Evaluation of Technology to Support Safe Patient Handling and Movement

1. Evaluation of Technology to Support Safe Patient Handling and Movement Acknowledgements: Andrea S. Baptiste, MA, CIE John Lloyd, PhD, CPE Audrey Nelson, PhD, RN, FAAN Funded by VISN 8 Patient Safety Center of Inquiry, Tampa, VAMC

2. What Is a Friction Reducing Device? Friction reducing devices provide a low cost technology solution for lateral transfers of patients E.g. Bed to stretcher transfers

3. Equipment Applications Nursing home/home care General rehabilitation Acute medical/surgical Or/recovery Spinal cord injury unit Inpatient/outpatient clinic Intensive care unit

4. Types of Friction Reducing Devices: There are 3 types : Air Assisted Lateral sliding aids Mechanical lateral transfer aids

5. Air Assisted Lateral Sliding Aids A flexible mattress placed under patient; inflates by portable air supply. Patient is moved on a cushioned film of air This reduction in friction makes the lateral transfer much easier for the caregiver Cost: $1200-$1600

6. An example of an air assisted lateral sliding aid: A waterproof, anti-bacterial anti-stain, nylon mattress that allows for lateral transfers. Key strength: no weight limit

7. Lateral Sliding Aids Assists with bed to stretcher type transfers-transfer boards or fabric Both devices are positioned under the patient providing a smooth surface to slide the patient

8. Example: Lateral Sliding aid Properly designed handles (fabric) reduce the forward reach as found in draw sheets Cost: $80-$300

9. Example: Lateral Sliding Aid Used for transfers and repositioning patients in bed Main advantages of this device are: portable, easily stored and lightweight (4 lbs)

10. Mechanical Lateral Transfer Aids This eliminates the need to manually slide patients This reduces risk to the caregiver Cost: $1800-$8000

11. Example: Mechanical Lateral transfer aid This device is used in lateral transfers of patients Key advantage: no manual work done to slide patient

12. An Evaluation of Technology The purpose was to evaluate eleven commercially available lateral transfer aids. Transfers were done from a hospital bed to a stretcher.

13. Lateral Transfer Study Air assisted: Airpal Hovermatt

14. Methodology: Subject: A 200 pound mannequin was used to represent a dependent pt. in all lateral transfers. Equipment: Chatillon force gauge, bed with non-inflating mattress, stretcher trolley.

15. Methodology: Measurement: A simple method was devised to capture maximum external forces applied during the transfer. Results captured: Force Mean results % Population capable Spinal Forces

16. Force Mean Results: Mean applied force was calculated across five trials. Device yielding: lowest mean force was the maxi slide (39.7lbf. or 176.6 N). highest mean force was the draw sheet (145 lbf. or 645 N).

17. % Population Capable Results: 0% population able to sustain forces at the shoulder with a disposable plastic bag (DPB) or draw sheet. > 70% would be able to do the transfer task using Airpal, Hovermatt, Slipp, Lateral transfer aid, Aqua flat sheet set, Resident transit assist and Maxi-Slide.

18. Spinal Force Results: Compression: highest at L5/S1 with use of Maxi Trans (661lbf.) lowest with use of aqua flat sheet set (216.9 lbf.) Anterior/posterior shear forces: highest with use of DPB (179 lbf) lowest with use of Maxi Trans (6lbf) Lateral shear force: highest with use of lateral transfer aid (6 lbf.) lowest with use of Aqua flat sheet set

19. Top Five Products: 1) Lateral transfer Aid 2) Flat sheet set 3) Maxislide 4) Hovermatt 5) Airpal

20. Conclusions: Key factors that affect spinal loading: Caregiver’s stance and posture Friction reducing properties Relative height of transfer surfaces Location of handles on device Angle of pull Extended pull straps and number of straps used Patient mass

21. Implications for Clinical Application: These lateral transfer aids do have limitations-some are n/a for bariatric patients. For patients over 200 lbs, use a mechanical device and two caregivers. Other factors to consider are: storage, infection control, cleaning, ease of use.

22. The subjective study The purpose – to acquire feedback on usability of devices from nurses on the units. Look at results of subjective data and biomechanical data Eight devices were randomly distributed for evaluation

23. Equipment Rating Survey Product ______ Unit ______ How would you rate your OVERALL COMFORT during use of this product? 0 1 2 3 4 5 6 7 8 9 10 What is your impression of this product’s OVERALL EASE-OF-USE? 0 1 2 3 4 5 6 7 8 9 10 How EFFECTIVE do you think this product will be in reducing INJURIES? 0 1 2 3 4 5 6 7 8 9 10 How EFFICIENT do you feel this product will be in use of your TIME? 0 1 2 3 4 5 6 7 8 9 10 How SAFE do you feel this product would be for the PATIENT? 0 1 2 3 4 5 6 7 8 9 10

24. Conclusions Use of Friction Reducing Devices has proven to be a better choice than using a draw sheet to laterally transfer a patient These low cost devices should reduce risk of injury in healthcare workers