Safe Bariatric Patient Handling Toolkit

Addressing the need for research on bariatric patient

During the past 3 decades numerous studies have documented the high prevalence of patient handling-related musculoskeletal injuries among healthcare workers and evaluated ergonomic interventions using mechanized equipment for lifting and moving patients. A great deal of research-based evidence now demonstrates the effectiveness of ergonomic interventions to reduce injury risk among healthcare workers who handle patients of average weights and sizes. In contrast, there is a lack of evidence-based research that evaluates ergonomic interventions for handling bariatric patients, whose extreme weights and sizes necessitate specialized handling equipment. The obesity epidemic, along with special medical and therapeutic concerns regarding bariatric patients, exacerbates healthcare workers' patient handling demands. The National Institute for Occupational Safety and Health is conducting a new study to evaluate bariatric patient handling hazards and interventions and identify evidence-based best practices for handling this population.

Physiological rationale and current evidence for therapeutic positioning of critically ill patients

Prolonged bed rest is common in critically ill patients, and therapeutic positioning is important to prevent further complications and to improve patient outcomes. Nurses use therapeutic positioning to prevent complications of immobility. This article reviews therapeutic positions including stationary positions (supine, semirecumbent with head of bed elevation, lateral, and prone) and active repositioning (manual, continuous lateral rotation, and kinetic therapy). The physiological rationale and current evidence for each position are described. Applicable evidence-based practice guidelines are summarized. Special considerations for therapeutic positioning of critically ill obese and elderly patients are also discussed.

Facing the Challenge of Patient Transfers: Using Ceiling Lifts in Healthcare Facilities

Objective:

The objective was to review the literature on the use of ceiling lifts to perform patient transfers in healthcare settings.

Background:

Manual patient transfers present a high risk of injury. Ceiling lifts are increasingly used in healthcare facilities. Despite this, little is known about the effects of this new technology.

Methods:

Research and review articles were searched on five databases using specific key words and phrases. Literature citations in the articles and gray literature (e.g., technical reports, conference proceedings, magazine articles, Web sites) were also evaluated when relevant for this review. Experts in this area were contacted regarding information on the topic, potential literature, and for their suggestions.

Results:

Few studies evaluated the use of ceiling lifts in healthcare. The studies available and the experiences of the experts contacted support the use of ceiling lifts. The musculoskeletal safety of healthcare workers and patients can be improved by the use of ceiling lifts. Having lifts available, organizing the workflow, and reducing the steps required during transfers and handling tasks can significantly lessen the risk of musculoskeletal injuries.

Conclusions:

Evidence supports the installation of ceiling lifts in patient rooms and recommends their use in bathrooms. However, additional studies are needed because the use of ceiling lifts in healthcare is relatively new.