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Hi Joanne,
A couple of years ago at WDHB, myself and a nurse educator wrote policies and proceedures for the bariatric patient journey.
We hold a bariatric study day, designed for the multidisciplinary team once a year. This was based off a bariatric study day that we attended in Melbourne.
We worked with the allied health team to purchase equipment since we are a provincial hospital and renting is not a viable option.
I encourage staff to contact me if they are stumped with regards to moving and handling but we have found that over time all staff have become aware of available equipment, how to use it appropriately and the ratio of staff needed to care for the bariatric patient.Thank you for asking this question!
This is an on going problem for us too and often results in staff injury.
I have asked for advice from our resuscitation educator since this type of transfer is often performed since there is a need to perform CPR.
We both agreed that the best place for the patient is on the floor and so recommend that by carefully using a slide sheet the patient can be slide to the floor and recovery efforts performed on the floor.
When patient is stable to move, they would be moved using a Hovermatt and Hoverjack back to bed.
HOWEVER….is this what happens in practice????
The answer is usually no…..
This month I am attending the CNM meeting to discuss this very scenario.
I feel it requires a team effort to discuss and risk assess and develop a plan BEFORE it happens.
As I am typing this Anne has added her response and I agree wholeheartedly.
Fingers crossed that we can have success spreading this message.Hi Julia, I work at another small DHB, currently equipment that is specific for an area/ward is funded by that area.
Single use Hovermats are funded by specific areas too but ideally I see this as an organisational cost.
We managed to get a separate budget for bariatric equipment. What we found is that we had to put together some work demonstrating the need for equipment so that the finance department could allocate specific funding for the following financial year.
Our bariatric equipment is stored in a central location and orderly request made for delivery.Hope this helps.
MichelleHi Julie,
Thank you for your feedback on the bed.
Yes the fact that it is able to go low to ground for mobile patients is what I like about it.Thanks Michelle
Hi Julie,
Whanganui DHB have been going through a long process to have senior management support more ceiling hoists too.
Currently we have a total of 6 in our ATR department, one of those between parallel bars in the gym and one is designed to be used with 2 motors and accommodate a patient weighing 350kg.
We would like ceiling hoists in all acute wards. And are proposing the need for one to span a 2 bedded space and bathroom if possible. This would include surgical, medical, and CCU wards. The emergency department would also benefit too.
We have been informed that some of our ceilings are not reinforced to hold a ceiling hoist.
Engineering questions and barriers is part of the problem.
Gantry hoists can be useful when the roof is an issue.
We had an unsuccessful trial of a gantry hoist in our CCU. Unfortunately it took up too much room and became a tripping hazard and made the room too cluttered with other essential patient care equipment.
We should try a different brand. However I personally see gantry hoists as an interim solution but ultimately we should strive for ceiling hoists.Hope this helps,
Michelle• 1: What is your role/job title? Manual handling injury prevention coordinator. I sent these questions out to members of our manual handling champion program. An RN from OPD responded, a radiographer, an RN from extended forensic and our health and safety coordinator.
• I have summarized their answers and my response below.
2: What are the 3 main barriers you face when it comes to moving and handling people safely?
(1)All respondents felt that having enough staff available to help with a safe transfer was the main problem. Our H&S coordinator felt that this may be a perceived problem and unfortunately Trendcare does not always take into account increased staffing needs and time for bariatric patients.
(2)Not enough time to complete the task safely including a thorough risk assessment and mobility plan. To include encouraging the patient to assist and move themselves and or understand why staff need to use certain equipment. Time and staffing levels are certainly linked. Having equipment readily available, “out of sight out of mind”.
(3)In some areas workplace culture of “she’ll be right”, which I feel would improve with Ministry of Health initiatives and leadership. As a manual handling coordinator one of my barriers is…… much needed equipment not being budgeted for prior to this role existing. Facility design not accommodating ceiling hoists or doors, rooms and bathrooms being too small to accommodate larger equipment.
3: 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 to all
4: Would you like hear more about the initiatives from the Workplace Safety team?
Absolutely!Last year at Whanganui DHB we identified the same problem that you are having Julie. We too send our slings to Allied laundry. Due to slings not being labelled properly we often did not have them returned. Overall we had a shortage in each ward and at the time slings were a departmental purchase and ownership.
We decided to purchase more slings that were labelled specifically “Whanganui” and not “WDHB” as in the past. We also made them an organisational item vs departmental.
Secondly we liaised with our local Allied laundry workers and have them on board as part of the sling allocation team.
I worked with ward nurses to identify exactly how many slings of each size they would need at any given time and now have the Allied laundry staff ensure that their is always a specific number of slings in each area.
I’m assuming they do this when they deliver clean laundry to the wards first thing in the morning.
It has been working very well and I have been really happy with the outcome.
Hope this helps.
MichelleThanks Kate, was your training to the anaesthetists centred around lateral transfers and air-assisted devices?
