Mechanical Lifts in Home Support A Unified Practice Standard

Transcription

1 Mechanical Lifts in Home Support A Unified Practice Standard TOOL KIT HOME SUPPORT SERVICE PROVIDERS NOVA SCOTIA

2 Credit Created as an adaptation of the Mechanical Lift Competency Package, Home Support Service Providers, Western and Northern Regions, Nova Scotia. (2004). All content has been developed by staff of non-profit home support service provider agencies. The working committee encourages the copying, reproduction, and distribution of these documents to promote and support the adoption of a unified, home support mechanical lift practice standard in Nova Scotia. However, no part of this tool kit may be copied, reproduced, or distributed for profit or other commercial enterprise, nor may any part be incorporated into any other publication. Disclaimer This Document was developed in good faith to provide a safety standard to assist in protecting both the client and the workers from mechanical lifting device injuries. Though every effort has been made to ensure the accuracy of the information contained, any inaccuracies or typographical errors may be changed or updated without notice. It is offered without warranty of any kind and reliance on any information presented is at your own risk. By adopting the Document in sole or part, the user agrees that the author and the committee members shall not be held accountable for any injuries or damage that may result from its use. If you are dissatisfied with any portion of the Document, or with any of these terms of use, your sole and exclusive recourse is to discontinue using the Document. Mention of any company or product does not constitute endorsement by the author or home support agencies committee members. In addition, citations to web sites do not constitute endorsement of the sponsoring organizations or their programs or products. Electronic Copies Requests for electronic copies may be forwarded to committee members listed in the acknowledgements or to the author at: Pamela Smith RN Resource Coordinator Western Region Home Support Telephone: (902) Fax: (902) pamsmith@eastlink.ca February, 2012 Page 2 of 48

3 Acknowledgements Special acknowledgement and tremendous thanks is extended to the following individuals for their many contributions, not limited to: providing their professional knowledge, expertise, time, and sharing of relevant workplace experiences and resources, and reviewing and assisting with document editing. Contributors: Alicia Buffett RN RN Supervisor Northside Homemaker Service Society Telephone: Andrea Dauphinee RN Manager of Clinical Care Northwood Homecare Telephone: Barbara Dunbar RN RN Supervisor Lunenburg County Home Support Services Society Telephone: Bette Linden RN RN Supervisor Northwood Home Care Telephone: Carol Rhynold RN, BScN RN Supervisor Guysborough Home Support Agency Telephone: Dianne Thimot-Hankinson RN, BScN RN Supervisor Digby/Clare Home Support Agency Telephone: Heather MacIntosh RN RN Supervisor Victoria County Home Support Services Society Telephone: Heather Reid RN Nurse Manager, Home Support VON Cumberland Branch Telephone: Helen Marsh RN Assistant Director & RN Supervisor New Waterford Homemaker Service Society Telephone: Jeanette Penner RN Nurse Manager- Home Support VON Colchester East Hants Telephone: Kelly Cameron RN BN Manager, Home Support Canadian Red Cross Telephone: Kyla Bourgeois LPN Field Supervisor City Homemakers Service Society Telephone: Ext Page 3 of 48

4 Lexie Steeves-Dorey BScOT, OTRegNS Team Leader, Community Occupational Therapy & Physiotherapy Integrated Continuing Care, Capital District Health Authority Telephone: Linda MacMullen RN, BScN RN Supervisor Cape Breton County Homemakers Telephone: Tish MacKinnon RN RN Supervisor Cape Breton County Homemakers Telephone: A special thank you is extended to Gloria Brown BAA, Administrative Assistant, Home Support, Canadian Red Cross Society for so expertly recording meeting minutes and revising several draft documents. A thank you is also extended to Health Association Nova Scotia for providing the opportunity to elicit the expertise of Steve Smith, Director of Clinical Engineering and Jeremy Dann, Service Development Officer. A huge thank you is extended to Steve Smith for providing an educational presentation and to both Steve and Jeremy for providing professional advice and guidance during the project. Page 4 of 48

5 Table of Contents: Acknowledgements...Error! Bookmark not defined. Introduction... 6 Implementation Process Home Support Services Mechanical Lift Guidelines and Process Agency/Society Mechanical Lift Policy Agency/Society Mechanical Lift Procedure Education Package Facilitators Notes: Learning Outcomes: Learning Objectives: Indicators: Measurement Tools: Why Use A Mechanical Lift? Who Uses the Mechanical Lift? Mechanical Lifts: Slings: Troubleshooting: When Using A Lift Important Points To Remember: Mechanical Lift Policy/ Procedure: APPENDIX A: STANDARD CARE PLANS Floor Model Portable Lift Ceiling Track Lift Sit /Stand or Stand-Up Lift APPENDIX B: SUPERVISOR PRACTICUM GUIDE APPENDIX C: LIFT CHECKLIST / VISUAL INSPECTION CARDS Portable Floor Lift Check List Ceiling / Wall Mounted Lift Check List APPENDIX D: National Standard of Canada, CAN/CSA-Z APPENDIX E: ALERT #109, HEALTH CANADA MARCH 20, Client Information: Using A Mechanical Lift At Home What Are Your Responsibilities? When Can You Expect Your Caregivers to Start Using the Mechanical Lift and Sling? What If You Require Assistance? Client Information and Requirements Agreement Glossary of Terms and Short Forms: References Mechanical Lift Research Documents Page 5 of 48

6 Introduction It is standard practice across Nova Scotia for home support staff to transfer clients using mechanical lifting devices. This practice requires a regulated health care professional (HCP) to first deem the worker competent in the use of the client s lift and to provide specific, client care instructions. Every home support service provider agency is responsible to develop and implement guidelines and processes governing this practice. A mechanical lift competency package was cooperatively developed in 2004 by the home support service provider agencies in Northern and Western Regions of Nova Scotia. It was developed for home support staff whom at that time, had little or no training and experience with mechanical lifting devices. The document was circulated to home support agencies in the other regions on request. In February 2011, inquires were received from several regulated HCP to determine if the mechanical lift practice standards had been updated and what the present practices standards were in other home support agencies. In March, 2011, in response to these inquires a questionnaire was circulated to seventeen home support agencies in Nova Scotia. Fifteen agencies responded, outlining their mechanical lift standard of practice. Another similar questionnaire was forwarded to several physiotherapists who frequently provided services to home support clients. During this time, several home support agencies across Canada were also contacted to ascertain their mechanical lift practice standards. The result of the questionnaires and telephone inquires indicated that the practice standards vary within Nova Scotia and across Canada. Because there is a variation in this practice, a committee comprised of sixteen regulated HCP reviewed & revised the 2004 home support mechanical lift standards documents. The documents were revised to include the committee members existing, generally accepted practice standards. The results are now offered to all home support service provider agencies in Nova Scotia indicating our support of a unified, provincial mechanical lift standard of practice. Page 6 of 48

7 Implementation Process Before implementing the practice standard it is recommended that the Guidelines and Process and the Using a Mechanical Lift at Home documents be shared with DHA, Continuing Care team members such as the Care Coordinators, Physiotherapists and Occupational Therapists. Implementing the process of clients or client family member s responsibility for mechanical lift inspections may require a gradual, phased-in approach due to the number of existing client lifting devices. Beginning this process with new clients as they are admitted to service or when initially assessed for needing a mechanical lift may be a good option. The Using a Mechanical Lift at Home document outlines the client s responsibilities. This document contains a client consent form which indicates the client agrees to have lift inspections completed. Page 7 of 48

8 1.0 Home Support Services Mechanical Lift Guidelines and Process 1. Once the determination that a mechanical lift is necessary, the Agency Supervisor will: a. Collaborate with the Continuing Care Team; b. Ensure that the Care Coordinator is informed of the agency s requirements; c. Formalize and complete the client care plan; d. Discuss with the client/family policy requirements and client obligations toward inspection of lift initially and annually; e. Ensure staff competency; f. Document verification of lift inspection. 2. The number of HSW/CCAs required per visit will be based on the complexity of client care, and may be determined through assessment and consultation with the appropriate Continuing Care Team members. 3. Each agency will develop a method of flagging inspections. The method used will flag inspection renewals two months before the due date. The Agency Supervisor is then responsible to obtain a list of when inspections are due. The Agency Supervisor notifies the client/family that re-inspection is due. They will also notify the Care Coordinator of the impending due date and the need for it to be completed in order to continue using the lift. 4. Evaluation/reassessment will be completed on an ongoing basis to: Ensure that the transfer with the mechanical lift is appropriate for the client. Reduce the degree of risk of injury to both the client and the care providers. Ensure that all care providers are consistent with the use of the lift. The evaluation/reassessment will be completed by: The HSW/CCA during each transfer. An Agency Supervisor as required. An Occupational Therapist or Physiotherapist as required. Recommendations: An annual review of body mechanics for all staff. Inspections must meet the CAN/CSA Z Standard in order to be valid. If guidelines are not met, those services requiring the use of a mechanical lift will not be provided. Refer to the Alert #109 issued by Health Canada March 20, 1997 along with the addendum issued January 2001, in relation to recommended safety measures. The lift will not be used to transfer a client who is uncooperative. Page 8 of 48

9 Definitions: CSI The agency regulated health care professional, after completion of an in-home client assessment, provides the home support worker/cca with specific client care instructions. The goal is to ensure the worker is competent to provide care to a client, based on their specific needs. Collaborative Assessment The process of determining the client s health care needs through assessment and consultation with the regulated health care professionals responsible for the client s care. Competent The ability to integrate and apply the knowledge, skills, attitudes, and judgment required to practice safely and ethically in a designated role and setting. Page 9 of 48

10 2.0 Agency/Society Mechanical Lift Policy (Insert) Page 10 of 48

11 3.0 Agency / Society Mechanical Lift Procedure (Insert) Page 11 of 48

12 Mechanical Lift Education Package For Nova Scotia Home Support Service Providers February, 2012 Page 12 of 48

13 4.0 Education Package Facilitators Notes: The Mechanical Lift Education Package is designed to facilitate provision of mechanical lift theory to home support staff requiring initial or refresher training. Appendix A consists of three different mechanical lift care plans. The intent is for the Agency Supervisor to complete the applicable care plan with client-specific information and be placed in the home for home support staff reference. Appendix B is a practicum guide checklist that can be used by the Agency Supervisor to ensure necessary in-home instruction is provided or as a record indicating individual staff competency. Appendix C consists of two different lift safety checklists that may be laminated and kept in the client s home, on or near the lift. It may be used by home support staff to perform a visual safety inspection prior to each use of the client s lift. Appendix D is intended to provide the home support staff with background knowledge concerning the reasoning for annual lift inspections. Appendix E is intended to provide the home support staff with background knowledge concerning past safety issues that have resulted in client injuries. All material may be used for handout purposes. Note: An additional copy of the appendices has been provided for printing purposes in order to ensure page alignment accuracy. Page 13 of 48

14 Learning Outcomes: Home support staff will be able to: Demonstrate an understanding of the guidelines and processes specific to the use of a mechanical lift; Acquire the knowledge and skills required to safely transfer clients using a mechanical lift in the home setting; Incorporate appropriate safety measures when using a mechanical lift; and, Be deemed competent to use a mechanical lift. Learning Objectives: Following completion of the Mechanical Lift Education Package, the service provider will be able to: Identify the main components of a mechanical lift and sling; Identify the roles and responsibilities of service providers and the client when using a mechanical lift in the home setting; Recognize the importance of visual inspections being completed before each use of a mechanical lift; Recognize the importance of annual, formal inspections being completed according to the CAN/CSA-Z Standard; Identify the safety measures set forth by Health Canada; Understand to report safety concerns to the family, & RN Supervisor / Nurse Manager; Demonstrate proper techniques for transferring a client using the mechanical lift; Demonstrate the use of safety measures while completing mechanical lift transfers; Value the use of a mechanical lift as an injury prevention strategy for both client and service provider; and, Achieve competence in using a mechanical lift through the application of theory and practical demonstrations. Page 14 of 48

15 Indicators: Participates and provides appropriate responses during class discussions; Successfully identifies the components of the mechanical lift and sling during demonstrations; Successfully demonstrate using a mechanical lift and if applicable, complete practical testing by the RN Supervisor / Nurse Manager in the client s home; and, Successfully demonstrates appropriate safety measures. Measurement Tools: Class discussions: Mechanical Lift types, use, safety, standard care plans, and roles and responsibilities; Lab and/ or practical in-home demonstrations: Verbally identifies the mechanical lift and sling components; Lab and/or practical in-home demonstrations: proper sling use and transfer techniques; and, Supervisor / Nurse Manager observations of following Health Canada s safety measures. Page 15 of 48

16 Why Use A Mechanical Lift? If a client cannot weight bear on his/her legs, a lift should be used. People who are unable to hold their head straight without support (head control) or who have no balance in a seated position (ability to sit straight without a backrest, or lack of trunk control), who are very flaccid (hypotonic) or who cannot weight bear are candidates for a lift, regardless of how much they weigh. These clients should not be lifted manually; It is used for specialized chairs with attachments; and, It is used when there is inadequate space for good body mechanics. Who Uses the Mechanical Lift? Home support staff are able to use a mechanical lift when deemed competent by the RN Supervisor / Nurse Manager; and, Family members who have received an in-service by a qualified individual and are competent to complete the transfer. Being Competent Means: o The ability to integrate and apply the knowledge, skills, attitudes, and judgment required to practice safely and ethically in a designated role and setting. Client-Specific Means: o The agency regulated health care professional, after completion of an in-home client assessment, provides the home support worker/cca with specific client care instructions. The goal is to ensure the worker is competent to provide care to a client, based on their specific needs. Mechanical Lifts: Types: There are two basic types of mechanical lifts: o manually-operated, hydraulic ("pump-action"); and, o electric / battery-operated ("push-button"). Categories: Portable lift (floor model): o May be difficult for one person to operate; o Available in different types; o Foldable/transportable options are available; o Home environment will impact use available space, flooring, use in bathroom; o Multiple sling choices available choice depends on self-care routine; Page 16 of 48

17 o o Each lift model has specific weight restrictions; and, Disadvantages related to size for storing and turning radius in the home environment. Ceiling track lift: o Different types: - Portable lift with multiple ceiling tracks. This option can mean more transfers but cost is often less; - Fixed lift with continuous ceiling tracks. This option eliminates the removal of the lift unit (14 lbs.) on and off of the track and automatically returns to the end of the track to charge. Challenge may be the cost of continuous tracking; and, - Non-permanent track free standing or pressure fitted system. This option used when renting or installing in the ceiling is not feasible. Sit/stand or stand-up lift o Client must be able to support majority of their own weight; o Not an ideal permanent choice for progressive illnesses. E.g. MS; o Only one type of sling available ideal for toileting (clothing on); o Sling is positioned across the lower back with arms outside of the sling; and, o Sling provides limited trunk/head support and potential for impact on shoulders if pulling through the axilla. Safety: Become familiar with recommended use as outlined in the owner's manual. Follow either the manufacturer's guidelines for use or the protocol established by a qualified health care professional; Always inspect the mechanical lift and all other equipment before using to ensure they are stable, in good working order, and all necessary attachments are available and in good order too; DO NOT use any equipment or lifting device that is not in good working order. Notify your Supervisor when a safety hazard is identified; Ensure the weight of the client does not exceed the load limitations of the patient lift. Weight capacity for lifts range from lbs., with bariatric lifts available for those clients over 450 lbs.; Make sure that there is sufficient head support when lifting a client; Ensure that wheelchair brakes are locked and safety devices of other equipment are in place for mechanical lift procedures; For optimum stability, ensure the base legs are opened to the maximum before lifting; Stability of the mechanical lift can be compromised especially when applying pressure to move the mechanical lift. Ensure that brakes are unlocked before attempting to move the mechanical lift; Page 17 of 48

18 Do not roll the caster base over objects such as raised carpet bindings, door frames, or any uneven surface or obstacles that would create an imbalance of the lift and could cause the lift to tip over; Certain mechanical lift devices exclude brakes altogether in the equipment design; and, A lift is NOT a transport device. Moving a person suspended in a sling over ANY distance is NOT RECOMMENDED. It is intended to transfer from one surface to another. Maintenance: Home support staff are NOT qualified to perform maintenance. Maintenance needs to be completed by an authorized medical supplier representative. Slings: Types: Quick Fit or Divided leg or Universal sling o Most often prescribed; o Does not provide head support; and, o Easy to apply and remove when client is in a wheelchair. Hammock sling o Provides full head/neck support; o Has a smaller opening; o Difficult to apply and remove when client is in a wheelchair; and, o Used with client who have had limb amputations. Hygiene sling or Toileting sling o Can remove clothing for toileting with sling in place; o Requires upper body (trunk) control; and, o Look for impact on the shoulders if sling pulls through the axilla. Safety: If a client is incontinent, DO NOT use plastic backed incontinence pads or seat cushions between the client and sling material as it may cause the client to slide out of the sling during lifting procedures. There are many types of slings, each with their own safety precautions. Sling-specific instruction will be provided for each client requiring transfer with a mechanical lift. Laundering: As per manufacturer's instructions; Refer to owner's manual; and, The most commonly suggested laundering method for nylon slings is: o Machine wash in cold water with mild detergent on gentle cycle. Air dry. Page 18 of 48

19 o Some manufacturers indicate that machine drying is safe. If this method is suggested as an option, BE VERY CAUTIOUS. Sling may shrink and the fit could be significantly altered. o Remember to remove any metal bars or hooks before laundering. Troubleshooting: Ensure the Emergency Stop Button is NOT engaged; Refer to Owners Manual; and, If unable to troubleshoot, contact your Supervisor. When Using A Lift Important Points To Remember: Are you confident and familiar with the lift and client information before starting transfer? Inspect the Lift, Sling and Client environment any barriers to use? Is anything different from previous visits? Change in client, equipment or surroundings-has the furniture been moved. Remember positioning of sling is individual to each client. Be organized-ensure environment is ready to transfer client-i.e. w/c is positioned correctly. Communicate with client and coworker during lift. Use the lift to your advantage-if a client is not sitting well in the wheelchair then raise again and reposition using the lift. Staff should not need to physically reposition the client. Use the lift to your advantage-if transferring a client back to bed and they need incontinence care, you may position them a little higher in the bed-once you turn them from side to side during care they tend to move down in the bed. Once care is completed you should not have to physically move them higher up in bed. Do you need to report an issue with the client or the transfer? Check placement of sling- stand at the foot of the bed and view-is client in the middle of the sling? If client is not positioned correctly you may need to remove the sling and start again. Only one direction at a time - lift up and stop and then move to position - then lower. Where are clients hands?- Ensure client s arms are positioned - according to sling type as per specifications. Page 19 of 48

20 Mechanical Lift Policy/ Procedure: Agency Policy (Insert) Agency/Society Procedure (Insert) Page 20 of 48

21 APPENDIX A: STANDARD CARE PLANS Name of Home Support Agency/Society Floor Model Portable Lift In-Home Care Plan Client Name: Date: Perform a visual safety check of lift equipment including the sling and environment BEFORE using the lift. REPORT any concerns to your Supervisor. *Mechanical Lift Transfers are Client-Specific and require Client-Specific Instructions BEFORE doing this task* Transfers with Floor Model Lifts: The base of the lift should always be open. Brakes of the wheelchair should be on. Brakes of the lift should be off. Transferring From Bed to Wheelchair: Adjust the bed to a comfortable working height if applicable. Place the sling (handles on outside) behind the client s back. Fan-fold the rest of the sling in place under the client. Ensure that the centre of the sling is at the centre of the client s back. Gently tug on the thigh section of sling to ensure no wrinkles, folds, or twists. Cross sling under legs between thighs. This ensures that the client will not slip through. Attach Appropriate Loops on Hooks of Lift. 1. Top/Shoulder loops 2. Mid/Waist loops 3. Lower/Leg loops Slightly raise client and check for sling s security, proceed with transfer. Slowly lower client into the wheelchair, stand to the side to guide the client into the chair. Applying slight pressure over the client s knees will assist in having client sit well back into the chair. Release the loops from the hooks and remove the sling if indicated. Comments: Page 21 of 48

22 Name of Home Support Agency/Society Ceiling Track Lift In-Home Care Plan Client Name: Date: Perform a visual safety check of lift equipment including the sling and environment BEFORE using the lift. REPORT any concerns to your Supervisor. *Ceiling Lift Transfers are Client-Specific and require Client-Specific Instructions BEFORE doing this task* Transferring From Bed to Wheelchair: Adjust the bed to a comfortable working height if applicable. Place the sling (handles on outside) behind the client s back. Fan-fold the rest of the sling in place under the client. Ensure that the centre of the sling is at the centre of the client s back. Gently tug on the thigh section of sling to ensure no wrinkles, folds, or twists. Cross sling under legs between thighs. This ensures that the client will not slip through. Attach Appropriate Loops on Hooks of Lift. 1. Top/Shoulder loops 2. Mid/Waist loops 3. Lower/Leg loops Slightly raise client and check for sling s security, proceed with transfer. Slowly lower client into the wheelchair, stand to the side to guide the client into the chair. Applying slight pressure over the client s knees will assist in having client sit well back into the chair. Release the loops from the hooks and remove the sling if indicated. NOTE: a) Always check that the lift is correctly positioned directly above the client. b) Before moving the client from one surface to another make sure that the sling is still securely in place on the carry bar and that it will not come off. c) Lift with docking station chargers: Always return the motor to the docking station when not in use to maintain the life of the battery. d) Lifts with portable battery: When not in use always return the battery to the charger. Please make sure that the unit is at a level where you don t have to reach to remove or return the battery. (Proper body mechanics) e) Use the emergency down function in an emergency only if other functions failed. This feature may be different with different types of lifts. If it s necessary to use this feature please report it to the family member and RN supervisor. f) Emergency STOP, will shut off the power to the motor of the lift and will immediately stop all movement. g) The lift will only charge if the emergency stop switch is on the ON position. Page 22 of 48

23 Comments: Page 23 of 48

24 Name of Home Support Agency/Society Sit/Stand or Stand-Up Lift In-Home Care Plan Client Name: Date: Perform a visual safety check of lift equipment including the sling and environment BEFORE using the lift. REPORT any concerns to your Supervisor. *Mechanical Lift Transfers are Client-Specific and require Client-Specific Instructions BEFORE doing this task* Wheelchair brakes should be ON. Lift brakes should be on when client is being raised or lowered The base of the lift should be fully opened. Position the standing sling around client as per client-specific instruction. (i.e. the sling needs to be under the clients arms and around the back / shoulder area. The belt should be towards the client with the labels facing out. Secure the standing sling to the client by buckling the belt. The belt must be snug but comfortable on the client otherwise the client can slide out of the sling during the transfer, possibly causing injury. Place client s feet firmly on the footplate. Attach the standing sling to the stand up lift. Make sure that the client s arms are outside the standing sling; and the base of the lift is open. Have client hold onto the handgrips. Both knees should come in contact with the padded kneepad. Comments: Page 24 of 48

25 APPENDIX B: SUPERVISOR PRACTICUM GUIDE Name of Home Support Agency/Society Instruction: Coordinate home visit with HSW/CCAs once equipment is in place and certified. This may include client, family/care providers, and vendor. Introduction of HSW/ CCAs attending and their role. Review the lift type and purpose if vendor not present. Review The Lift Components And Possible Safety Issues. Patient floor lift: cradle, base, casters (brakes), control box, battery pack, controller. Ceiling Track lift: track, lift (portable vs. fixed), extension handle (for portable lift only), cradle, hand held controller, charger Teach Use Of The Sling: Demonstrate how to put on sling by identifying land marks, ensuring straps are not under client and are on the outside, and confirming that the client is centered on the sling. Ensure proper body mechanics are used. Ensure proper fit position. Review proper care of the sling (washing, wear and tear etc). Type of sling choice(s) and where each is used. Teach Use Of The Lift: Review positioning of lift relative to client and transfer surface. Confirm area is clear and clutter free. Ensure transfer surface is appropriately set up. Once the sling is in place review how to secure straps to the lift. Discuss which loops are used and in what situation. Ensure set up is the same on both sides. Review lift controller and emergency switch. If using floor lift demonstrate how to open, close base and when to use. Page 25 of 48

26 Demonstrate Lifting of Client: Reinforce importance of client comfort level. Ensure catheter and/or other attachments, if present, are in a safe location. Ensure client s arms are positioned - according to sling type as per specifications. Move client using lift. Lower client to new surface: Ensure client in good position over surface. If necessary use handles on sling to help reposition. If necessary and appropriate tilt chair to allow for better positioning. Demonstrate removal of sling once lift is completed. Ensure reminders provided regarding use of proper body mechanics. Review Maintenance Information: Ensure client has information on charging of battery and routine maintenance of lift and components. (Lift Manual). Review Using A Mechanical Lift At Home document and obtain client signature re yearly inspection of lift and components. Ensure client, caregivers and staff are aware that reassessment may be required should client status change. Other Client-Specific Points: Comments: Page 26 of 48

27 APPENDIX C: LIFT CHECKLIST / VISUAL INSPECTION CARDS Check lift Care Plan Perform visual inspection (see reverse) Examine sling Sling on client evenly, handles on outside Loops same colour on both sides Check loops when tension applies Legs of lift open Brakes on wheelchair Portable Floor Lift Check List Visual Inspection Checklist Report Before Using - If There Is Any Change In Equipment OR Client Portable Floor Lift Frame: Wheels (castors) in good working order Wheels (castors) firmly attached to base of lift Brakes are operational Nuts and screws are secure No cracks or sharp edges on frame Slings: No frayed edges No holes No ripped, loose stitching Manufacturers instructions are readable Page 27 of 48

28 Check lift Care Plan Perform visual inspection (see reverse) Examine sling Sling on client evenly, handles on outside Loops same colour on both sides Check loops when tension applies Brakes on wheelchair Ceiling / Wall Mounted Lift Check List Visual Inspection Checklist Report Before Using - If There Is Any Change In Equipment OR Client Ceiling / Wall Mounted Lifts: Lift strap (between motor and spreader bar) no signs of fraying Track flush against surface (ceiling or wall) and no signs of ceiling damage Ceiling track end plates/stops are secure No signs of loose hardware Slings: No frayed edges No holes No ripped, loose stitching Manufacturer s instructions are readable Page 28 of 48

29 APPENDIX D: National Standard of Canada, CAN/CSA-Z Page 29 of 48

30 Page 30 of 48 2

31 Page 31 of 48 3

32 APPENDIX E: ALERT #109, HEALTH CANADA MARCH 20, 1997 Page 32 of 48

33 Page 33 of 48

34 Page 34 of 48

35 Page 35 of 48

36 Page 36 of 48

37 Page 37 of 48

38 Page 38 of 48 1

39 Page 39 of 48 2

40 USING A MECHANICAL LIFT AT HOME CLIENT INFORMATION February, 2012 Page 40 of 48

41 5.0 Client Information: Using A Mechanical Lift At Home The health care professionals whom provide your care have discussed with you, and have determined that for transfer purposes, a mechanical lift is needed. The following information will help you and your family to understand your role and your home support agency s role in providing safe, quality care when using a mechanical lift. What Is a Mechanical Lift and Sling? A mechanical lift is a device used to safely lift a person from one place to another. A mechanical lift is often used when other ways of helping you to transfer become unsafe for both you and your caregiver. A sling is used to support your body while you are being transferred with the mechanical lift. What Type of Mechanical Lift and Sling Will Be Needed? There are different types of mechanical lifts and slings. A qualified health care professional, eg. Occupational Therapist, Physiotherapist, etc. will assist in determining the appropriate device for you. What Are Your Responsibilities? You or a family member will need to arrange to purchase, rent, or borrow a mechanical lift and a sling that is suitable for you, in your home. Purchasing/Renting From An Authorized Medical Supplier: If you choose to purchase a lift and sling, a company representative will come to your home. When the representative delivers your mechanical lift, you or a family member will need to do the following: Have the medical supplier representative show you and a family member or any other person who will be using the mechanical lift and sling how to properly use it. Ask the representative to provide you with a report saying an inspection is completed, confirming that the lift and sling are safe to use. Give this report or a copy of it to the home support agency that provides your care. Ask the representative for a user manual for the lift and sling. 1 Page 41 of 48

42 Obtaining From Another Source: If you choose to obtain a lift and sling from another source, you or a family member will need to do the following: Arrange for an authorized medical supplier representative to inspect the lift and sling and provide you with a report saying that an inspection has been completed that meets the CAN/CSA Z Standard, and is safe for use. Please note that you will have to pay for any fees associated with this service. Give this report or a copy of it to the home support agency that provides your care. Have the representative show you and a family member or any other person who will be using the mechanical lift and sling, how to properly use it. Ask the representative for a user manual for the lift and sling. Annually: Once a year you will need to make arrangements for an authorized medical supplier representative to visit your home to inspect both the lift and sling and provide you with a report saying that an inspection has been completed, meets the CAN/CSA Z Standard and is safe to continue to use. Please note that you will have to pay any fees associated with this service. Please give this report or a copy of it to the home support agency that provides your care. Repairs: Repairs of the mechanical lift and sling need to be arranged with the authorized medical supplier representative. The representative is required to provide you with a report confirming the lift and sling are safe for your use. Please note that you will have to pay any fees associated with this service. The home support agency providing your care will ask you for a copy of this statement and they are unable to use the lift and sling until it is written. 2 Page 42 of 48

43 When Can You Expect Your Caregivers to Start Using the Mechanical Lift and Sling? To help ensure everyone s safety the home support agency has processes and guidelines in place that need to be followed. These include: Staff will begin using your lift and sling once they have received proper training by a qualified health professional. A copy of the inspection report from the medical supplier representative will need to be given to the Supervisor before caregivers can start using this equipment. At the same time each year, when you have your lift and sling inspected, a copy of the inspection report you received from the representative will need to be given to the Supervisor. If the inspection is not completed in a timely manner, staff will stop using the equipment. If your lift or sling requires repairs, home support staff will immediately stop using the equipment. This information will be provided to the Supervisor. Staff will start using them again once you have had the medical supplier representative complete all necessary repairs and you have provided a copy of the report from the representative to the home support agency. What If You Require Assistance? For assistance or any questions you may have concerning accessing a lift or sling, inspections or repairs, please contact your Care Coordinator or an Agency Supervisor. Please contact your Care Coordinator to assist you in obtaining information for financial assistance, when necessary. Safety is very important and working together we can help prevent accidents and injuries to both you and to your caregivers. We hope the information that has been provided will assist you and your family to understand the home support agency s processes and guidelines. If you have any questions or concerns please do not hesitate to contact us at: Agency Logo and Return Address 3 Page 43 of 48

44 MECHANICAL LIFT Client Information and Requirements Agreement The health professionals who provide your care have discussed with you, and have determined that for transfer purposes, a mechanical lift is needed. To help ensure everyone s safety when a mechanical lift is used in the home, the Name of Agency has processes and guidelines in place to be followed by home support staff and the client &/or client s family. The guidelines that the client and/or client s family must agree to follow are: Purchase, borrow, or rent an appropriate mechanical lift and sling; Arrange and pay for an inspection of the mechanical lift and sling by the manufacturer/supplier before initial use, and annually thereafter; Provide the home support agency with a copy of all inspection reports received from the manufacturer/supplier that states the lift and sling are safe, appropriate, compatible and meets the CAN/CSA Z Standard; Obtains a mechanical lift user manual from the manufacturer/supplier; and, Arrange and pay for lift or sling repairs as needed Name of Agency thanks you in advance for your cooperation. If you have any questions or concerns, please do not hesitate to contact us. Client / Substitute Decision Maker Signature Supervisor/Nurse Manager Signature Date Date Page 44 of 48 4

45 6.0 Glossary of Terms and Short Forms: CAN/CSA-Z An approved National Standard of Canada describing the requirements and testing for all hoists used in Canada for the transfer of disabled persons. CCA Continuing Care Assistant Ceiling Lift A generic term referring to any type of client mechanical lift that lifts the client by a motorized unit secured above, in the ceiling or wall or from a frame that travels along tracking mounted overhead. These systems can be portable or permanent. Collaborative Assessment The process of determining the client s health care needs through assessment and consultation with the regulated health care professionals responsible for the client s care. Competent The ability to integrate and apply the knowledge, skills, attitudes, and judgment required to practice safely and ethically in a designated role and setting. CSA Canadian Standards Association CSI The agency regulated health care professional, after completion of an in-home client assessment, provides the home support worker/cca with specific client care instructions. The goal is to ensure the worker is competent to provide care to a client, based on their specific needs. Floor Lift A generic term referring to any type client mechanical lift that is supported on the floor, is moveable and consists of a sling attached to a stand on wheels. It takes the whole weight of the patient. HCP Health Care Professional HSW Home Support Worker Medical Supplier Representative A qualified person authorized by the medical supply company to inspect and repair mechanical lifts. Regulated Health Care Professional A person licensed or registered under Provincial legislation to provide health care; Sit/ Stand Lifts A type of floor model client mechanical lift that is used with weight-bearing patients as well as those needing rehabilitation. They typically have a smaller base than floor sling lifts, and can more easily fit and maneuver a patient into tight spaces such as bath and shower rooms. Page 45 of 48

46 7.0 References: Documents: Community Occupational Therapy and Physiotherapy: Checklist for Lift Training. Capital Health District Authority, Halifax, NS. N.d. Health Canada Alerts: Incidents Involving Patient Lifts March 20, 1997& Addendum Medical Device Alert 109. Ottawa, Canada. January, Marsh, Helen, RN: Tips For Using Mechanical Lift. New Waterford Home Support Services Society. New Waterford, NS. October 18, 2011 National Institute for Occupational Safety and Health: Safe Patient Handling Training for Schools of Nursing Curricular Materials. Cincinnati, Ohio. November, (Received from Christian Goudge, CRSP, Occupational Health and Safety Coordinator, Cumberland Health Authority. August 2, 2011.) Northern and Western Region Home Support: Mechanical Lift Competency Package, Home Support Service Providers. Western and Northern Regions, NS Northwood Homecare Limited: Northwood Homecare, Ceiling Lift Client Care Plan. Halifax, NS. December Northwood Homecare Limited: Northwood Homecare, Mechanical Lift Client Care Plan. Halifax, NS. December Northwood Homecare Limited: Northwood Homecare, Sit to Stand Lift Client Care Plan. Halifax, NS. December Standards Council of Canada: National Standard of Canada, CAN/CSA-Z , Annex A (Informative) Periodic Inspection. October (Received from Steve Smith, Clinical Engineering, HANS. April 6, 2011) Steeves-Dorey, Lexie, BScOT: Practice Related to Transfers and Use of Mechanical Lifts in the Home. (PowerPoint presentation). Capital District Health Authority, Community Occupational Therapy. Halifax, NS. September The Canadian Red Cross Society, Home Support Services: Policy & Operating Procedure, Transfers and Lifts. Dartmouth, NS. November Page 46 of 48

47 Correspondence: Ann Schleit, Instructor, Nova Scotia Community College, Burridge Campus, Burridge, NS. March 31, Eileen Stevens, Instructor, Université Sainte Anne, Clare, NS. March 31, Ginny Milne, Instructor, Nova Scotia Community College, Middleton Campus, Middleton, NS. March 31, Expert Survey: Gayle Ogilvie, Physiotherapist, South Shore Health, Seniors Community Health Team, Lunenburg, NS. April 5, Internet: Canadian Center for Occupational Health and Safety: OSH Answers: Ergonomic Patient Handling - Policy Guidelines. April 29, Internet Document: ISO: International Standard ISO Hoists for the transfer of disabled persons Requirements and Test Methods. December 15, Internet Document: National Institute for Occupational Safety and Health: Workplace Safety and Health: Safe Lifting and Movement of Nursing Home Residents. February, 2006.CDC Workplace Safety and Health. Internet Document: National Institute for Occupational Safety and Health: NIOSH Publication No March Safe Patient Handling and Movement. American Nurses Association Handle With Care Campaign Developed with support from NIOSH. Internet Document: Ontario Safety Association for Community & Healthcare: OSACH Planning Guide Implementation of Client Mechanical Lifts, Second Edition Internet Document: Preferred Health Choice: How to use a Hoyer Lift. Hoyer Lift Safety Instructions. Internet Document: online.com/how_to_use_hoyer-lift_a/146.htm Toronto RehabSCI : Mechanical Lift Instructions. Spinal Court Connections. March 1, Internet Document: Mechanical-Lift-Instructions pdf 2 Page 47 of 48

48 University of Texas Medical Branch at Galveston: Guidelines for Safe Patient Handling and Movement. UTM Institutional Handbook of Operating Procedures Internet Document: Safety_and_Security/PNP_ Workers Compensation Board of B.C.: Patient Handling In Small Facilities: A Companion Guide To Handle With Care Internet Document: dling_small_facilities.pdf Presentations: Jeremy Dann, CET, CBET, Service Development Officer, Health Association Nova Scotia, Bedford, NS. Patient & Resident Ceiling Lifts Update. January, 12, Steve Smith, P.Eng., Director of Clinical Engineering and IT Services, Health Association Nova Scotia: Patient / Resident Lift Inspections Home Support Program. Bedford, NS. April 6, Telephone Conversations: Gaye Moffett, CEO. GEM Health Care Services Inc. Ottawa, ON. March 30, Gilles Boudreau, Sales Manager. Medi-Chair, Halifax, NS. March 30, Janet Noseworthy, HR Coordinator and Beth Robinson, RN (Conference Call). Compassion Home Care, St. John s, NFLD. March 30, Jennifer Murphy, Home Support Worker Supervisor, Wedgewood Manor, Summerside, PEI. March 30, Jeremy Dann, CET, CBET, Service Development Officer, Health Association Nova Scotia, Bedford, NS. March 22, Linda Stilwell, Senior Service Co-ordinator. King Valley Home Care, NB. March 29, Meredith Alexander, Assistant Director. Tideview Terrace, Digby, NS. March 31, Sandra Woodford, RN. Staff Development / Infection Control. Queens Manor. Liverpool, NS. March 29, Shauna La Pierre, Community Physiotherapist. Lunenburg County, NS. March 11, Steve Smith, P.Eng., Director of Clinical Engineering, Health Association Nova Scotia, Bedford, NS. March 22 & September 6, Page 48 of 48 3