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Hi all
We found through years of trial and error (in multiple areas) that a fitted sheet and a flat sheet works best for patients needing assistance with slide sheets. The patient is better protected as less chance of bare skin against the mattress. The staff have better purchase/grip using the top flat sheet with the top slide sheet. We did have some resistance re cost but in reality whats the cost of laundering an extra sheet compared to the cost of an injury to either staff, patient or both!
Thanks
AnneI have to say its really worth while having a look and a play with this. Its not a sit to stand hoist, once you get your head round that, (as I had to) its easier to place the use. The video is not my favorite but working with the actual machine and proper instruction is really worth while. Richard is kindly bringing the equipment to our team day in December so the whole M&H Educator team can have a look.
Hi Jessie, Megan and Kate
I agree the techniques used in this video are unsafe. The carers are using the strap handles to lift and lower the patient. No I would not advocate this technique and no I would definitely not teach it to our staff. But I think this type of equipment is great as long as its used in the right way and with the appropriately assessed patient/client. They are a great way to test and improve sit to stand ability and standing tolerance. They have a small footprint and obviously don’t need to be near a power point, making them easier for clinical and residential spaces to accommodate. But they do not replace the need for a sit to stand and/or full body hoist. If the patient cannot stand themselves onto this equipment then a higher acuity of equipment should be used.
We train staff to use the strap only once the person is standing and to remove the strap before they sit down. We remove the moveable slide before implementation so staff are not tempted to try drag or lift anyone up. I have not seen the technique on the video used anywhere before. I have seen the strap with the slide in use but I think there is a risk that it will be used to lift the person physically. Everyone teaching M&H needs to consider as you say Jessie, A. can you do it safely and B. can you teach it and have confidence that the learner will do it safely. Transfer belts have been contentious for some time, I think for similar reasons. There is a round table discussion article in the international Journal (Int J SPHM. Volume 7, number 3, 116-121) discussing ‘gait belts’ with representatives from NZ, the UK and the US. Just FYI!
Thanks
AnneHi Julia
Welcome to MHANZ.
We run events most years that provide opportunities for updating, these usually include overseas speakers, workshops and presentations. We also encourage our members and practitioners, like yourself, to participate in the programme.
There is a post grad certificate in Moving and Handling available at AUT, course lead is Dr Fiona Trevelyan. This is based on the curriculum from Dr Mike Fray in Loughborough University in the UK. MHANZ, Dr. Fray and ACC were integral to the introduction of this in 2015.
There is also the Australian AAMHP (Australian Association for the Manual Handling of people http://www.aamhp.org.au/) and their next conference is September 2020 in Adelaide. We provide information on these events in our newsletter and within the website itself so have a good look around.
Hope that helps!
AnneHi Ellen
As far as I am aware the only update was the condensing of the 2012 document for the Worksafe website. That was done a couple of years ago. Many MHANZ members delivered robust and thorough feedback to the first draft but no acknowledgement of this was given. There was no evidence of any of that feedback being integrated into the final product. I would be keen for the Guidelines to be updated, they were always intended to be a living document to evolve and develop with progress in knowledge and technology.
If any MHANZ member is aware of this could you please post on the forum or PM me? I feel it is very important that subject matter experts, those involved and responsible for M&H programmes and the people actually doing the work, be represented in any revision.
I will update you all if i hear anything further.
Thanks
AnneMy preference would be either slide sheets under the calves to reduce the friction and allow the person to pull their own legs up or using a limb sling with a hoist. The staff shouldn’t be lifting legs, it is detrimental to their and the patient safety. If the person can’t get one leg up at a time (with these aids and the right positioning) I would be questioning their ability to stand and/or walk, do they need a hoist? The positioning of the patient and the bed is crucial. Lowering the bed to an optimal level, getting the patient to the right point of the mattress, putting the back of the bed up and using any handles the bed has built in e.g. hill rom has multiple points allowing the patient to safely assist in propelling themselves backwards. Then getting the person to sit back into the middle of the mattress and bring one leg up at a time. I think often this task doesn’t need assistance when the person is instructed correctly and given the time to do it.
Possibly the inability to get legs back onto a bed is the justification to have more automation, particularly in the home setting. A bed that is electrically height adjustable, a sit to stand aid allowing better positioning or even a ceiling hoist allowing limb assistance without making the floor space of a room unmanageable. If the patient cannot get their legs onto a bed they are likely to require some level of assistance for other tasks. The weight of legs, especially in the presentations mentioned, will be in excess of any kind of ‘safe’ load limit.
I agree Kate and Julie, i am also concerned that any focus on single handed care will disadvantage rather than benefit patients and/or carers. The focus must be on what is required for the task to be performed safely and in that environment. If, as you say, a reduction of ‘bodies’ can be justified in an upgrade in facility design e.g. ceiling hoists then great but that must be a case by case and not only risk assessed but repeatedly risk assessed.
The good news is you’ll be able to ask Deborah herself as she is joining us on the AGM day on the 3rd of May here in Auckland. A MHANZ plans is going out shortly and Cubro are supporting Deborah to come join us for the day. She is very excited about the prospect and wants us to work her to the bone, which we will!
Good question Jo, I believe every birthing pool should have a ceiling track above it. Its the only way to get the mother out of either she or the baby are in trouble safely. It is also documented on page 273 of the guidelines ‘birthing pools need ceiling tracking above for handling and emergency evacuations’. Ive yet to see one but should an emergency happen the precedent has been set by the guidelines.
Hi Angela and Leona
The information on the Worksafe is a cut and paste from the original 2012 document and this is far more detailed and robust. You can find it at the end of that section or here is the link https://www.acc.co.nz/assets/provider/acc6075-moving-and-handling-people-guidelines.pdf
Thanks
AnneHi Angela and Leona
The information on the Worksafe is a cut and paste from the original 2012 document and this is far more detailed and robuts. You can find it at the end of that section or here is the link https://www.acc.co.nz/assets/provider/acc6075-moving-and-handling-people-guidelines.pdf
Thanks
AnneIn reply
1: What is your role/job title? Moving and Handling Consultant
2: What are the 3 main barriers you face when it comes to moving and handling people safely?
(1) Lack of Ministry of Health advocacy/input/directives that make inclusion of M&H in Health and residential care strategy/budget compulsory
(2) Lack of compulsory and specific consideration for M&H in facility refurbishment and design, e.g. ceiling hoists AND ratio/design of them
(3) Perception – often nice to have for an expendable workforce is the perception, instead of the potentially catastrophic or therapeutic effects on both workforce and patients3: Does your workplace, in your opinion, have a basic Moving & Handling programme? E.g. a policy that includes training and equipment and consideration of moving and handling in facility design? Yes but needs all of the above to be truly business as usual
4: Would you like hear more about the initiatives from the Workplace Safety team? Yes please
Hi
To clarify, during consultation with the Counties M&H steering group, we were asked to implement the Waitemata DHB M&H programme there. I recommended a base line measurement of the organisations M&H status, via the TROPHI tool, pre-implementation. I would urge any organisation to do this before any major intervention for M&H is planned. After connecting Dr Mike Fray with the Counties team, led by Dana, the TROPHI tool was introduced, carried out in 14 clinical areas and results were analysed by Mike. The next stage is underway and the implementation of the Waitemata programme starts in August. Training for Counties Staff goes live in September, with our support during the transitional stage and ongoing. Counties will be implementing all of WDHBs M&H tools, documents and practises in a gradual planned process.The TROPHI tool will then be repeated, analysed by Mike and can inform us of both progress or lack of it and where the gaps remain. The benefits are multiple but for at least a basic start, staff transitioning from one DHB to the other won’t need to be either retrained or be convinced of a differing set of practises just because of geography!
As we know relying purely on Staff injury information does not give us the basis for either investment for improvements or the real impact of doing little or nothing. The TROPHI tool can help change this with actual evidence gathered through measuring and analysing the data from the 12 key focus tools. It is also an opportunity to highlight the absence of a whole professional group in managing this hazard for themselves and others. Evidence is what drs will expect to convince the profession as a whole to be part of this.
I feel this could be further strengthened in the additional measurement of the financial, ethical and overall health benefits for patients. Plus stronger integration of the currently siloed areas of pressure injury prevention, falls and early recovery and earlier discharge care.
Dr Mike Fray is joining us for the whole MHANZ roadshow in November and will be presenting on this specific project as well as other topics. We are very lucky to have him so please encourage and advertise attendance. We and Counties intend to have some feedback of where we are at and what’s next. MHANZ was integral to the introduction of the M&H post grad cert at AUT. The content and premise is based on Dr Fray’s at Loughborough University in the UK.
Establishing our credibility in this practise is crucial in lieu of any standards or regulation from MoH, unions or professional bodies.Finally from me personally, developing a national programme has been my lofty aim for nearly 13 years. A programme that could also be measured on both the sucess or failure of its interventions and then tweaked accordingly, can only be good for us as an industry. It can only benefit patients who are ultimately also us and every other person in New Zealand. We have to stop diluting and confusing our messages or philosophies if we want to progress M&H to the level of professionalism it should be at.
Only when have this can we expect to fully integrate M&H into all professions and environments in health and social care. Embedding M&H practise into the training and practise of Drs, I think, will be a national issue but a crucial one. Again having a clear evidence based programme can only help strengthen the argument.Apologies for the giant message! 🙂
The hoists here have a range of sizes available, rather than specific bariatric ones. I think we go up to an XXXL but the standard S,M and L go up to 200kg. We have some sizes (S,M,L and XL) in our pool equipment area and some areas have bought larger sizes themselves. I am aware that the Liko ones go up to 500kg and I think that is in the disposable and re-washable options. If there any supplier members who would like to respond to this please do!
I think there are some real risks in hoisting a person over 200kg (the standard hoist SWL) using a floor hoist. Ceiling tracking would be far safer for patient and carer alike and reduce the space required to transfer. A gantry system installed into an area without ceiling hoists could be a possible solution. That would be my preference but so far has not happened here in this DHB. Any patients exceeding 200kg have routinely been managed using the beds and air assist products until they are ambulating, as far as I am aware. The larger walking frame has been in use recently for those who can mobilise The option for portable gantry systems to my knowledge has not been utilised much in New Zealand.
We don’t have a vascular surgery service so demand for bilateral amputee slings has not happened. We do advise in training these should be purchased by the clinical areas and again have advised to buy for the pool in preparation of need. However we do not hold that budget and can only advise, again to my knowledge there are none stored in our DHB.
Hope that is of some assistance.
