January 12, 2018

By: Roric P. Hawkins RN, MBA, BSN

Focusing on Safe Patient Handling 2017-2018

As we ended 2017, I reflected on some of the feedback I’ve received from the blogs that I wrote during the year. Most people’s comments have been very positive and supportive, but some have raised questions or concerns. As we start the new year, I thought this would be a good opportunity to address some of those questions here.

Why does nursing seem to be the primary focus of all your blogs?

Most hospital organizational missions are written as a commitment for what patients should expect when choosing to receive care within their hospital facility. It would be next to impossible to accomplish these missions without the direct involvement and unwavering support provided by nursing staff. In hospital settings, nurses are the most central figures to patient care, responsible for not only the delivery of consummate quality, but also acting as coordinators of care both within and often outside of hospital settings. Nurses represent the direct link between the patient’s health, physicians, support services, and associated family members and friends.

As it relates to implementing safe patient handling programs, it must be understood that most patient handling injuries in hospital settings are incurred by the nursing staff. By virtue of the way hospital care is delivered in the American healthcare system, patients during any inpatient hospital stay will spend the majority of that hospital time under the direct care of nursing staff; meaning that nurses are left to assume all associated responsibilities of the patient’s well-being to include all patient activities of daily living. This of course also includes any physical challenges the patient may present with, especially those requiring manual assistance regardless of the patient’s ability to help or participate. These type of daily physical activities, coupled with the amount of time spent with one patient, times the five patients for which the nurse may be responsible for on any given shift, directly correlates with a high injury risk to nurses, all associated with performing the physical aspects of patient care.

However, I want to add that whether the healthcare worker is a nurse or another patient-care provider, my focus when writing these blogs is to address the injury risks created by outdated lifting practices while offering solutions for how to implement a more modernized alternative, patient-lift equipment.

Why do you discuss patient lifting in terms of the nursing process?

In thinking about the physical aspects of what it takes to care for patients more specifically at the bedside, overcoming patient’s mobility limitations ultimately hinges upon the nurse’s physical capabilities to perform patient mobility tasks. This accentuates the idea that serious injury risks are a relevant part of nursing duties for those staff responsible for providing patient care. So much so that not only are manual lifting techniques taught in most nursing schools, but also many hospital organizations teach these same unfounded lifting principles as part of their new employee hospital orientation process.

Because nurses learn these unsafe practices and attempt to safely apply them as prudent skills needed to perform bedside nursing duties, hazardous techniques are consistently incorporated into nursing practice solidifying them as the standard for manually lifting patients. This represents the very foundation for which safe patient handling programs are built; strategizing how to effectively change traditional patient-lift processes that many patient care staff find comfortable regardless of any perceived injury risk. It becomes even more challenging when patient care providers have performed these types of practices over a significant amount of time without having sustained any major injuries.

Instead of expending energy attempting to directly convince nurses that there is a safer more efficient way to lift and move patients, I tend to focus more on the nursing processes associated with lifting patients. I understand that if I can incorporate patient-lift equipment into traditional patient-lift processes without creating any additional steps, I increase the likelihood of nurses choosing to change manual patient-lift practices. By devoting attention to the process of patient-lifting opposed to stimulating debates with staff about how to appropriately lift patients, experience has taught me that outcomes are more likely to happen when patient-care processes are simplified through the use of patient-lift technology; not necessarily because it’s the safest most efficient way to lift.

Why do you feel so strongly that a safe patient handling coordinator is necessary?

Clinical practice in hospital settings is complex. Consider all the moving parts that go into taking care of one patient, let alone multiple. This not only includes specialized professional services needed to address the specific health care needs of patients, but also the support from other services that are rarely considered such as laundry, housekeeping, logistics, and engineering. Safe patient handling programs are often described as needing to be comprehensive to be effective. What this actually represents is the technical need for this level of injury prevention program to seamlessly fit into all factions of an already complex clinical system. This is more likely to happen when someone who understands the dynamics of patient care in hospital settings are in place. A safe patient handling coordinator is a necessity for protecting the organization’s capital equipment investments and sustaining the program’s longevity.

On my website, www.therphawkinsgroup.com, I have written an extensive whitepaper under the resources tab highlighting the value of having a safe patient handling coordinator. In short, coordinators are needed for comprehensive planning, strategic implementation, on-going monitoring, and necessary adjustments and critiques. A healthcare professional in place to address these challenges as the on-site expert is essential to preserving such an injury prevention initiative.

We deserve safety

I hope my blogs at minimum have provoked thought and stimulated discussions about the risks that healthcare workers endure everyday while performing patient care. Though many of us have chosen a profession dedicated to the service of others, I do believe that we are deserving of relevant safety measures capable of minimizing injury risks which are prevalent in our work environments. If we were to consider the positive impacts that safe patient handling programs are capable of producing, we will find that this injury prevention program directly aligns with many hospital organizational missions particularly the statements that address quality patient care. It has been my goal (and will continue to be my goal in 2018) to offer potential safety solutions that help protect both patients and healthcare workers.

Roric P. Hawkins is the founder and President of The RP Hawkins Group (www.therphawkinsgroup.com) and is the safe patient handling coordinator at Michael E. DeBakey VAMC in Houston, TX. The views expressed here are his own.

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