Anne McMahon Waitemata District Health Board Anne.McMahon@waitematadhb.govt.nz (P21, Thursday 27, Civic Room 1, 10.30)

1. HOW WAS IT FOR YOU?
The patient experience
Anne McMahon
Mark Cranswick
Waitemata District Health Board
Auckland, New Zealand

3. “Hoisting is not inherently undignified,
let alone inherently inhuman or
degrading ... hoisting can facilitate
dignity, comfort, safety and
independence. It all depends on the
context”.
Justice Munby 2003
High Court of England & Wales (cited in Alexander 2009)

4. Occupational Therapy – Code of Ethics
Occupational Therapists have the
responsibility always
to promote and protect
the dignity, privacy, autonomy and safety
of all people with whom
they come in contact
in their professional practice

5. Code of Professional Conduct for Nurses
Values Statement 1:
“3. Respect - for individual needs,
beliefs and values includes culturally
informed and appropriate care, and
the provision of as much comfort,
dignity, privacy and alleviation of
pain and anxiety as possible.”

6. Pain has become the 5th vital sign,
after pulse, respiration, blood
pressure, and temperature
Emotional distress (including anxiety)
should be considered as the 6th vital
sign

7. Risk indicators LBP-SL 12/12
N=2164 working nurses and midwives
Risk indicators LBP-SL 12/12
Fear of movement
Passive coping
Frequent manual handling
Severe or radiating pain
Anna Dawson - PAIN 2011

8. Objective
To explore the views of patients whose
involvement in a hospital setting is
facilitated by either
slide sheets or hoist and sling

9. Themes We Studied
Anxiety and fear Satisfaction
Feeling safe Being informed
Feeling Exposed Timely
Dignity Respect

10. Phenomenology
Phenomenological approaches are
based in a paradigm of personal
knowledge and subjectivity and
emphasise the importance of personal
perspective and interpretation

11. Demographics
N= 65
Female 40
Male 25
Mean age 74.7 years
Range 19-94 years
Mean age Female 79.6 years
Mean age Male 66.2 years

12. Methodology
Slide sheets 33
Hoist 32

13. BMI
Underweight 7%
Healthy 33%
Overweight 23%
Obese 37%

15. Hoist
Informed and involved 100%
Feeling safe 93%
Maintaining dignity 93%
Satisfaction 93%
Timeliness 93%
Respect 86%
Not exposed 80%
Not anxious 73%

16. Themes
Exposure / Dignity / Respect
There was a lack of privacy – I likened it to having a
baby (89 yr female)
I felt it was my decision. I felt I could say yes or no if
necessary (26yr male)
I felt uncovered but just so happy to get into the chair
to see outside the room. A good feeling (72 yr female)
I had 2 female nurses and I felt I needed more
protection, it was uncomfortable. Best to have
underwear on beforehand (62yr male)

17. Themes
Safety / Rushed
At times I need to put myself in the care of others –
these things are necessary (62yr male)
A necessary item. Better than being man-handled
(53yr male)
I’d rather be hoisted than lifted by people (77yr male)
The nurses were prepared well, they knew their
rules, kept me in the picture (62yr male)
Everything explained, machine shown to you. The sling
looked like a flying frog (65yr female)

18. Themes
Anxiety
I know the hoist was doing it … it all depends on
whether you trust the person who’s doing it
(93yr female)
The first time it was frightening. It gets better the
more it happens. I was frightened I might fall and
not be safe (72yr female)
I knew I was going to sit out in the chair .. every time
they move me I wonder what they are doing
(93yr female)

20. Slide Sheets
Respect 100%
Satisfaction 100%
Safe 93%
Dignity 93%
Not exposed 89%
Timeliness 86%
Informed and involved 79%
Not anxious 59%

21. Themes
Exposure / Dignity / Respect
I think I was covered, but I would not have worried as I
was out of my comfort zone and also out of control
(86yr female)
I felt a little uncomfortable as the curtains were not
around and there were male patients sharing the
ward (74yr female)
I had to remind the staff to pull the curtains around. I
felt the staff kept forgetting (77yr female)
Staff hoist vs. slide sheets and I was given a choice. I
preferred the idea of not being hoisted … felt that
would be too out of balance (86yr male)

22. Themes
Safety / Rushed
It was the best for me otherwise I wouldn’t be able to
move (72yr female)
I wanted them used for ease of handling for both
myself and staff (71yr male)
It was good for me, I wouldn’t want to be lifted
(78yr male)
It’s much better than being pulled up and down –
especially you girls with your nails (65yr male)
At times I felt rushed. I grabbed a nurse’s breast
because I wanted her to slow down (65yr female)

23. Themes
Anxiety
In retrospect I realised staff considered my feelings but
at the time I was so unused to any personal
interference, everything was uncomfortable
(86 yr male)
Although they explained the procedure it was
unfamiliar. I thought I was going to be bundled up
with the sheets (86 yr male)
I think slide sheets are a good idea but I wasn’t
informed why it was happening prior – I thought I
was being moved somewhere else (74 yr visually impaired,
transferred at night)

24. What Next?
 Use outcomes as training content indicators
 Consider retrospective study and sub groups
 Apply similar audit to staff

26. Contact us
Anne.McMahon@waitematadhb.govt.nz
Mark.Cranswick@waitematadhb.govt.nz