The Development of Policies for Patient Lifting in Acute Care Settings Rick Barker, MA Certified Professional Ergonomist Practice Leader, Global Safety Program Hill-Rom [e-mail]

1
The Development of Policies for Patient Lifting
in Acute Care SettingsRick Barker, MACertified
Professional ErgonomistPractice Leader, Global
Safety ProgramHill-Romrick.barker_at_hill-rom.com
2
Lifting Policies are Cited as a Critical
Component for Reducing Caregiver Injuries
And more frequentlyThe lack of a clear program
or enforcement of that program is cited as the
reason for poor effectiveness with injury
reductions efforts
3
No Lift or Zero Lift Policy
Ergonomics Nirvana
OR
Consultant Myopia
4
No Lift or Zero Lift Policy

• Proponents point to
• Success in Long-Term Care
• Application in England

5
Success in Long-Term Care

• Critical Differences
• Length of Stay
• Direction of Capability Changes
• Speed at Which Capabilities Change
• Urgency of Transfers
• Therapeutic Handling Activities

6
Success of Lifting Regulations in England

• Critical Differences
• Length of Stay/Payment Structure
• Open Floor/Ward Design
• No Competition for Patients

• Descriptions Have Been Overstated, Reality Is
• Law Does Not State That Lifting Patients is
  Illegal
• Many Units Have Little or No Lifting Equipment
• Many Facilities Emphasize Training Instead of
  Equipment
• Funding for Lifting Equipment Difficult to Obtain
• Therapeutic Handling Activities Excluded
• Few Indications of Success in Past 10 Years

7
No Lift or Zero Lift Policy

• Fundamental Questions
• Can you truly avoid ALL lifting?
• What about pushing, pulling, repositioning,
  tugging, or holding?

8
Safe Patient Handling Policy Rather ThanNo
Lift Policy
9
Value-Added Patient Handling

• Is the reason for the caregivers physical
  exertion in handling a patient
• To speed or promote the healing process or
• Change the patients location

10
The Need For Unit Specific Policies
11
Managing Policy Compliance
12
Making a Plan Work

• What works?
• Clear discipline policies
• Manager/Supervisor accountability
• Employee involvement in policy development
• Reinforcement of desired behaviors

13
Discipline Policies
Heavily Promoted Cited as Reason for
Failures Unrealistic in Health Care Job
Market Impact on Organization Safety Culture
14
Manager Accountability
Insufficient in most organizations, rare in
health care You cant change what you dont
measure Organization behavior will match
organization reward structures, not vision and
policy statements
15
Employee Involvement in Policy Development

• Why?
• Ownership
• Workplace Insight

16
Reinforcement of Desired Behavior
If you supervise a parts machining department and
the policy that you establish is that once a
person completes their daily quota, they can
spend the remainder of the day in the break room
what behavior do you expect to see?
17
Reinforcement of Desired Behavior
What behaviors among nurses do you want to
encourage? How can you measure these
behaviors? What options do you have for
providing reinforcement?
18
Questions for The Panel