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file://c:\documents and Settings\cruzal\Desktop\Safe Patient Handling\Content_1\01MainMenu_1\01MainMenu_1.html Introduction Main menu 1 of 23 1 / 1 Welcome to the Applying Principles of Safe Patient Handling (SPH) e-learning course. Background Positioning and mobility techniques are to be used in conjunction with safe patient handling equipment. More than 35 years of research indicates that training staff in body mechanics and lifting techniques by themselves is not effective in reducing risk of musculoskeletal injuries during patient handling tasks (including transferring and repositioning of patients). Research In general, the forces involved in manual patient handling tasks are found to be beyond what is considered to be a safe limit, regardless of the number of staff members providing assistance, and the attempt to use correct body mechanics. Manually lifting patients is the most frequent reason for work-related back pain in health care. The greatest risk is associated with oneperson transferring techniques. Sudden high effort from unexpected events, such as preventing a patient from falling, is also associated with high risk for injury. Current evidence-based research indicates that a comprehensive safe patient handling program that incorporates the use of technology-based safe patient handling equipment including ceiling lifts, mobile floor lifts, stand assists, and lateral transfer devices reduces the risk of injuries from transferring and repositioning patients. This course includes the topics listed below. We recommend you view them in order. Course Information Safe Patient Handling (SPH) Approximate length: 15 minutes Need help getting started? Read the brief directions for using this e-learning course, or access more information on e-learning courses by clicking the Guidelines button in the blue navigation bar at the top of this window.

file://c:\documents and Settings\cruzal\Desktop\Safe Patient Handling\Content_1\02CourseOverview_2\01CourseOverview_1... Course Overview Course information 2 of 23 2 / 1 Audience and prerequisites RNs, NAs, and all direct patient care staff involved in patient handling There are no prerequisites to this course. Objectives Upon completion of the course, learners will be able to: Identify a variety of patient handling techniques/tasks that can contribute to patient handling injuries and utilize appropriate safer techniques/tasks Identify various program elements and where to access details of the PNHS Safe Patient Handling Program Apply the patient mobility assessment algorithm to determine a patient's level of mobility, the appropriate safe patient handling equipment, and number of staff to complete the task Identify the various types of patient handling equipment available at Park Nicollet Apply positioning and mobility techniques

file://c:\documents and Settings\cruzal\Desktop\Safe Patient Handling\Content_1\02CourseOverview_2\02DevDisclosures_2.h... Course Overview Development disclosures This course was developed using the following internal resources: 3 of 23 2 / 2 Bill Hirschuber, MA, OTR/L Employee Occupational Health and Safety Alex Cruz the Learning Center All faculty and planning committee members listed above have indicated no potential conflict of interest in relation to this activity. No faculty intends to discuss any unapproved/investigative use of a commercial product.

file://c:\documents and Settings\cruzal\Desktop\Safe Patient Handling\Content_1\03SafePtHandling_3\01Toc_1.html Safe Patient Handling (SPH) Introduction Topics covered in this section include: 4 of 23 3 / 1 Safer techniques/tasks for patient transfers Safer techniques/tasks for patient repositioning and boosting The PNHS Safe Patient Handling Program Patient Mobility and Transfer Equipment Determination Algorithm Safe patient handling equipment available at Park Nicollet Applying positioning and mobility techniques Principles used to encourage patient participation in a safe transfer

file://c:\documents and Settings\cruzal\Desktop\Safe Patient Handling\Content_1\03SafePtHandling_3\02SPH_2.html Safe Patient Handling (SPH) Safer techniques/tasks for patient transfers Compare these high risk patient transfer techniques/tasks (that put the caregiver at risk of injury) with the appropriate safer technique/task. 5 of 23 3 / 2 High Risk Technique/Task Allowing the patient to push/pull on staff's neck, arm, shoulders, etc., to provide leverage for any transfer Lateral transfers with no friction-reducing device (including 2-4 person to gurney, or cardiac chair using draw sheet) Manual lifting of a total assistance patient from the floor including cradle lift (lifting patient under knees and behind back regardless of how many staff are available to assist) Safer Technique/Task Coach the patient: tell the patient what action you plan and expect from them. Show them what to do, and then help them move through the activity, without the patient using staff for support during any transfer. For lateral transfers, use a friction-reducing lateral transfer device including a HoverMatt or yellow Slipp sheet, with a minimum of 2 staff Use a floor lift; refer to "Post Falls Work Standard" for details (available on Facets) View the "Post Falls Work Standard" on Facets. Pivot transfers or 2-person "hook & toss" lift and transfer by grasping patient under arms Using a transfer belt to lift a total assistance patient to transfer from a sitting position Minimal assistance patients: use a transfer belt Total assistance patients: use a floor lift, ceiling track lift, or EZ Stand (if patient is partial weight bearing) Transfer belts are to only be used with minimal assistance patients; use a stand assist device or floor lift for total assistance patients

file://c:\documents and Settings\cruzal\Desktop\Safe Patient Handling\Content_1\03SafePtHandling_3\03SPH_3.html Safe Patient Handling (SPH) Safer techniques/tasks for patient repositioning and boosting Compare these high risk patient repositioning and boosting techniques/tasks (that put the caregiver at risk of injury) with the appropriate safer technique/task. 6 of 23 3 / 3 High Risk Technique/Task 1 person turning total assistance patient on their side (log roll) in bed 1-2 person(s) boosting patient up in bed using a draw sheet or hooking under patients arms/axilla. Safer Technique/Task Minimum 2-3 staff Put bed flat and/or in Trendelenberg position Instruct patient to grasp bed rails and pull with arms Use a floor or ceiling track lift or friction-reducing device and at least 2 people, one on either side of the bed Put bed flat and/or in Trendelenberg position Instruct patient to bend knees and push with legs Instruct patient to grasp bed rails and pull with arms Pulling patient up in wheelchair by grasping chest or arms/axilla Implement measures to prevent sliding down in chair (wedge cushion, etc.)

file://c:\documents and Settings\cruzal\Desktop\Safe Patient Handling\Content_1\03SafePtHandling_3\04SPH_4.html Safe Patient Handling (SPH) The PNHS Safe Patient Handling Program The PNHS Safe Patient Handling Program includes the following program elements: 7 of 23 3 / 4 1. Safe patient handling risk identification and assessment 2. Maintaining an adequate supply of appropriate safe patient handling equipment 3. Education and training of nurses and other direct patient care workers 4. Facility remodels and construction project coordination 5. Safe patient handling program evaluation 6. Patient mobility assessment and decision making criteria 7. Peer leader roles 8. Incident analysis reviews 9. Policies and work standards For further details on the PNHS Safe Patient Handling Program, visit the Employee Occupational Health and Safety page on Facets. To access the "Safe Patient Handling" page on Facets, go to (1) Departments and select "Employee Occupational health and Safety". On the EOHS page, look under (2)"For Customers" on the left and select (3)"Safe patient Handling".

file://c:\documents and Settings\cruzal\Desktop\Safe Patient Handling\Content_1\03SafePtHandling_3\05SPH_5.html Safe Patient Handling (SPH) Patient Mobility and Transfer Equipment Determination Algorithm 8 of 23 3 / 5 A Patient Mobility Assessment must be completed prior to the transferring/repositioning of a patient upon admission, and as any changes occur in the patient's status. The PNHS Patient Mobility and Transfer Equipment Determination Algorithm can be used to classify patient mobility levels, determine the appropriate transfer equipment, and use the appropriate number of staff. View a larger version of "Patient Mobility and Transfer Equipment Determination Algorithm". No staff member should lift more than 35 pounds of the patient's weight. Assemble staff and equipment accordingly. The number of staff recommended for total assistance patients includes number needed for positioning the patient for utilizing the transfer device. The assessed level of assistance should be displayed on the patient whiteboard so that all members of the care team are aware of how to safely transfer the patient.

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file://c:\documents and Settings\cruzal\Desktop\Safe Patient Handling\Content_1\03SafePtHandling_3\06SPH_6.html Safe Patient Handling (SPH) Safe patient handling equipment available at Park Nicollet 9 of 23 3 / 6 For more information on this equipment, visit the Employee Occupational Health and Safety website.

file://c:\documents and Settings\cruzal\Desktop\Safe Patient Handling\Content_1\03SafePtHandling_3\07SPH_7.html Safe Patient Handling (SPH) Applying positioning and mobility techniques 10 of 23 3 / 7 Positioning and mobility techniques are to be used in conjunction with safe patient handling equipment. Current evidence-based research demonstrates body mechanics alone is not sufficient to protect you from the heavy weight and awkward postures involved in patient transferring and repositioning tasks. No staff member should lift more than 35 pounds of the patient's weight; assemble staff and equipment accordingly. In/out of bed transfer to chair/commode/toilet Place head of bed at 45 degrees and side rail in mid-position when assisting patients back in bed Utilize a transfer belt with all patients that are assistance of 1 or assistance of 2 Repositioning/turning in bed A HoverMatt can be left under a patient and then inflated for boosting/repositioning as long as there are no medical contraindications A Slipp sheet can be placed under the patient for boosting/repositioning and then removed (it is not to be left under a patient) Put the bed at waist level Lower all side rails to allow keeping the patient as close to your body as possible Two caregivers should be on the same side of the patient opposite the direction of turning the patient. Face the direction of your movement; avoid twisting your body Other resources The House Nursing Assistant can be paged with questions/concerns regarding transferring/repositioning of patients, and patient handling equipment utilization.

file://c:\documents and Settings\cruzal\Desktop\Safe Patient Handling\Content_1\03SafePtHandling_3\08SPH_8.html Safe Patient Handling (SPH) Principles used to encourage pt participation in a safe transfer These principles are used to assess the alignment of patients. 11 of 23 3 / 8 Coach the patient. Tell the patient what action you plan and expect from them. Show them what to do, and then help them move through the activity. Bend their knees Reach for the side rail Push up from side rail and/or bed Take responsibility for knowing how equipment works and its availability. Assess the client and the environment using the Patient Mobility and Transfer Equipment Determination Algorithm. Gather the appropriate equipment and other staff members needed. Organize the physical environment and the equipment to ensure safe completion of the task. This includes locking the wheels of the bed or chair, putting the bed/stretcher at the correct height, removing clutter, and making sure any mobile equipment is charged. Procedures with two or more caregivers require communication and coordination. Make sure your team members know their role Rehearse if necessary \ It is a high risk of injury to allow the patient to use the caregiver for support to push/pull during transfers.

file://c:\documents and Settings\cruzal\Desktop\Safe Patient Handling\Content_1\04quiz_4\01Intro_1.html Launch Internet Explorer Browser introduction 12 of 23 4 / 1 You are now ready to take the course quiz to assess your understanding of the course material. You must score 80% or higher on the quiz in order to complete the course. If you score less than 80%, you must retake the quiz until you receive a passing score. Ready to begin? Click the forward arrow to start the quiz. Single answer questions Read the question and click the radio button next to the best answer. You may change your response by clicking a different answer. When you are ready to submit your final choice, click Check Answer. Multiple answer questions Read the question and click the checkboxes next to as many answers as apply. When you are ready to submit your choice, click Check Answer. See examples of graded quiz questions.

file://c:\documents and Settings\cruzal\Desktop\Safe Patient Handling\Content_1\04quiz_4\02_2.html After Course: Editing Applying Question: Principles of Safe Patient Handling (SPH) 1. Make "answershield" layer visible. 2. Hide Current "notes" Section: layer. 13 of 23 4 / 2 or false? Body mechanics training alone is effective in preventing injuries.

file://c:\documents and Settings\cruzal\Desktop\Safe Patient Handling\Content_1\04quiz_4\03_3.html 14 of 23 4 / 3 or false? The use of safe patient handling equipment including ceiling lifts, mobile floor lifts, EZ stands, HoverMatts, and Slipp Sheets reduces the risk of injury to both staff and patients.

file://c:\documents and Settings\cruzal\Desktop\Safe Patient Handling\Content_1\04quiz_4\04_4.html 15 of 23 4 / 4 or false? A patient should be considered assistance of 1 staff if able to assist with 75% of the effort for transfers and/or repositioning; with or without assistive devices. View the "Patient Mobility and Transfer Equipment Determination Algorithm" to help answer this question.

file://c:\documents and Settings\cruzal\Desktop\Safe Patient Handling\Content_1\04quiz_4\05_5.html 16 of 23 4 / 5 or false? A patient that is total assistance is unable to assist with 50% of effort for transfers and/or repositioning. View the "Patient Mobility and Transfer Equipment Determination Algorithm" to help answer this question.

file://c:\documents and Settings\cruzal\Desktop\Safe Patient Handling\Content_1\04quiz_4\06_6.html 17 of 23 4 / 6 or false? Assessing each patient's mobility level and determining the appropriate safe patient handling methods should be determined prior to transferring or repositioning a patient.

file://c:\documents and Settings\cruzal\Desktop\Safe Patient Handling\Content_1\04quiz_4\07_7.html 18 of 23 4 / 7 or false? The patient should always be instructed as to what you expect from them during any transfer and/or repositioning, including to assist with the transfer as much as possible depending upon the medical diagnosis.

file://c:\documents and Settings\cruzal\Desktop\Safe Patient Handling\Content_1\04quiz_4\08_8.html 19 of 23 4 / 8 or false? The maximum weight any patient caregiver should lift during any patient handling task is 35 pounds.

file://c:\documents and Settings\cruzal\Desktop\Safe Patient Handling\Content_1\04quiz_4\09_9.html After Course: Editing Applying Question: Principles of Safe Patient Handling (SPH) 1. Make "answershield" layer visible. 2. Hide Current "notes" Section: layer. 20 of 23 4 / 9 or false? A minimum of 2 staff should be used to reposition/boost a 250 pound total assistance patient in bed. View the "Patient Mobility and Transfer Equipment Determination Algorithm" to help answer this question.

file://c:\documents and Settings\cruzal\Desktop\Safe Patient Handling\Content_1\04quiz_4\10_10.html 21 of 23 4 / 10 or false? A patient should be considered total assistance if any staff member is required to lift more than 35 pounds.

file://c:\documents and Settings\cruzal\Desktop\Safe Patient Handling\Content_1\04quiz_4\11_11.html After Course: Editing Applying Question: Principles of Safe Patient Handling (SPH) 1. Make "answershield" layer visible. 2. Hide Current "notes" Section: layer. 22 of 23 4 / 11 or false? It is safe to manually lift a total assistance patient up from the floor, even if a staff member is required to lift more than 35 pounds.