Bariatric Times - February 2009 - (Page 24) 24 Patient Management Perspective Bariatric Times • February 2009 PUTTING IT ALL TOGETHER Safe patient handling and the obese patient need to be considered in all areas of patient contact.21 Wider wheelchairs are necessary to move the patient from one department to another. Wider, heavy-duty, reclining, stretcher chairs are essential for patients with obesity hypoventilation syndrome or other conditions that require reclined positioning when transferring. Lateral transfer products are important to move the patient Part A from the gurney to bed or diagnostic table. Fixed ceiling-mounted lifts, portable ceiling lifts, and floor lifts work together to provide a cost alternative and flexible solution to lift and transfer needs and should be tailored to the needs of the specific service line. Along the same line, a number of lifting bands, slings, and litters (lift baskets) are available, again designed to match the specific task to be accomplished. Take the opportunity to learn what vendors offer and make suggestions when there is an unmet need. The bariatric task force best serves the needs of caregiver safety and patient outcomes by investigating every area of patient care and determining what hazards of care exist in each.22 Frontline workers— those in direct contact with the patient—are the most valuable as these individuals can relate the real risks of specific care area. An example of a risk is a bed that is wide enough for the patient but too wide for the clinician to provide proper care without caregiver injury; likewise, a bed that is a manageable size for the caregiver may be too narrow for the patient. CONCLUSION Safe lifting techniques should be integrated into every aspect of clinical and nonclinical care in order to maintain the safety, not only of the patient, but the caregiver. A caregiver who finds that the physical strain of providing care becomes too difficult may place the patient at risk for injury. Knowing when to ask for help and not being hesitant to do so may prevent accidents and injuries. Caregivers must assess daily assignments and plan their day to avoid excess numbers of transfers and utilize resources and equipment. Encourage patients to participate in their care whenever clinically appropriate. Keep in mind, England, the Netherlands, Switzerland, Australia, Finland, Ireland, and Canada already prohibit manual patient handling and require mechanical handling devices. An array of equipment and devices is commercially available to help move even the largest, fully immobile patients. However, equipment should never be a substitute for proper safe patient handling assessment, administrative support, on-unit mentoring, policies and procedures, and meaningful training. REFERENCES 1. Gallagher S. Issues of caregiver injury: addressing needs of a changing population. Bariatric Times. 2005;2(1): 3–7. 2. Tuohy-Main K. Why manual handling should be eliminated for resident and caregiver safety. Geriaction. 1997;15:10–14. 3. Nelson A. Patient Safety Center of Inquiry: Veterans Health Administration and Department of Defense, Patient Care Ergonomics Resource Guide. November 2003. 4. Bureau of Labor Statistics, Department of Labor, Nonfatal Occupational Injuries and Illnesses Requiring Days Away from Work, 2005. November 2006. 5. Nelson A, Matz M, Chen F, Siddharthan K , Lloyd J, Fragala G. Development and evaluation of a multifaceted ergonomics program to prevent injuries associated with patient handling tasks. International Journal of Nursing Studies. 2006;43(6):717–733. 6. Hignett S, Work-related back pain in nurses, Journal of Advanced Nursing. 1996; 23(6):1238–1246. 7. Nelson A, Collins J, Siddharthan K, Matz M, Waters T. Link between
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