SAFE PATIENT HANDLING ACT WHAT S HAPPENING IN ILLINOIS May 12, 2011 Aida Trinidad Illinois Department of Public Health Division of Health Care Facilities and Programs
TITLE 77 IL ADM. CODE 250 HOSPITAL LICENSING REQUIREMENTS Section 250.1030 c) 7)
NURSING POLICIES AND PROCEDURES THAT ADDRESS A policy to identify, assess and develop strategies to control risk of injury to patients and nurses and other health care workers, associated with the lifting, transferring, repositioning, or movement of a patient.
POLICY SHALL COVER Analysis of the risk of injury Education of nurses Evaluation of alternative ways to reduce risks Restriction to the extent feasible of patient s weight through use of equipment and aids and not by staff Collaboration with, and an annual report to nurse staffing committee Procedure for a nurse to refuse to perform in a patient handling due to risk of injury Submission of annual report to governing board or QA Consideration of incorporating patient handling equipment when remodeling
ANALYSIS OF THE RISK OF INJURY Review the patient population served in each nursing area (how often/how hard) Review the physical environment in which patient handling and movement occurs Review current patient equipment
ANALYSIS OF THE RISK OF INJURY Review the patient population served in each nursing area (how often/how hard) Medical condition/physical ability, acuity and behavior Types of transfers, (1) bed to and from Chair, gurneys, walker, toilet/bed side commode Transfers (2) Chairs to and from Wheelchair, gurneys, walker, toilet Ambulating, repositioning, manipulating Repositioning/Turning/Holding; assisting with ambulation
REVIEW THE PATIENT POPULATION SERVED IN EACH NURSING AREA (CONTINUED) Transporting or moving Beds or gurneys, wheelchairs, Geri chairs, room furniture, carts, equipment Medically related activities Weighing, wound care, inserting catheters, starting IV lines, applying medical devices
REVIEW THE PATIENT POPULATION SERVED IN EACH NURSING AREA CONTINUED Performing activities of daily living Handling food tray or feeding Bathing in bed, tub or shower Performing personal hygiene Dressing and undressing Removing prostheses or braces Changing adult depends Making beds with and without patient Replacing draw sheets or incontinence pads
REVIEW THE PHYSICAL ENVIRONMENT IN WHICH PATIENT HANDLING AND MOVEMENT OCCURS High threshold or obstructions in entry ways Size of room/bathrooms/hallways Steep ramp (greater than 10 degrees) Floors slippery/uneven/cluttered Bedside medical and electrical outlets too low/only on one side Storage space No grab rails by toilets or in showers
REVIEW CURRENT PATIENT EQUIPMENT Brakes Takes to long or hard to adjust Casters/wheels do not roll easily Hard to steer To low/high Armrests/foot pads not removable/ adjustable Items missing (e.g., slings/iv med poles) Storage or location of lifting device
EDUCATION OF NURSES AND OTHER HEALTH CARE WORKERS Training tips Hand-on-practice Opportunity for feedback Demonstrated in competency Systematically reinforced
EVALUATION OF ALTERNATIVE WAYS Review the new process and procedures developed Evaluate the equipment; is it appropriate for the specific use, effective and safe Is equipment readily available Staff in compliance with new process (QA set up how this is determined by enforcement, demonstration etc.)
RESTRICTION,, OF MANUAL PATIENT HANDLING OR MOVEMENT OF ALL OR MOST OF A PATIENT S WEIGHT EXCEPT FOR EMERGENCY, LIFE THREATENING OR OTHERWISE EXCEPTIONAL CIRCUMSTANCES.
REPORTING TO NURSE STAFF COMMITTEE "Nursing Care Committee" an existing or newly created hospital-wide committee or committees of nurses whose functions, in part or in whole, contribute to the development, recommendation, and review of the hospital's nurse staffing plan established pursuant to subsection (b). (Section 10.10(b) of the Act) This can be found at 250.1130 The analysis and policy shall be developed by collaborating with the above committee Provide an annual report of the new process to include its effectiveness or revisions required to control risk of injury.
PROCEDURES FOR A NURSE TO REFUSE TO PERFORM OR BE INVOLVE WITH PATIENT HANDLING OR MOVEMENT
ADMINISTRATIVE REVIEW Annual Report to governing board or QA committee on activities related to the Identification Assessment Development of strategies to control risk of injury Evaluation of the effectiveness of the new process
REMODELING Consider the feasibility of incorporating patient handling equipment or the physical space for patient handling devices. (i.e. single rooms, accessibility, ceiling lifts, etc.)
QUESTIONS? KAREN SENGER RN 217-782-0381 KAREN.SENGER@ILLINOIS.GOV AIDA TRINIDAD 312-793-2222 AIDA.TRINIDAD@ILLINOIS.GOV