Manual handling risk management: critical care beds and support systems

Adverse risk: a 'dynamic interaction model of patient moving and handling'

AIM

The aim of the present study was to examine patient adverse events associated with sub-optimal patient moving and handling.

BACKGROUND

Few studies have examined the patient's perspective on adverse risk during manual handling episodes.

EVALUATION

A narrative review was undertaken to develop the 'Dynamic Interaction Model of Patient Moving and Handling' in an orthopaedic rehabilitation setting, using peer-reviewed publications published in English between 1992 and 2010.

KEY ISSUES

Five predominant themes emerged from the narrative review: 'patient's need to know about analgesics prior to movement/ambulation'; 'comfort care'; 'mastery of and acceptance of mobility aids/equipment'; 'psychological adjustment to fear of falling'; and 'the need for movement to prevent tissue pressure damage'.

CONCLUSION

Prevalence of discomfort, pain, falls, pressure sores together with a specific Direct Instrument Nursing Observation (DINO) tool enable back care advisers to measure quality of patient manual handling. Evaluation of patients' use of mobility aids together with fear of falling may be important in determining patients' recovery trajectory.

IMPLICATIONS FOR NURSING MANAGEMENT

Clinical governance places a responsibility on nurse managers to consider quality of care for their service users. 'Dynamic Interaction Model of Nurse-Patient Moving and Handling' provides back care advisers, clinical risk managers and occupational health managers with an alternative perspective to clinical risk and occupational risk.

Falls and patient mobility in critical care: keeping patients and staff safe

Creating safe passage for patients is a priority in hospitals across the United States, a priority in which critical care and advanced practice nurses play a crucial role. Three unique but related areas within this safety framework are fall prevention, the emerging practice of early mobility in intensive care, and safe patient handling. This article explores these 3 topics in tandem to determine whether sufficient evidence exists to guide fall prevention strategies, to explore patient safety associated with early mobility in intensive care units, and, because mobilizing patients is physically demanding for health care workers, to describe safe patient-handling techniques aimed at injury prevention for critical care nurses and others. A review of what is currently known about falls, effects of mobility, and safe patient handling provides a foundation for practice considerations and reveals research opportunities.

Sustaining staff nurse support for a patient care ergonomics program in critical care

Applying management concepts from marketing and business sources can assist critical care units with establishing a planned change in the way nurses perform manual handling tasks, and thus, help insure that it is sustained.