A Patient is Not a Box

Maureen Larkin, for HealthLeaders Media, July 17, 2008

Proper lifting techniques used to be part of every nurse's training, but as patients get older, heavier, and sicker, the traditional "Lift with your legs, not with your back," just doesn't work anymore. Injuries to both patients and employees are on the rise, and to make sure that they're providing the best healthcare possible, many hospitals are instituting mandatory mechanical lift programs.

"Historically, you were always taught about body mechanics--knees bent, back straight when you lift a box, but patients are not boxes. When you pick a patient up, they're limp, they move, and their weight is not equally distributed," says Mary Godwin, RN, MSN, in this month's issue of HealthLeaders magazine. Godwin is program manager of training and development, employee health and infection control for Alamance Regional Medical Center in Burlington, NC. Alamance developed its Safe Patient Handling and Moving Program more than three years ago. The program teaches caregivers the importance of using mechanical lifts to assist them in moving patients to a chair, a bed, or the restroom--regardless of their size.

At Baptist Medical Center in Jacksonville, FL, using mechanical lifts is mandatory--regardless of the patient's size, says Chris Olinski, RN, MSN, director of employee health at BMC Jacksonville. Baptist's Transferring and Lifting With Care (or TLC) program was developed in response to a rising number of patient and employee injuries and the organization's desire to provide its patients with quality care.

Keeping nurses and other experienced caregivers on the floor is important as the nursing population ages, Olinski says. But if a nurse is injured while moving patients, there's no telling how long he or she will be out of work. TLC was created to prevent not only injuries, but the loss of knowledge among the nursing staff.

"We wanted to look at what we needed to do... to keep that nurse and her experience at the patient bedside," Olinski says. For nurses to have the piece of mind that their employer is looking out for them and working to keep them safe is important to morale, she says.

Making it easier for staff to move patients also helps a healthcare organization combat two conditions listed in CMS' 2008 list of conditions for which it will not reimburse hospitals: pressure ulcers and hospital acquired fractures, dislocations, and other injuries.

"It's the right thing to do for the patient," says Kristin Vondrak, system director of quality for Baptist Health. "Primarily, it promotes good patient care by empowering the direct care providers. (With TLC) we keep our patients safe and our employees in the workforce longer."

We need to look out for the safety of not just our patients but our employees, too. We need to make sure that they have the equipment they need to prevent on-the-job injuries that will leave our hospital departments without their years of valuable job experience. And we need to make sure that employees with aching backs and sore shoulders aren't taking a chance by continuing to lift patients.

What we need, is to think outside the box.

Maureen Larkin is quality editor with HealthLeaders magazine. She can be reached at mlarkin@healthleadersmedia.com.

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