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Mechanical Lift Systems

Reprinted from PN April 2011

From the patients' perspective, what issues must be considered?

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Most articles written about mechanical patient-lift systems seem to focus on how they can help medical facilities’ staff. Not one of those I read mentioned patients’ needs and concerns. This article addresses some of those needs and explores how the use of mechanical lift systems can affect patients’ safety, comfort, and dignity in healthcare facilities.

Background

Many healthcare facilities throughout the United States, including the Department of Veterans Affairs (VA), have increased the use of patient-lift systems—portable or fixed (ceiling mounted).

In the past, portable lift systems have been primarily used in healthcare facilities. These units can be cumbersome and take up a lot of storage space. They are not always convenient for patient use as staff members often must search for the lift equipment that might be located somewhere else on the unit. Ceiling-mounted lift systems are located near the patient and are always available when needed.

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In 2009, a bill introduced in Congress directs the Secretary of Labor to issue an occupational safety and health standard to reduce injuries to patients, direct-care registered nurses, and all other healthcare workers by establishing a safe patient-handling and injury prevention standard. Although this bill was never passed, it may be only a matter of time until healthcare facilities are mandated to increase the protection of their employees from patient-handling injuries. These mandates, however, must also protect patients.

A Ceiling-Lift Experience

Ceiling lifts have the potential of making things easier for staff and patients when a transfer is required. Education on the lifts’ proper use as well as potential risks is key in the system’s success. Following is one patient’s experience while using a ceiling lift:

“During my recent annual examination, I had serious bruises as a result of being placed in a ceiling lift to facilitate a transfer from my wheelchair to a gurney for transport to an x-ray appointment. The belt webbing that fits around both thighs caused serious bruising to my legs that took five weeks to clear up.

“Upon investigation, I discovered my healthcare provider has no standard protocol for patients placed in such a device. No questions about my possible vulnerability to being placed in the ceiling lift were ever considered by the attending healthcare professional who put me in the device.”

While most people are not harmed when lifted mechanically, this person’s experience was not a positive one. Proper protocols were not followed to ensure this individual’s safety.

When mechanically lifting people, staff must be aware of the risks to the patients and ensure their safety, comfort, and dignity. Patients and staff must also be aware of any medical conditions that may increase their risk of injury when using a patient-lift system.

Priority Issue

Safety must be the primary concern when transferring a patient via a mechanical lift. Possible injuries can include skin tears and bruising. People with spinal-cord injury/disease (SCI/D) can be particularly vulnerable to these injuries, which can lead to serious complications. The potential for the person to fall out of the sling is also a concern and may result in serious injury. The correct placement of the individual in the lift harness is paramount to the safety of his/her being transferred using a lift system.

It is important that the correct harness type be specified, based on the patient’s needs and abilities. The person must be properly fitted and positioned correctly into the harness prior to being lifted. This helps ensure safety and comfort.

Ideally, patients should have their own assigned sling during their entire stay at a healthcare facility. This can help ensure the proper harness is used every time they are transferred using the mechanical lift. In addition, the harnesses must be properly cleaned and sanitized. Care must be taken to prevent the sling from exposure to infections, such as MRSA, during the cleaning process. Regular inspection must occur to ensure the sling’s continued strength and integrity.

Comfort and Dignity

Common complaints I have heard from patients regarding lift systems is that they are not properly repositioned in their bed or wheelchair after being lifted. This is particularly critical to those who can’t reposition themselves.

Ceiling-mounted lift systems can be used as transfer (preferred for people with SCI/D) or transport devices. When a system is used as a transfer device, the patient goes from one object, such as the bed, to another object, such as a wheelchair. If the lift system is used as a transport device, a person moves from one place, such as the bedroom, to another place, such as the bathroom. 

The horizontal motion of being transported from room to room may be frightening to some patients. They may experience a loss of dignity while “flying through the air.” Also, the longer a person is in the lift sling, the greater the chance for him/her to sustain an injury. These are just some of the reasons a lift should be used only as a transfer device for SCI/D patients—and not for transport.

To ensure dignity, it is important the person is properly covered while using the patient lift. The configuration of the lift system can conflict with the ability of cubicle curtains to provide privacy. This is an important consideration when a ceiling-mounted patient-lift system is designed.

Caregivers must ensure all patients’ physical and emotional needs are addressed while they are using a mechanical patient-lift system.

Patient-Lift System Protocols

The following protocols should be implemented during the design and use of mechanical patient-lift systems:

- Ceiling-mounted lift systems should be installed only above the immediate bed area in the patient’s room and should not cover the entire bedroom area. A separate lift system can be placed in the bathroom if desired. No track connection between the bedroom and bathroom should be provided in order to prevent transporting patients around the bedroom and into the bathroom.

- Clinicians must strictly prohibit extended lift transportation of SCI/D patients.

- Portable lifts should be readily available to aid in transfers occurring in areas not provided with ceiling lifts.

- Staff should regularly inspect the slings to ensure their continued integrity and strength.

- Staff should talk to each patient about their particular physical, medical, and emotional issues before using a patient lift.

Design Considerations

Many issues need to be addressed when designing a ceiling-mounted lift system:

(1) The selection and design of the patient-lift system should be an integral component in the design of a new facility in order to prevent conflicts between the lift system and other building systems.

(2) The building’s structure must be investigated to ensure it can support the loads generated by use of the lift system. Some systems are designed to accommodate bariatric patients and support weights of up to 1,000 pounds.

(3) The location of lighting, mechanical diffusers, and other items mounted on the ceiling must be coordinated with the lift system’s track to prevent conflicts between the lift system and other building components.

(4) Cubicle curtains can conflict with the lift system if not planned properly. This is of particular concern in semiprivate patient rooms.

(5) Lift systems should be located within the track of the cubicle curtains to ensure privacy. Adequate space must be provided at the side of the bed in order to transfer the patient from the bed to a mobile device.

Conclusions

It appears patient-lift systems are here to stay. They can help in preventing staff injuries when lifting and positioning patients. Although this is important, considerations for patients are equally important. The lift systems must be designed correctly. Patients must be protected from the potential hazards of being lifted mechanically.

Protocols must be developed and enforced. These should address not only staff safety but also the requirements of patients—safety, comfort, and dignity.

Contact: PVA Architecture, 800-424-8200

 

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