Safe lifting and transferring is dependent on good technique, proper equipment and accurate patient assessment. An appropriate lift or transfer should be safe for the patient, allow the patient to assist as able, and provide the least work for the caregiver by making use of good body mechanics and/or equipment.
By requiring less physical demand on the caregiver, there is less risk of back or shoulder injury.
When using any patient lift or transfer, the caregiver must check posture to eliminate twisting, reaching or stooping. Patient handling and assistive devices are designed to make the job easier. With proper body mechanics and when used correctly, the devices outlined below can greatly reduce the risk of injury to the health care worker.
The belt allows the caregiver to control the movement of the patient during the transfer. It can be used for one-person pivot/knee block transfers, two-person side-by-side transfers, and patients who need walking support. The belt is worn at the waist by the patient, and provides a handhold and secure grip.
The patient should be flexible enough to be able to stand; able to cooperate and follow directions; capable of gripping a handle with at least one hand and sitting unassisted on the edge of a bed or chair; and able to partially bear weight on one or both legs.
If a patient is unable to transfer from bed to stretcher without assistance, a sliding device such as a slide board can be used. The board is rigid and strong enough to fill gaps between two surfaces. Some models have moving sliding sections.
The patient can assist with the transfer when needed. The patient must also be cooperative and reliable.
Durable, tubular sliding sheets are designed with materials that alleviate resistance during movements. They are used to move a supine or seated patient up or down in the bed, turn a patient, and reposition or pivot a patient in bed.
If the patient does not fit properly on the sheet, or is too large for the width of a large sheet, he is probably too large to move without a mechanical device.
A mechanical lift can be used for transferring from bed to chair, bed to stretcher, bed to commode and floor to bed. These lifts are used to move patients who are unable to help themselves during a transfer, if a patient is unable to bear weight, or is particularly heavy. Two types of mechanical lifts are detailed below.
Ceiling Lift – Does not require floor space and can be used by one caregiver. The ceiling lift is battery powered, and can be used for all types of lifts/transfers: fallen patients, bathing, toileting, bed to chair, etc. They are used for totally dependent patients, and those who re.quire special medical considerations due, for instance, to skin integrity and broken bones. There are special slings for toileting, bathing and orthopedic needs.
Hoyer Lift – To use this type of lift, the bed must be 4-6 inches off the ground, so the base of the lift can fit under it. A sling that provides adequate head and neck support is used with this type of lift. Hoyer lifts are not to be used for bathtubs as they cannot be positioned close enough to the tub.
Standing/bent pivot transfer devices are used for those who have trouble standing and/or transferring on their own.
With this device, the user is bent over a chest pad and kneepad, via a strap underneath the legs, which is connected to a rotation lever. They are available in manual and powered versions. Patients must be weight bearing and have some upper body strength and control.
Used to transfer patients between two seated postures, the sit-to-stand device is designed to support only the upper body.
These devices have a wide adjustable base, sling materials that are extremely strong, and most have an electrical motorized lifting mechanism. The newer devices can transfer patients up to 300 lbs. The patient should be able to bear weight through one leg and hold the frame with at least one hand.