiency, safety, and ease of use
• Greek word; Ergon = work, Nomos = Laws;
• “laws of work”
• Fit the task to the worker – not fitting the worker
to the task
Equipment available at
• Lift – Invacare (2 North), Prism
(Med/Surg) & Golvo (CCU/ICU)
–For Prism; reusable sling is blue,
disposable sling is white
–Slings are par leveled on every
• Transfer boards
Culture Change: Never Lift Alone
Benefits of SPH:
• Reduced injuries
• Less re-injury
• Pregnant/Older workers can work longer
• Reduced workman's compensation medical and
• Reduction of lost days worked
• Improved recruitment and retention
• Improved employee satisfaction
• Increased patient referrals; feel more dignified
transferring with use of equipment
Benefits of Safe Patient Handling
CAN IT DO
quality of care
What Should be Looked At:
• Is the patient dependent?
• Is the patient minimally to moderately dependent?
• Is the patient independent?
• Weight-bearing capability?
• Upper extremity strength?
• Level of cooperation and comprehension?
• Other conditions; stoma, fractures, severe edema or
• Equipment i.e. foley, oxygen mask, IV
Communication of Patient’s Mobility Status:
• After procedures
• Administration of medication or medication
• Have you worked with equipment elsewhere
that you think would be beneficial for us to
• Send suggestions to:
– Lisa Affatato RN, Nurse Manager, 2 Southwest
– Kevin M. Cerrone, DPT, MHA, MS, CSCS
Director Physical Therapy & Orthopedics
• Cadmus, E., Brigley, P. & Pearson, M. (2011). Safe patient handling:Is your
facility ready for a culture change? Nursing Management. Retrieved
• Fitzpatrick, M.A. (2014). Safe patient handling and mobility: A call to
action. Current Topics in Safe Patient Handling and Mobility.
• Gallagher, S. (2013). Implementation guide to the safe patient
handling and mobility interprofessional national standards. ANA:
Silver Springs, MD
• Garcia, A. Standards to protect nurses from handling and mobility injuries.
Current Topics in Safe Patient Handling and Mobility.
• Kumpar, D. (2014). Prepare to care for patients of size. Current Topics in Safe
Patient Handling and Mobility.
• Ryan, L. (2014). Safe patient handling leadership briefing. Greater New
York Hospital Association.
• Stenger, K., Montgomery, L.A. & Briesemeister, E. (2007). Creating a culture of
change through implementation of a safe patient handling program. Crit
Care Nurs Clin N Am 19 (2007) 213-222
• U.S. Bureau of Labor Statistics, U.S. Department of Labor.
• U.S. Bureau of Labor Statistics, U.S. Department of Labor.
• Zitkus, B.S. (2010). Obesity management workbook. Retrieved