Safe resident handling can reduce injury

By Holly Carlson, MS, RN, CCRN

Faulty Equipment or Inadequate Training?

A few weeks ago I had a new aide caring for a resident who was having difficulty getting into bed in the evenings. The resident could transfer to a wheelchair or recliner in the morning but became weaker throughout the day.

For those who provide direct care you know this is not uncommon. Strength decreases as people get tired. The facility the resident lives in is fortunate enough to have lift assist equipment, however it is not used often.

Staff Brain Storming

The staff brainstormed together and wondered if they could use a Hoyer Lift to move the resident from the wheelchair to the bed to prevent a fall. They approached the wellness nurse and she agreed it was a good idea. She in-serviced the care givers that were on shift at the time.

First the staff were instructed on how to center the sling behind the resident so that his head and neck were supported. Then they were also taught to cross the sling between the resident’s legs to prevent him from sliding out during transfer.

Lift assist equipment is very helpful and protects healthcare workers, but it can also be very dangerous and cause injury if not used properly.

Care staff were enthusiastic about using the equipment, but a major issue arose when the lift usage training was provided in a see one, do one, teach one method. A few caregivers were taught by the wellness nurse and then the training transitioned to them teaching each other. When the caregivers taught other caregivers, they failed to teach the need to crisscross the sling between the resident’s legs. The resident got scared, panicked, and slipped out of the sling.

Faulty Equipment?

After the incident, the care staff went to the wellness nurse and told her the resident fell out of the sling because it was faulty. The nurse investigated the situation and found that the equipment was just fine, but the staff had been using it wrong.

While advanced medical equipment is very important to care for others and help the staff, there have to be processes in place to prevent injury. Here are three different ways to ensure care staff efficiently use equipment, prevent harm to themselves and to residents; education, support, and basic instructions.

Staff Training on Equipment

Training

There are three major ways to provide basic education on using equipment.  These include:

• Hands-on in-services by someone who is efficient in using the equipment. This could be your facility educator, wellness nurse, or the sales representative from the company.
• Online courses by the manufacturer or other third-party education companies. These provide self-paced education that can be accessed anytime.
• Peer to peer return demonstration which can be effective in instilling the dos and don’ts of the equipment through personal experience. Understanding the resident’s experience because you experienced it can prompt staff to pause if the resident becomes uncomfortable. It’s a relatable experience.

Support

• Equipment champions are perfect resources for all staff and it saves on education time. Champions are staff members who are committed to maintaining the knowledge and skills to operate the equipment properly and safely. Having one on each shift who can be available will help mentor less experienced staff and keep residents safe.

• Leadership support may be necessary until you are confident there is someone on shift at all times that can back up the staff. Making sure questions can be answered and reliable help is available will prevent injury.

Basic Instruction

Every piece of equipment comes with instructions. Equipment manufacturers make learning videos, booklets, and step by step cards that can be physically attached to the equipment. Make sure these are available at all times and that the staff are aware of where to find them will prevent an injury.

While all of the items listed are important. The most import question that should be asked before using any equipment with a resident is:

Is the person a candidate for the equipment?

Make sure the person can cooperate. To safely use equipment with a resident, they  must be cognitively alert enough to follow simple directions or be talked through the process. This is key to deciding whether equipment is used. Answering these questions will prevent injury to staff and residents.

Holly Carlson MS, RN, CCRN is a freelance writer and owner of HDC Consulting.  Holly is a registered nurse with 25 years of healthcare experience in both acute and post-acute healthcare environments. Her experience includes direct care, organizational leadership, facility management, and organization culture development.