Since the advent of the pandemic, we’ve seen so many distressing scenes in the media of COVID-19 patients in ICU, struggling to breathe. A key element of the treatment regime we have seen is what is referred to as ‘Proning’ or prone positioning – the placement of patients into a prone position so that they are lying on their stomach. Commonly used in the treatment of patients in intensive care with acute respiratory distress syndrome, the position allows for better expansion of the dorsal (back) lung regions in compromised COVID-19 patients, improving body movement and enhanced removal of secretions which may ultimately lead to advances in oxygenation.
This movement of patients however carries some risk to healthcare workers. Lifting patients into position can require up to 8 people or more to turn a patient and can often result in musculoskeletal injuries from overexertion.
How big is the problem?
An Australian hospital study conducted in 2008 into manual handling activities and injuries among nurses revealed that 40% reported an injury associated with manual handling activity, of which 76% comprised back injuries. Approximately 34% of all injuries were associated with lifting patients and this activity comprised one half of all causes associated with injuries arising from direct patient care activities.
Data from the U.S. Bureau of Labor Statistics showed that injuries from overexertion in healthcare are among the highest in all of U.S. industries. The rate of overexertion injuries averaged across all industries, was 33 per 10,000 full time workers. By comparison, the overexertion injury rate for hospital workers was twice the average (68 per 10,000) and the rate for nursing home workers was over three times the average (107 per 10,000).
What reduction strategies have been employed?
There have been numerous recommendations and standards put in place over recent years to reduce the risk to healthcare workers such as the Victorian Nurses Back Injury Prevention Project (VNBIPP). On managing risk, Safe Work Australia details control measures for lifting, supporting and moving patients as follows:
- provide beds and chairs that can re-position the patient. For example, an electronic bed that can be raised into the sitting position
- provide equipment designed to lift and move patients safely
- ensure there are enough workers to be able to perform the manual handling task safely
- ensure workers are trained in how to safely lift, support and move patients.
What benefits can technology bring?
Recommendations made in 2018 in the Australian Institute for Safety, Compensation and Recovery Researchs’ Improvements in patient handling for worker and patient safety report suggested that facilitators to good patient manual handling and increasing the success of patient handling initiatives included “Modern equipment, in particular the use of overhead tracking for hoists”.
In the report, the Director OHS and Emergency Management, Eastern Health stated “The Utopia for me would be not having to physically touch a patient in order to move them, that you have got equipment in place to actually do all that for you. I know that is Utopia…That’s where we should get”
Technology in action at Hornsby Ku-ring-gai Hospital
One Sydney hospital, Hornsby Ku-ring-gai, took the initiative with the redevelopment of its ICU to install a Patient Lift Pendant (PLP) and Equipment Transfer System (ETS) from Wilhelm. Jay Halkhoree, Nurse Unit Manager of the Intensive Care and High Dependency Unit said “the integrated Patient Lift Pendant with GoLift was selected, determining it was the best product for the patient, after looking at many different pendants available in the market”.
The Hornsby Ku-ring-gai team had an occasion where they had to turn a 380-kilo patient. The patient lift required 8 team members to complete. With the Wilhelm solution lifting up to 454kgs, this could have at least halved the number of team members to perform the lift whilst making it safer for both team members and the patient. Reducing the number of staff required is particularly important at this time as there are often less resources inside the unit due to COVID-19 protocols.
According to Jay, the solution also makes transferring patients so much easier “When you’re looking after a really sick patient there are a lot of devices, tubes and connections. When transferring patients to radiology theatres, transferring all the pumps from the pendant to the pole and then undoing the whole lot again when they return really wastes time. With the equipment transfer system you just lift off the pumps with the bed, attach it to the bed dock and it’s the easiest thing to do”.
Staff at the unit use it practically every day taking patients to medical imaging for CT’s or MRI’s and in Jay’s words “it is the simplest and safest system available”.
There’s no doubt that patient lift solutions such as these from Wilhelm can have a positive impact to improve both clinician and patient safety. They can enhance the dignity of patients when moving them at a most vulnerable time and substantially reduce the potential for musculoskeletal injuries in team members.
Contact the Wilhelm Team here.