There are many challenges faced by healthcare workers for whom patient handling is a part of their daily job. While mechanical lifts make it much easier to move and lift patients and can help reduce the ergonomic risks associated with manual patient handling, they also introduce other workplace hazards.

Most hospitals, long term care facilities and private homes use mechanical lifting systems to move or reposition patients and clients with mobility issues. There are several different types that you may encounter including wheeled hoist/portable floor lifts, stationary hoist/fixed lifts, ceiling tracks complete with motors, sit/stand lifting aids, and bath lifts.

Although using patient lifts can make the job easier, they come with hazards to the worker and or the patient. Parts that are suspended can fall and loads can be dropped. There is risk of equipment and or structural failure, and electric shocks. There is also the risk of body strain if a hoist should fail, and an attendant tries to catch a falling client.

The following tips and good practices offer practical guidance to help prevent injuries to attendants using patient lifts.

Injury prevention: Have a program in place
An ergonomic safe patient handling program can help reduce musculoskeletal injuries that result from the long-term cumulative physical effort of patient transfers as well as immediate injuries that result from incidents during transfers. The program should involve approval and commitment from management and will be more effective if developed in collaboration with union representatives, health and safety committee members and workers.

The ergonomic safe patient handling program will include steps to perform a needs analysis, create and standardize patient assessment criteria, develop decision trees to standardize actions, determine which controls are needed to implement specific tasks or patient needs and may institute a “no-lift” policy, where possible.

A no-lift policy would state that all manual handling tasks are to be avoided wherever possible. These policies successfully reduce the risk only if the organization has the infrastructure in place (technical solutions, lifts, equipment) to support the initiative. Training is also necessary to recognize the risk in activities, and how to follow appropriate steps to move or transfer a patient safely.

Legislation
Find out about, and meet, the legal requirements in your own jurisdiction for the use of lifts in workplaces. Some general requirements may include providing adequate lifting equipment and proper training of employees who use this equipment. It may also include proper installing of any lifting machine, as well as the testing, operating, use of, servicing, maintenance, and repair according to the manufacturer’s or an engineer’s specifications.

Sling safety
Slings are a key part of the lifting system. It is important to use the correct sling, approved for use by the patient lift manufacturer, for the specific hoist. The safe working load must be clearly marked on both the lift and the sling. Take care to ensure the sling is compatible with the load limits of the lift and the patient’s weight. Perform sling maintenance according to the manufacturer’s specifications. Inspect the sling fabric and straps to make sure they are not frayed or stressed at the seams or otherwise damaged, and if there are signs of wear, do not use it.

Equipment inspections
The manufacturer’s specifications will provide a frequency for periodic inspections and pre-use inspections. The periodic inspection requires documentation to demonstrate it has been completed. Pre-use inspections ensure that compatible parts are used and properly configured, and that load restrictions are not exceeded. They also identify any visible signs of damage to equipment that may lead to a failure. Create a system to ensure that defective equipment is clearly marked and taken out of service until replaced or repaired.

Tips for users of patient lifts
To reduce injuries, how we approach the transfer or lift is equally important as the equipment, staffing, and workload. Share these safety tips with all workers using patient lifts.

• Make sure you are properly trained on, and understand, how to operate the lift.
• Assess the client before every transfer and ensure the path of the transfer or lift is clear from obstructions.
• Be sure that furniture and aids that the client is being transferred to are properly placed and secure.
• Fasten all clips, latches, and hanger bars securely during operation.
• Keep the base (legs) of the patient lift in the maximum open position and position the lift to provide stability.
• Ensure the patient’s arms are inside the sling straps.
• Lock the wheels on any device that will receive the patient such as a wheelchair, stretcher, bed, or chair.
• Ensure that the weight limitations for the lift and sling are not exceeded.
• Do not rotate or twist the spine. Move your entire body in the direction of the transfer.
• During transfers, tighten your abdominal muscles, keep your back straight, and use your leg muscles to avoid injury.
• Position yourself close to the client and assure footing is stable.
• Try to maintain eye contact with the client and communicate while the transfer is in progress.
• Follow the instructions for washing and maintaining the sling.
• Follow a maintenance safety inspection checklist to detect worn or damaged parts that need immediate replacement.

Regardless of size, all workplaces can benefit from a code-of-practice, or safe work procedure for hoist operation, inspection, and maintenance. And most importantly, healthcare workers, patients and clients will be safer.

This article was submitted by the Canadian Centre for Occupational Health and Safety (CCOHS). The Canadian Centre for Occupational Health and Safety (CCOHS) promotes the total well-being — physical, psychosocial, and mental health — of workers in Canada by providing information, advice, education, and management systems and solutions that support the prevention of injury and illness. Visit www.ccohs.ca for more safety tips.