Aparatura Mutat Pacienti

7/29/2019 Aparatura Mutat Pacienti

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section 7

Contents

Usingequipmentformovingandhandlingpeople

Typesofequipment

Examplesofmovingandhandlingequipment

Slidesheets

Transferbelts

Transferboards

Airassistedtransferdevices

Electricprofilingbeds

Mobilehoists

Standinghoists

Ceilinghoists

Gantryhoists

Fixedwallhoists

Slings

Stretchers

Wheelchairs

Standingandpivotingaids

(nonelectric)

Showerandbathequipment

Emergencyequipment

Othertypesofequipment

andaids

Referencesandresources.

Note:Allimagesandotherreferencestoequipmentshowninthissectionare

providedforillustrativepurposesonly.Theyarenot,andshouldnotbetakenas,

endorsementsofspecificequipmentorsuppliers.

Equipment for moving and handling people


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7.1 Using equipment for moving and handling people

Thissectiondescribesthemaintypesandfunctionsofequipmentformovingand

handlingpeople.Section8oftheGuidelines,Equipmentmanagement,covers

equipmentprocurementsystems,maintaininganequipmentregisterandequipment

storage,maintenanceandreplacement.

Equipmentisacorecomponentineffectivemovingandhandlingprogrammes,

togetherwithriskassessments,theuseofcorrecttechniques,stafftrainingand

appropriatefacilitydesign.Thesupplyofequipmentbyitselfwillnotleadtoreduced

ratesofinjuryunlessequipmentuseispartofacomprehensivemovingandhandling

programme.Successfulprogrammesprovidebothequipmentandtraininginhowto

usespecificitemsofequipmentforlifting,transferringandrepositioningclients.

Theproperuseofequipmentisessentialforthesafetyofbothclientsandcarersandimprovesthequalityofclientcare.Equipmentcanalsofacilitateclientrehabilitation,

decreasemorbidityandpreservethedignityofclients.Comparedwithtechniques

thatinvolvemanualtransfersofclientswithoutequipment,theuseofequipment

lessenstheforcesrequiredformovingandhandlingclientsandcanreducetherisks.

Movingandhandlingequipmentalsoimprovesclientoutcomes,suchasreducing

theirlengthofstayandtheriskofcomplicationssuchasdeepveinthrombosis,chest

infections,urinarytractinfections,pressureulcers,skintearsandfalls.

Havingfitforpurposeequipmentisoneofthemostimportantaspectsofmoving

andhandlingprogrammes.Newmovingandhandlingequipmentisconstantly

beingdeveloped.Withtheincreasingcomplexityofequipmentandtechnological

developments,informationaboutspecificequipmentcanbecomeoutdated.

Managersresponsibleforpurchasingequipment,andpeopleprovidingtraining

inequipmentuse,needtokeepuptodatewithdevelopmentsinequipmentfor

movingandhandlingpeople.Theprimaryfocusofthissectionisondescriptionsof

equipmentandspecificfeatures.Specificproceduresforusingequipment,suchas

slidesheets,slingsandhoists,aredescribedinSection4Techniquesformovingand

handling people.


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Section 7: equipment for moving and handling people

7.2 Types of equipment

Table7.1showsthemaintypesofequipmentusedformovingpeople,andexamples

ofcommonuses.Sometypesofequipmentareknownbyseveralnames,asshown.

Detaileddescriptionsofeachtypeofequipmentareprovidedlaterinthissection.

Forsomecategoriesofequipment,thereareseveralrelatedtypes,whichmayhave

differentnames.

Table 7.1 Common types of equipment

Type of equipment(and alternative names) Description and common uses

Slide sheet

(slidingsheet,slipperysam)

Asheetmadeoflowfrictionmaterialandusedunderaclient

toalloweasyrepositioninginbed,slingattachmentand

lateral transfersTransfer belt

(handlingbelt,gaitbelt,

walking belt)

Abeltplacedaroundaclientswaistduringseveraltypesof

transferandforassistedwalkingforrehabilitation.Thereare

multipletypesofbelt

Transfer board

(PATslide,slideboard,

banana board)

Afullbodylengthboardmadefromwoodorplastic,usedto

bridgegapsforclienttransfersfromonesurfacetoanother,

suchasfromastretcherorwheelchairtoabed.Smallertransfer

boardscanalsobeusedforlateral,seatedtoseatedtransfers

Airassisted transfer device Thereareseveraltypes:inflatablemattressesforlateral

(bedtobed)transfersandairassistedliftingdevicesor jacks

Electric profiling bed

(electricbed)

Anelectricallyoperatedbedthathasamattressplatformsplit

intotwo,threeorfoursections,whichallowsadjustmentusing

acontrolhandsetorpanel

Mobile hoist

(floorhoist,floorlift,mechanical

lift,portable hoist)

Ahoistwithwheelsthatcanbemovedalongthefloorused

forliftingaclientinsideaslingoronastretcherdesignedforuse

withhoists

Standing hoist

(sittostandhoist,standinglift,

standaidhoist)

Aspecifictypeofmobilehoistdesignedtoassistpeoplebetween

sittingandstandingpositions.Standinghoistsaredesignedto

fitunderandaroundchairs

Ceiling hoist(overheadhoist,ceilinglift,

mechanicallift,gantryhoist)

Ahoistattachedtopermanentlymountedceilingtrackthatmovesaclientinsideasling.Gantryhoistshaveoverheadtracks

mountedonwheeledframes

Sling Afabricsupportusedforcarryingaclientwhilebeingmoved

withahoisttherearemultipletypesofsling

Stretcher Arigidframeusedtocarryaclientinalyingorsupineposition.

Oftenmadeoflightweightmaterialandcommonlyusedin

ambulancesandbyemergencyservices.Wheeledstretchersare

usedinhospitalsfortransportingclientsbetweenlocations,and

shouldbeelectric

Wheelchair Amobilechairusedfortransportingaclientinasittingoruprightposition.Bariatricwheelchairsmustbepoweredor

movedwithbedpushers


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Themaintypesofequipmentthatarecommonlyusedcanbesummarisedwithinthe

fourmaingroupsofclientmovingandhandlingtasks.Thesegroupsoftasksare:

Sitting,standingandwalking

Bedmobility

Lateraltransfers

Hoisting.

Table7.2providesasummaryofthecommontypesofequipmentusedforthese

handlingtasks.Therecommendedtechniquesforeachoftasksinthetablebeloware

describedinSection5oftheGuidelines.

Table 7.2 Handling tasks for which equipment may be used

Type of taskExamples of specificmovements

Examples of equipment that couldbe used

Sitting,standingand

walking

Sittingtostandingfrom

a chair

Transferbelt,standinghoist,mobilehoist,

chairlifter

Standingtosittingona bed Transferbelt

Assistedwalking Transferbelt,walker,gutterframe,hoist

withwalkingharness

Bedmobility Turninginbed Slidesheets,electricbedwith

turning function

Slidingclientupinbed Slidesheets,electricbedSittingpersonupontoedge

ofbed

Slidesheets,electricbed,bed accessories

Lateraltransfers Lateraltransferfrombed

to stretcher

Slidesheets,transferboard,airmattress,

standinghoist

Transferringfromchair

to commode

Ceilinghoist,mobilehoist,seatedtransfer

board,standinghoist

Transferringtotoilet Ceilinghoist,mobilehoist

Hoisting Fittingaslingtoclientin bed Sling

Hoistingfrombedtochair Ceilinghoist,mobilehoist,standing hoist

Hoistingclientfromfloor Ceilinghoist,mobilehoist,airjack

Transferringtotoilet Ceilinghoist,mobilehoist,standing hoist


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7.3 Examples of moving and handling equipment

Thenextpartofthissectionprovidesexamplesofthemorecommonlyusedtypesof

equipmentforclienthandling.Furtherinformationaboutspecifictypesandfunctions

ofequipmentcanbeobtainedfromthewebsitesshownattheendofthissection,

andfromcompaniessupplyinghealthcareequipmentinNew ZealandandAustralia.

Traininginproperuseisessentialforalltypesofequipment.

Slide sheets

Slidesheetsareoneofthemostcommonly

usedtypesofequipmentinhealthcare

services.Theyareusedtomoveclients

horizontallyonbeds,trolleysandchairswithoutlifting.Slidesheetsarerelatively

lowcost,havemanyusesandarerelatively

simpletouse.Theyavoidtheneedtolift

clients,butdespitetheirsimplicitytheydo

requiretrainingintheirproperuse.

Itisimportantthattheuseofslidesheets

isconsistentwithcurrentbestpractice,

asdescribedinSection4Techniquesformovingandhandlingpeople.Trainingis

necessaryinthecorrectapplicationanduseofslidesheets.Incorrectusecancause

injurytobothcarersandclients.Slidesheetsaremadefromlightweightfabricand

havelowfrictionsurfacesthatbecomeveryslipperywhenplacedtogether.They

comeindifferentconfigurations:thefabricmaybesewntogethertomakeadouble

sheet,ortheymaycomeassinglesheetsthatthecarerfoldsovertoformadouble

layer.Twosheetscanalsobeusedtogether.Theymayormaynothavehandlesfor

hangingup.Twosinglesheetsarepreferableastheyaremultidirectionalandallow

optimalmovement.

Thereareseveralhandlingtechniquesthatuseslidesheets(seeSection4Techniques

formovingandhandlingpeople).Usingthemunderneathapersonallowsan

independentorassistedslidingmovementonabed.Theycanbeusedformanytasks

involvinglateraltransfersandrepositioning,suchas:

Movingaclientinbed

Turningaclientontotheirsideinbed

Transferringaclientfromabedtoabedwithatransferboard

Foraclientwhohasfallenintoaconfinedspace;slidesheetscanbeusedto

movetheclientalongthefloortoalocationwhereahoistcanbeused

Facilitatingindependentbedmobility.

Slidesheetscomeindifferentsizesandtheymaybepaddedorunpadded.Slide

sheetswithloopscanbestoredonhooksbesideclientsbeds.

Slide sheets

figure 7.1


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Points to note about slide sheets

Alwaysconductariskassessmentpriortomovingaclient

Mostslidesheettransfersrequiretwocarers

Theriskassessmentshouldincludeskinintegrity,pressureareas,wounds,

attachmentsandsensitivities

Assesspainmanagement

Encouragemobilitywherepossible

Whenmovinglargeclients,ensurethereisasufficientnumberofcorrectly

sizedslidesheetsandenoughstaffforthetransfer

Infectioncontrolconsiderationsrequireslidesheetusewithoneclientonly

beforebeinglaundered

Slidesheetsshouldbeaccessible

besidethebedoftheclientforwhom

theyarerequiredasuitablestorage

facilityisneeded,suchasahook,

containerorfabricholdingbag

Whenaclientisdischargedormoved

toanotherlocation,orthesheets

becomesoiled,theslidesheets

shouldbesentforlaundering

Bedtobedtransfersshouldalways

usebothslidesheetsandatransferboard

Mosttypesofslidesheetaredesignedtobelaundered(seeSection8,

Table 8.2).Theusualslidesheetlifespanisaround80washes,dependingon

thequality

Slidesheetsmustbeinspectedfortearsandotherdamagebeforeuse.

Slidesheetscanbeusedmultipletimesonthesameclientandrequirelaundering

whensoiled,orbeforeusingwithadifferentclient.Organisationsneedtohavea

systemforlaunderingslidesheetsseparatelyfromregularlaundry,asahotwash

destroysthefabric,reducingthelifespanoftheslidesheet.Slidesheetcareshouldbe

outlinedintheorganisationsmovingandhandlingpolicy.Therearealsodisposable

slidesheetsforsingleclientuseonly,whicharediscardedwhennolongerneededfor

thatclient.

Transfer belts

Transferbeltsarefastenedaroundclientswaistsortrunksduringtransfersandforassistedwalking.Theyareprimarilyforclientswhoaremobile.Themainfunctionof

transferbeltsistoassistalmostindependentclientsinmobilising.Theycanalso

Store slide sheets beside bed

figure 7.2


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assistwithclientswhomightbedifficulttohold,eitherbecauseofsize,ordiscomfort

(malewalkingfemale)orbecausetheclientisuncomfortablewithbeingassisted.The

beltscanprovideanextralayerbetweencarersandclients.Beltsdesignedspecifically

toassistclientswhenwalkingaresometimesreferredtoasgaitbelts.Transferbeltsareusedtoassistthe

developmentofmobilityandrehabilitation

forclientswhoareminimallydependent,

haveweightbearingcapacityand

arecooperative.Typesofuseinclude

bedtochair,chairtochairandchairtocar

transfers,repositioningclientsinchairs,and

supportingclientswhilewalking.

Therearemultipletypesofbelt.Mostbeltsaremadeoffabricorcushionedmaterial

andhavemultipleloopsorhandholds.

Thebeltsaresecuredaroundclientswaistsandadjusteduntiltheyarefirm,not

tight.Transferbeltsshouldonlybewornbyclients,neverbycarers.

Points to note about transfer belts

Therearesomerisksforcarersassociatedwithusingtransferbelts.Forthisreason,

somemovingandhandlingcoordinatorsrecommendthattransferbeltsnotbeused

forclienttransfers.Ifused,thecarershouldholdontothehandlesfromtheoutside,andneverputtheirthumbsinsideorthroughtheloops(incasetheclientfallsand

thecarercannotdisengagetheirhands).Transferbeltsshouldneverbeusedto

lift clients.

Transfer boards

Therearemultipletypesoftransfer

boardandrelatedassistivedevices.

Fullbodylengthtransferboards(sometimeslabelledasPATslidesor

TransglidesinNew Zealand)areusedto

bridgegapsforclientswhoarelyingdown

whenslidingbetweentwoadjacentsurfaces

atsimilarlevels,suchasfromabedtoa

stretcher.Theyareusuallymadeofplastic

andshouldbeusedinconjunctionwithslide

sheets.Smallertransferboardscanbeused

forseattoseattransfers,suchasbetweenacarseatandawheelchair.

Inthepast,rollerboardshavebeenusedaslyingtolyingtransferdevices.These

boardshavealoosevinylcoveringthatisdifficulttocleanandpotentiallyaninfection

Transfer belt

figure 7.3

Fulllength transfer board

figure 7.4


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controlrisk.Theseboardscreaterisksforcarerswhenreachingandrisksforclients

withskinshear.Itisrecommendedthatrollerboardsbereplacedwithfulllength

transferboards.

Sittingtositting transfers

Forsittingtosittinglateraltransfers,a

smallertransferboardorslideboardcanbe

usedtobridgegapsbetweenadjacentseats.

Theseboardscanbestraightorcurvedlike

aboomerang(anexampleistheyellow

bananaboard).Smalltransferorslide

boardscanbeusedforlateraltransferssuch

asthosebetweena:

Chairandwheelchair

Bedandwheelchair

Wheelchairandtoilet

Wheelchairandcar.

Curvedtransferboardsmakeiteasiertotransferaroundfixedarmrests.Theboards

areusuallyprescribedbytherapists.Notethatclientsshouldhavesittingbalanceto

usetheseboardsandbothcarersandclientsrequiretrainingintheiruse.Iffeasible,

arrangetohavethesurfacetowhichtheclientisbeingtransferredslightlylowerthan

thesurfacefromwhichtheyarebeingtransferred.Thismakesiteasierfortheclient

to move.

Airassisted transfer devices

Thereareanumberofairassistedtransfer

devicesavailable.Therearetwogeneral

types:inflatablemattressesforlateral

(e.g.bedtobed)transfersandairassisted

liftingdevices,orjacks.Thesedevices

aregenerallyversatileandcosteffective,

especiallyforsmallfacilities.

Inflatable mattresses

Forlateraltransferswhilelyingdown:the

clientliesonthemattresswhiletheclient

andmattressaretransferredbetweentwoadjacentsurfaces,andairassistedlifting

devices.Alateraltransferairmattresscanbeusedasanalternativetoatransfer

boardandslidesheets.Themattressesareeffectiveforreducingfriction,andthustheloadoncarersduringlateraltransfers.

Sitting transfer board

figure 7.5

Airassisted mattress

figure 7.6


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Air jacks

Airassistedliftingdevices,orjacks,canbeusedtoraiseclientsfromthefloorto

bedorstretcherlevelbypumpingairintoanairmattresswithmultiplelayers,which

expandverticallyasmoreairispumpedin.Thejackscanbeveryusefulforliftingfallenclientsfromthefloor.Figure7.7showsanexampleofanairjackthatliftsclients

inasittingposition.Figure7.8showsaHoverjackthatliftsclientsinalyingposition

fromthefloortobedheight.Alltypesofairassisteddevicerequirecarerstosteady

theclient,andanairpump.

figure 7.7

Airassisted jack

figure 7.8

Airassisted Hoverjack

Electric profiling beds

Anelectricprofilingbedhasamattress

platformcomprisingtwo,threeorfour

separatesections,eachofwhichcan

beadjustedusingacontrolhandsetor

panel.Heightadjustmentallowsthebed

toberaisedorloweredquicklyforclient

movementsandclinicalservices.

Someelectricbedshaveonemovable

sectioninwhichonlytheheadorbackrestsectioncanberaised,allowingaclienttosit

upinbed.Withthesebeds,clientsaremore

likelytoslidedownthebedsandmayneedfrequenthelpfromcarers.

Example of an electric bed

figure 7.9


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Figure 7.10

Electric bed showing profile positions

Thegeneralbenefitsofelectricbedsare:

Promotionofclientmobilityandindependence

Reducedworkloadforstaff

Reductioninmanualhandlingrisksandinjuriestostaff

Reducedincidenceofpressuresoresinclients.

Withelectricbeds,staffcanadjusttheheightmoreaccuratelytosuitindividualclient

andcarerneeds.Beingabletostandbackandobserveaclientwhileoperatingabed

allowsstafftoobservetheclientmovingintodifferentpositions.Improvedclient

comfortismorelikelyasadjustmentsofthebedsareusuallysmootherthanwithbeds

requiringahydraulicpumpingaction.

Allclinicalareasandclientsbenefitfromthebedheightadjustmentthatallowslow

bedheights.Electricbedsalsofacilitateclientsgettingoutofbedbyraisingthem

closertoastandingposition.Stafftimecanbesavedbythereducedneedformanual

handlingofclientsandtheremovalofhydraulicpumpingonnonelectricbeds.

Points to note about electric beds

Mattress compatibility:

Someelectricbedsmay

requirespecialsectioned

mattresses.Bedsrequiring

specialmattressesmaymeanreplacingbedsas

a combinedbedand

mattress procurement

Size:Electricbedscan

belarge.Bedswitha

longerthanaveragelength

mayleadtoreducedspace

inareassuchasmultibed

units.Theycanbedifficult

Box 7.1

Compatibility of electric beds and

mobile hoists

A common problem I have come across is the

incompatibility of some cheaper electric beds

with mobile hoists. The beds do not allow

clear access underneath for the hoist legs to

go under. Staff have to push and pull resulting

in jerky movements for the resident. There was

an incident where electric bed wires under the

bed caused an accident when the hoist was

pulled over the wires and the patient fell out

of the sling. Manufacturers need to provide a

way of hooking up the wires out of the way.Source: Manual handling trainer


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Bedtoseat or bedtostand profiling:Somemodelsofelectricbedallowthe

profileofthebedtoconverttoaseatortoastandingpositionwhiletheclient

isinthebed.Thisavoidstheneedforcarerstofitslingsonclientswhoare

lyingdown,ormanuallyrepositioningclientsfromlyingtosittingandsittingtostanding

Side rails:Railsatthesideofthe

bedthatcanberaisedorlowered

preventclientsrollingoutofbed.

Theminimumheighttowhichbeds

canbeloweredmaybecompromised

bytheuseofsiderails,particularly

dropdownrailsandthosethatfold

underneaththebed.Siderailsneedtobeadjustabletoallowtransfers

betweenbedandstretcher.Siderails

arearecognisedformofrestraint,

andifbeingusedforrestraintneedtobenotedintherestraintregister,

consistentwithorganisationpolicy.Splitrailsarepreferableandseenlessas

a restraint

Turning function:Somebedshaveturningfunctionsthatallowclientstobe

turnedontheirsides.Dependingonthetypeofbed,turningcanbeactivated

bytheclientinbedorbyacarer,orthebedcanbeprogrammedtoturnatsetintervals.Cautionmustbeusedwithturningfunctionsasthereisthepotential

forlimbstobetrapped,particularlywithclientswhohavedecreasedsensation

orcommunicationdifficulties.Mechanicalturningdoesnotreplacetheother

functionsofcarerprovidedturningofaclient,suchascheckingbreathingand

skinandprovidinghumancontact

Battery backup:Beingabletooperatebedsonbackupbatteriesmaybe

neededwhereclientsaremovedbetweenlocationsinbed,orwhereaccessto

electricalsocketsislimited

Manual operation:Isthereprovisionformanualoperationincaseofbatteryorelectricalfailure?Themanualleversneedtobeidentifiedeasilybystaff

Cleaning and infection control:Thecomponentareaoftheelectricbedframe

andanyattachmentsshouldbeaccessibleforcleaning.Easeofcleaningisbest

assessedwhentriallingabed

Preventing client moving down the bed:Clientsoftenmovedowntheir

bedswhenmovedfromlyingtosittingpositions.Onelectricbeds,thismay

occurasthebedsareprofiledtoliftupclientsheads.Thiscanbeavoided

ifthebedsincludeafeaturecalledautoregressionofthebackrestsinthebed specification

Side rails on a bed

figure 7.12


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Lockout facility:Afacilitytolocktheadjustmentstopreventbedsbeing

profiledortiltedmaybeimportantinclinicalareaswhereitisnecessaryto

preventkneeflexionorothermovementsinclientswhoneedtobenursedflat.

Thelockoutfeaturemayalsobeusefulduringvisitingtimestoavoidmishapsassociatedwithvisitors

Wheel locks:Locksonbedwheels

areusedtopreventbedsbeing

moved.Theseareimportant

forsometypesoftransfer,such

asbedtobedtransfersusing

transfer boards

Handsets:Twofeaturesofthe

controlhandsetstoassessaretherobustnessofthehandsets

andcontrolpanels,andtheirease

of operation

Other features:Thereareanumberofotherspecialistoperationsand

functionsavailableonsomeelectricbeds.Theseincludeweighingscalesbuilt

intothebeds,motorisedbedsthatassistmovementalongcorridors,and

antifallalarms.

Bed accessories

Therearemultipleaccessories,oraddons,forbedsthatcanbeusefulforsometypes

ofclientandsetting,especiallyincommunitysettingswhereelectricbedsarenot

available.Theseinclude:

Bed ladders:Smallladdersorstepsplacedatthesidesorendsofbedsthat

allowpartiallymobileclientstogetinandoutofbed

Bed or hand blocks:Handblockshavewidebasesandhandholds.Theyare

usedinpairsbyclientswhoaresittinginbed

Bed levers:Abedleverisagrabrailthataclientcanusetohelpthemsituporturnoverinbed.Therearevarioustypesandtheycanbefixedtothewall,

bedorfloor.Somemayobstructpartofthebedside,makingitdifficultforthe

clienttogetinandoutofbed,whileothersareadjustableandcanbemoved

awayfromthebed.Bedfixedleversmustbesecurelypositionedandfittedto

besafeforuse.Somebedfixedlevershaveplatformsorrailsthatgounderthe

mattresses,sotheyaresecuredinpositionbytheclientsbodyweight

Rope ladders:Aropeladderhelpstheclienttopullthemselvesupinbedfrom

alyingpositiontoasittingposition.Ithasplasticorwoodenrungslinked

togetherwithropetoformaladder.Theladderattachestothefootorbaseofthebed.Ropeladdersareunstabletopulluponandoftenneedpracticeto

master.Clientsneedtohavestrongupperlimbsandabdominalmuscles.Itis

Wheel locks on a bed

figure 7.13


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essentialthattheropeladderissecurelyfixedtothebedandtheclientcan

reachthefirstrungwhentheyarelyingonthebed.Ropeladderswithplastic

rungsmaybeslipperytohold

Overhead poles:Overheadorliftingpoles(sometimescalled

monkeypoles)areusedbyclients

tomoveinbed,suchasupand

downthebedandinandoutof

thebed.Theycanalsobeusedby

clientstoliftthemselvessothat

bedpanscanbeplacedunderthem.

Mostoverheadpolesuseflooror

bedmountedcantilevergantries,withhandleshangingfromthem

onheightadjustablestraps.Thegantryframesmustbesecuredtostop

themtipping.Allpolesshouldhavesafeworkingloads(SWLs)clearlymarked

on them

Bed lifters:Theseareusedtoliftbedstosuitableworkingheightssothat

carersdonothavetostoop.Theyaresuitablefornonelectricbeds,suchasin

homeswheretheyallowclientstocontinueusingtheirownbeds.Theydonot

provideprofilingactions,andtheyrequiresufficientspacetogetunder

the beds Bed movers:Thesebatteryoperated

devices(seeFigure7.15)attachunder

thefootendsofbedsandallow

operatorstotransportbedsand

clientstootherlocations.Theyhave

controlsthatallowmanoeuvringin

confinedspacesandsteeringalong

corridors.Theirpositioningallows

theoperatorstoseetheclientsduringuse.Bedmoversreducestrain

onstaffwhoregularlymovebeds

duringtheirworkshifts.However,theyincreasetheoveralllengthofthebeds

andmaynotfitinlifts.Bedmoversrequireadditionalstorageanditmaybe

difficulttohavemoverskeptwhere needed.

Overhead pole

figure 7.14

Bed mover

figure 7.15


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Hoists

Therearethreegeneralcategoriesofhoist:mobilefloorhoists,standinghoistsand

ceilinghoists(sometimescalledoverheadhoists).Insomecountrieshoistsarecalled

liftsormechanicallifts.Allhoistsuseslingstoholdclients,andsomehoistscan

liftclientsinspeciallydesignedstretchers.Allhoistsshouldbecompliantwiththe

StandardsNew ZealandrequirementsinAS/NZS3551:2004Technicalmanagement

programsformedicaldevices.Thisstandardcoversprocurement,acceptanceprocess,

safetyandperformancetestinganddisposal.

Thetypesofslingusedwithhoistsaredescribedlaterinthissection.Allhoists,slings

andceilingtrackingshouldbeclearlylabelledwiththeirSWLs.

Allcarersusinghoistsshouldbetrainedinfittingslingsandintheproperuseofhoists

priortousingthem.Carersalsoneedtobefamiliarwiththespecificfunctionsofparticulartypesormodelsofhoist.Likeothermovingandhandlingequipment,hoist

designsandfeaturesarecontinuallyevolving.

Mobile hoists

Mobilehoists(sometimescalledmobilefloorhoists)areusedtotransferclients

whoarenotmobilebetweenlocations,suchasfromabedtoachairorabathroom.

Theycanalsoassistwithambulation,gaittrainingandotherspecialisedfunctions.

Theclientissupportedinahoistsling,whichshouldbesingleclientassignedfor

infection control.

Mobilehoistscanbeverycosteffective,astheycanbemovedtodifferentlocations

inafacility.Onehoistcanbeusedforavarietyoftasks.Normallytwocarersare

requiredwhenhoistingaclientwithamobilehoist.2

2. ProceduresforusingmobilehoistsforspecificmovingandhandlingtasksaredescribedinSection4Techniquesformovingandhandling people.


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Box 7.2

Parts of a mobile hoist

Boom (goes up and down)

Sling bar, spreader bar or yoke

Legs (move in and out)

Mast upright part of hoist

Handles for manoeuvring the hoist

Brakes only to be used for storage. Do

not use brakes when hoist is in use as

the hoist needs to find its own centre of

gravity, otherwise it may tip over Emergency stop button (if hoist is not

working, check it is not pushed in)

Emergency lower buttons (you may

need extra pressure to come down on

older hoists)

Weight limit (SWL)

Maintenance alert do not use if out

of date.

figure 7.16

Example of a mobile hoist

Mobilehoistscomeinmultiple

designs.Allhavecentrallifting

frameswithboomsandslingbars

(alsoknownasspreaderbarsor

yokes)towhichtheslingsare

attachedusingthehooksorclips

onthebars.Thebasesorlegs

havewheelsthatallowthehoists

tomovealongthefloor.Some

havebasesthatcanexpandor

contractinwidthtofitaround

orundercommodes,shower

chairs,recliners,wheelchairs

andbeds.Somehoistsarefoldableorcollapsible.Somemobilehoistshavevertical

liftmovementsandsomehavearcmovements.Verticalliftmovementsgenerally

provideahigherliftandcanusuallybeusedforassistedwalkingwithwalkingslings.

Nearlyallmobilehoistsarebatterypowered,soaroutinebatterychargingsystemis required.

Box 7.3

Using a mobile hoist without training

I was a nurse aide in this rest home. One day

the manager wheeled in a hoist and told me

to use it to lift the patient who was sitting

on a commode and left me to it. So I hoisted

a patient complete with commode and all.

I didnt have any training on how to use

the hoist.

Source: Patient handling trainer


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Mobilehoistscanhavesomedisadvantages.Carersmayneedalotofstrengthto

movemobilehoists,inareaswithcarpet(especiallyifthehoistshavesmallwheels),

throughdoorwaysandinslopingcorridors.Thereneedstobeenoughspaceinthe

roomtouseamobilehoistandsometimesfurniturecanrestrictmovement.Whenusingmobilehoistsoverbeds,somecannotlifthighenoughtoallowtheclientsto

clearthebeds,especiallybedswithpressurecaremattresses.Somebedsmaynot

haveenoughspacebeneathtoallowthehoistbasetogetunderneath.

Points to note about mobile hoists

Whilemobilehoistscanbeversatile,usersshouldnotethefollowingspecificfeatures

andpotentiallimitations.

Mobilehoistsneedadequatestoragespaceclosetolocationswheretheyare

used.Theyrequiremorestoragespacethanceilinghoists

Mostmobilehoistsarepoweredbybatteriesthatneedregularcharging.They

needasystemforroutinechargingofbatteries.Ifbatteriesaredetachable,itis

desirabletohavetwobatteriesforeachhoistsothatonebatteryisalways

beingcharged

Allmobilehoistsshouldhaveastickerorcertificatewithdatesforroutine

checkingandservicing.Ahoistshouldnotbeusediftheexpirydateonthe

stickerhaspassed

Allhoistsshouldbelabelled

withaSWL.Aspartof

riskassessment,aclients

weightshouldbechecked

toensureitislessthan

theSWLofthehoist,prior

to lifting

Wheelbrakesarefitted

onmostmodelsofmobile

hoist.Thebrakesshouldnot

beappliedwhilehoisting

aclient.Mobilehoistsare

designedtomovewhile

hoistingclientssothatthe

slingbarisoverthecentre

ofgravityofthe load

Itcanbeunsafetousea

mobilehoistonaslopingfloororsurfacewherethereisariskthatthehoist

cantipover

Notallmobilehoistscanliftclientssafelyfromthefloor.Todothis,thefeetor

baseofthemobilehoistmustbedesignedtoallowafloorlift.Ifthisfeatureis

needed,checkthatthemodelbeingconsideredcandothissafely

Box 7.4

Lifting equipment reduces assaults on

carers

Assaults by residents on caregivers in

a residential care facility reduced after

equipment to lift and transfer residents was

introduced and carers were trained how to use

the equipment. Residents felt caregivers could

be trusted to move them comfortably and

safely. Also, the physical separation between

the caregiver and the resident through use

of the lift, particularly patients with a known

history of violence, is likely to have reduced

assaults on caregivers when using lifts.

Source: Collins et al, 2004


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8

Liftingheightnotallmobilehoistscanliftclientshighenoughtoclearbeds,

especiallyifthebedshavepressuremattresses

Somehoistsallowforinterchangeablespreaderbars;othersrequirethatonly

themanufacturersspreaderbarscanbeused

Somehoistsallowdifferenttypesofslingtobeused,whileothersrequirethat

onlythemanufacturersslingforeachmodelofhoistcanbeused.Ifseveral

modelsofmobilehoistareusedinafacility,theinterchangeablyofspreader

barsandslingsshouldbeconsidered.

Mobile hoist features and accessories

Thefollowingaccessoriesandfeaturesareavailableonsomehoists,orcanbe

purchasedasoptionalaccessories.

Ahandheldcontrolpaneltooperatethehoistitneedstobeabletoclip

ontotheuprightframeofthehoist

Awalkingslingallowsamobile

hoisttobeusedformobilityand

rehabilitation(seeFigure7.17)

Scalestoweighclientsareavailable

onsomehoists.Whenfittedasan

additionalattachmentabovethe

slingbar,scalesmayreducethe

lifting height

Allelectrichoistsmusthaveemergencystopbuttonsandmanualrelease

mechanismstoallowclientsheldbythehoiststobeloweredwithout

battery power

Alowbatterylevelindicatororwarninglightisdesirable

Thelengthoftheboomtowhichthespreaderbarisattachedneedstobe

consideredwhenhoistingatallorlargeclient.Alongerboomprovidesmore

legroombetweentheslingandtheuprightframe.However,withashorter

boomtheclientcansitwithbothkneesononesideoftheframe,which

reducestheriskoftheirkneesknockingagainsttheframe

Gaittrainingbarsassistwith

mobility(Figure7.17)andareuseful

forturning hoists

Stretcherattachments(Figure

7.18)enabletheimmobilisationof

potentialspinalcordinjuryclientsandareusefulinanytraumaor

suspectedinjuriesafterfalls.They

canalsoenabletheweighingof

theseclientsiftheyhaveweigh

scale accessories.

Example of a mobile hoist withwalking sling and gait training bars

figure 7.17

Example of a mobile hoist with astretcher attachment

figure 7.18


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209


Standing hoists

Amobilestandinghoist(alsocalledasitto

standhoistandstandinglifter)isaspecific

typeofmobilehoistusedtomoveaclient

fromoneseatedsurfacetoanother,suchas

fromachairtoatoilet.Thehoisthasa

platformorfootrestonwhichtheclient

stands.Theclientissupportedbyasling

fittedaroundtheirtrunk(aspecialsling

knownasastandaidsling)andbyaleg

braceorkneeblockthathasstrappingto

holdtheclientslegsinplace.Standing

hoistsaresuitableforclientswhoarepartiallyweightbearingandcansupport

mostoftheirownweightwhilestanding.

Standinghoistsareusefulastheyallow

moreaccesstoclientsclothingthansling

hoists.Forthisreason,theyareusefulfor

movingclientsfromoneseatedposition

toanotherandcanassistwithtoileting

partiallymobileclients.Theyalsohavea

therapeuticbenefitforclientsinprovidinganopportunitytoincreaseweightbearing

tolerance.Theyshouldonlybeusedfortransportingclientsforshortdistances,

suchaswithinaroomortoanadjacentbathroom,notforlongerdistancessuch

as corridors.

Points to note about standing hoists

Itmaybeeasiertouseastandinghoistratherthanamobileoroverheadhoist

fortoiletingaslongastheclienthassufficientweightbearingcapacity

Extracareneedstobetakenwithclientswithspecificclinicalconditions,suchaslowmuscletone,osteoporosis,spinalmetastasisanddifficultystanding

withtheirfeetflat

Standinghoistsshouldhaveadjustablelegstogounderandaroundchairs

and toilets.

Example of standing hoist

figure 7.19

Example of standaid sling

figure 7.20


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Ceiling hoists

Ceilinghoistsorceilingliftshavetracking

fastenedalongtheceilingandaregenerally

apermanentfeaturebuiltintoeithera

singleroomormultiplelocationsinaunit

orfacility.Someversionsofceilingtracking

aredesignedtoberelativelyportable;the

trackingcanberemovedwhennolonger

needed.Gantryhoistshavethetracking

mountedonamobileframeandcanprovide

ahoistforasingleroomwhere,forexample,

themainuseisfortransferstoandfrom

a bed.

Ceilinghoistshavefourmajoradvantagesoverothertypesofhoist:

Theyrequirelessforcetomove

Becauseoftheirimmediateavailability,thereisahigherlikelihoodofuse

when needed

Floorcoveringsandunevensurfacesdonotaffectuse

Theyhaveminimalstoragespacerequirements.

However,therearesomedisadvantages:theuseofceilinghoistsislimitedtoareaswithtrackinginstalled;andhoistswithfixedceilingtrackingmayinitiallybemore

expensivetoinstallthanprovidinggantryhoistsormobilehoists.

Ceilingtrack(andgantryhoist)systemscanusuallyliftoveragreaterheightrange

fromceilingtofloorthanmobilehoists.Ceilingtrackandgantryhoistsystems

requirelessspacetooperatethanmobilehoistsandshouldbeconsideredifspace

is restricted.

Thehoistmayhaveaportablehoistunitormotorthatcanbeliftedoffthetrack,ora

fixedhoistunitthatispermanentlyattachedtothetrack.Table7.3outlinessomeof

theadvantagesanddisadvantagesoffixedandportableceilinghoistunits.Electricity

torunthehoistunitcanbesuppliedthroughthetrack,orbyabatteryfittedintothe

hoistunit.Someunitsareonlymotorisedforliftingclientsinslingsandnotformoving

clientsalongthetrack.Theseunitsrequirecarerstopushclientsalongthetrack.

Otherunitshavemotorfunctionsforbothliftingclientsandmovingclientsalongthe

track,operatedbyaremotecontrol.

Example of a ceiling hoist with afixed unit

figure 7.21


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211


Table 7.3 Portable and fixed hoists for ceiling hoist systems

Portable hoist unit Fixed hoist unit

Chargingfacilityforhoistunitisusuallyoffthe

track;maybelessaccessible

Optionofwallmounteddockingunitor

ontrack charging

Manualhandlingrequiredtoattachunitto track Nomanualhandlingofhoistunitrequired

Canbemovedtoothertrackswhenneededor

storedwhennotneeded

Canonlybeusedontrackwherefitted

Requiresadditionaltimeandefforttoattach

thehoisttotracking.Thisislikelytobea

disincentiveforstaffusingthehoist

Staffmorelikelytousethehoistifitis

permanentlyattachedtotracking

Ceiling track systems

Forceilinghoists,therearemultipletracksystemsavailable.Thetypeofceilingtrack

systemselectedwilldependonthetypesofuseintended.Forsinglerooms,straight

trackingmaybetheeasiesttoinstall.However,itsmajorlimitationisthatitonly

allowstheliftingandmovingofclientsinastraightline.Addingcurvedsectionsof

trackingallowsincreasedcoverage,especiallyinbathrooms(seeFigure7.22).

Figure 7.22

Examples of ceiling tracking into a toilet

ThemostversatiletrackingsystemisaparalleltrackingpatterncalledtheXY

system,whichprovidesfullroomcoverage.Withthissystemaclientcanbemoved

anywhereintheroom.TheXYsystemhastwostraightsectionsoftrackoneachside

oftheroom,paralleltoeachother,withanothertrackjoiningthetwo.Thejoining

trackcanslidealongthetwoparalleltracks.

Morecomplextracksystemsareavailableforhealthcarefacilitieswheretransfers

betweenrooms,suchasbedroomtotoilet,arerequired.Forexample,gates(for

transitbetweentwoadjacenttracksystems)andturntables(whichallowmovement

fromonetracktoanotherattrackjunctions)canalsobefittedtoincreasethe

versatilityofceilingtrackingsystems.Moreinformationabouttheinstallationof

ceilingtracksystemsisprovidedinSection9Facilitydesignandupgrading.


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2

Points to note about ceiling hoists

Ceilinghoistsareusuallypermanentfixtures,sothebuildingstructuremustbe

suitable.Somestructuralconsiderationscouldbewhetherceilingjoistsneed

tobereinforced,andwhetherdoorwaysneedtobealteredtoaccommodatetracking

Retrofittingispossibleformosttypesofstructureandceiling

Ceilingtrackingcanbemostcosteffectivewhenincorporatedintoanew

buildingorinstalledduringplannedrenovations

Allelectrichoistsmusthaveanemergencystopbuttonandmanualrelease

mechanismtoallowclientsonthehoiststobeloweredwithoutbatterypower/

electricitysupply

Allceilinghoistunitsshouldhaveastickerorcertificatewithdatesforroutinecheckingandservicing.Hoistsshouldnotbeusedaftertheexpirydateson

the stickers

AllhoistsandceilingtrackingshouldbelabelledwiththeSWL.Aspartofrisk

assessmentpriortolifting,aclientsweightmustbecheckedtoensureitis

lessthantheSWLofthehoistandtrack.

Ceiling hoist features and accessories

Thefollowingaccessoriesandfeaturesareavailableonsomeceilinghoistsorcanbe

purchasedasoptionalaccessories:

Scalestomeasureaclientsweightareavailableonsomehoists

Alowbatterylevelindicatororwarninglightisdesirable

Awalkingslingallowsaceilinghoisttobeusedformobilityandrehabilitation.

Gantry hoists

Agantryhoistmaybeapreferredoption

wherefittingceilingtrackingistooexpensiveorwherealargecapacityhoistis

onlyrequiredforalimitedtime.Thetransfer

rangeofgantryhoistsystemsislimitedby

thelengthofthetrack.Someversionsof

gantryhoistaresemiportableandcanbe

disassembledandtransportedbyvehicle.

Gantry hoist

figure 7.23


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213


Fixed wall hoists

Afixedwallhoistisapermanentfixturebesideaclientsbedorinabathroom(itis

sometimescalledabathinghoist),andswingstoallowtheclienttobemovedfrom

wheelchairtobath.Itcanonlybeusedforshorttransfers,forinstancefromabedto

abedsidecommodechair.Thebracketsfortheswinginghoistframecanbefixedin

variouslocationsinahospitalorfacilitysothattheportablehoistcanbeattached

whenneeded.Fixedwallhoistscanbelocatedinsmallroomswherethereisnot

enoughroomtousemobilehoists.Theyalsoprovideanalternativeifthebuilding

structuredoesnotallowoverheadtrackstobeinstalled.

Fixedwallhoistscanbeusefulinnursingandresidentialhomeswherehoistuseis

variable.Bracketscanbeinstalledinmultipleroomsandthehoistsmovedaroundas

needed.However,fixedhoistsdohavesomedisadvantages.Theyareusuallymore

expensivethanmobilehoists.Asthebracketsarepermanentlymounted,positioning

mustbecarefullyplannedtosuittheroomlayoutandtransferneeds.Oncethehoist

bracketshavebeenfitted,theclientsbedandothernearbyfurnitureusuallyneedto

stayinthesamelocationinordertousethehoist.

Slings

Slingsareusedtosupportclientsbeingmovedwithhoists.Theslingisattachedto

hooksorclipsonthehoistspreaderbaroryoketoprovidesupportfortheclientwhile

theyarebeingmoved.Thereareseveraltypesofslingavailablethataremadefromvariousmaterials.Becomingfamiliarwiththemultipletypesofslingisanessential

partofusinghoists.Trainingprogrammestypicallyspendsometimeonteaching

thecorrectuseofslings.Accidentsthatoccurduringtheuseofhoistsofteninvolve

incorrectslinguse.Table7.4summarisessomeofthekeyfeaturesofslings.

Choosingtherightslingandfittingitcorrectlyimprovecomfort,dignityandsafety

fortheclient.Havingacomfortableandsecureexperiencecanhelptoovercomea

reluctancetouseahoist,whichsomeclientshave.Generally,themoremateriala

slinghasthegreaterthecomfortandsupportitprovides.


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4

Table 7.4 Sling features and functions

Sling feature Sling type Functions

Fabricormaterial Synthetic Mostcommontypeofslingforgeneralpurposeuse

Mesh Usedforbathing

Sheepskinor

quilt lined

Forclientswithfragileskinorincreasedpainwhen

beinghoisted

Singleormultiple

client use

Disposable Forusewithoneclientonly.UsuallyhasaDonot

usetagthatbecomesvisiblewhenwashed

Washable Canbeusedandlaunderedmultipletimes

Shapesand

functions

Dividedlegsling Mostcommontypeforgenerallifting

Hammocksling Usedforliftingclientswhorequireadditionalsupport

Toiletingoraccess sling

Designedfortoiletuseortoallowaccesstoclothing;haslessfabricforsupport

Walkingsling Supportsaclientwhenwalking

Points to note about slings

Compatibility of slings with hoists:Somehoistsaredesignedtobeusedwith

onlyaspecifictypeofsling.Otherhoistscanusemultipletypesofsling.This

pointshouldbecheckedinthehoistinstructionmanualorwiththesupplier.

Whenorderingnewslingsorhoistsitisimportanttoknowwhetherthenew

versionswillbecompatibleorinterchangeablewithanyexistingslingsorhoists.Iftheyarenotcompatible,moreworkwillberequiredtomaintainand

servicedifferentslingandhoistsystems.Itispossibletousemultiplebrands

ofslingonsomehoists,butthisrequiresasuitablyqualifiedpersonto

documentcompatibility,preferablywithagreementfromthe suppliers.

Reusable and disposable slings:

Mostfacilitieshavereusableslings

thatarewashedbeforeusewith

anotherclient.However,ifheavy

soilingislikelyorinfectionriskishigh,disposableslingsmaybe

preferred.Disposableslingsarefor

oneclientuseonlyandshouldbe

disposedofwhensoiledornolonger

neededfortheclient.Theymustnot

bewashedorcleanedthenreused.

Laundry services:Thereareseveralwaystolaunderslingsandeachfacility

needstohaveasysteminplace.Thesesystemsinclude:thefacilityownsthe

slingsandtheyarecleanedbyitsownlaundry;thefacilityownstheslingsanditslaundrycontractorcleansthemasanaddedservice;andthecontract

laundryserviceprovidestheslingsinagreement(e.g.types,numbers)withthe

Example of labels

figure 7.24


25/34

215


facilityandcleansthem.Notethatsomeexternallaunderingservicesprovide

specificbrandsofslingonly.

Standard labelling:Eachslingshouldbelabelledwiththefollowingdetails:

Thenameoftheslingoritsmodelnumber

Thenamesortypesofhoistforwhichtheslingisdesigned

Thesizeofthesling

TheSWLofthesling

Anyspecialwashing,dryingandsterilisationinstructions

Themanufacturersnameorlogo,orregisteredtradename.

Checking slings:Allslingsshouldbecheckedbeforetheyareused:

Checkallloopsatconnectionpointsforsignsoffrayingand

loose stitching

Checkentireslingbodyforloosestitching,rips,holesandbleachstaining

Checkforsignsoffabricweakening,suchasheatdamage,distortedfabric

andstaining

Checkallbuckles

Size,shapeandfittingofslings.

Standard slings Fitting of sling so lower loops crossbetween clients legs

figure 7.25 figure 7.26

Slingsareavailableinmultiplesizestosuittheweightsandbodysizesofclients.

Slingsizescanrangefromverysmalltoextralarge.Theslingsizewillbeshownon

alabelattachedtothesling.Mostslingsarenowcolourcoded;thesizeindicatedby

eachcolourshouldbeshownonastickerattachedtothehoistthatwillbeusedwith

thesling.Notallmanufacturersusethesamecolourstoindicateslingsizes,sothis

shouldbenotedifusingslingswithdifferenthoists.Slingsizesmayvarybetween

manufacturers,socarersneedtomeasuretheslingforeachclienttoensurethe

correctsizeisused.Whenorderingslings,ensureeachslingislabelledwithitssize

andSWL,whichshouldbeinkilogramsforuseinNew Zealand.Iftheslingistoo

large,thereisariskoftheclientslippingoutofthesling.Aslingthatistoosmallcan


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6

resultinthespreaderbarcomingtooclosetotheclientsface,canbetightinthe

crotchandcausediscomfort,ormaynotprovideenoughsupportfortheback.

Slingshaveloopsorstrapsthatareattachedtospreaderbarsonhoists.Sometimes

thesestrapsareadjustableandcanbesetforaspecificclientbybeingmarkedwithapieceofwoolorapentoidentifythesettingfortheclient.Thismeanstheycanbe

hoistedinthesamepositionwithdifferentcarers.

Table7.5summarisesthemorecommontypesofslingandthesearedescribedin

moredetailbelow.Thereareothertypesofsling,suchasamputeeslings,thatrequire

specialistknowledgeforuse.Clientswithhipreplacements,morbidobesity,bilateral

amputationsorothercomplicationsmayrequirespecialisedtransferassessments

andspecialtyslings.

Table 7.5 Types of sling and purposes

Type of sling Purpose Limitations and comments

Standardor

dividedlegsling

(universal sling)

AUshapedslingforgeneral lifting Notsuitablefortoiletingorclients

whocanonlybetransferredina

lyingposition

Accessortoilet sling

(hygienesling)

Allowsmoreaccesstoclothing

for toileting

Clientneedssomeupperlimband

truckcontrol

Hammocksling Arectangularslingthatsupports

thebodyoveralargearea

Moredifficulttoputonandtakeoff

theclientthanastandardslingno

accesstoclientsbodyforwashingRepositioningsling Afullbodyslingusedforturningor

positioninginbed

Aspecialisedslingforclientswho

needturningregularly

Stretcher Allowsmovementofaclientina

lyingposition

Thehoistmustbedesignedtobe

usedwithastretcher

Walkingharnesssling Allowssupportforaclient

while walking

Mainlyusedwithceilinghoistsor

mobilehoistswheretheboomcan

beraisedhighenough


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217


Standard or divided leg sling

ThisisaUshapedslingandmayormay

nothaveupperbackandheadsupport.Its

advantagesarethat:

Itiseasytoputonwhentheclientis

sittingorlying

Itcoversalargesurfacearea

oftheclientsbodyandismore

comfortablethanatoiletsling

Whenthelegbandsarepositioned

correctly,thereislesslikelihoodoftheclientslippingorfallingoutofthesling

Thestandardslingcanbeusedtopickupaclientoffthefloor.

Somedisadvantagesarethatstandardslingsmaynotbeassuitableforbathingand

toiletingastheaccessortoiletsling.Thelegbandsorstrapscanbeuncomfortable

fortheclientiftheyarenotpositionedcorrectlyoriftheclientisleftintheslingfor

too long.

Access or toilet sling (hygiene sling)

Toiletslingsprovidesplitlegsupportanduppermidbacksupport.Someslingscome

withwaistsupportinsteadofuppermidbacksupport.Theadvantagesofthissling

arethatitisusefulfortoiletingiftheclienthassomeupperlimbandtrunkcontrol,anditcanbeputonaclientinmostpositions.Itprovidesgoodaccessforwashingas

wellastoileting.Someclientsmaybeabletoputthisslingonindependently.

Toiletslingshavedisadvantages.Theydonotprovideasmuchsupportasstandard

slings,sotheyshouldonlybeusedforashorttime.Aclientwithreducedmuscle

tonehasanincreasedriskofslippingthroughthesling.Theclientmustbeableto

cooperatefullyandnotraisetheirarmsovertheirhead.

Hammock sling

Thisisarectangularsling.Somehavecommodeopenings.Itiscomfortabletouseastheclientsbodyissupportedoveralargerareathaninastandardsling.Thereis

lesslikelihoodofdiscomfortordamagetotheclientsskin.Itissuitableforliftingthe

clientoffthefloor.Somedisadvantagesarethatitcanbedifficulttoputonandtake

offwhentheclientisseatedorlyinginbed,andthereisnoaccesstotheclientsbody

forwashing,eveniftheslinghasacommodeopening.

Standard sling

figure 7.27


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8

Repositioning sling

Thisisaspecialisedfullbodylengthsling

usedforturningorpositioninginbedclients

whoneedtobeturnedseveraltimesaday.Repositioningslingsareusuallyleft

undertheclientintheirbed.Ifleavinga

slingunderaclient,careshouldbetaken

toremovewrinklesfromthematerialand

tuckthestrapsunderthemattress.Flatbed

sheets,soakerpadsandotheritemscan

beplacedontopofarepositioningslingto

absorbmoistureandimprovecomfort.

Stretcher attachment

Astretcherorflatlifterenablesthe

movementofaclientinalyingposition.

Thestretcherisabodylengthrigidscoop

frame,oraseriesofflexiblebatonsthatare

positionedundertheclientandattachedto

aframethatisassembledaroundtheclient.

Somestretcherattachmentsaremade

ofspecialmaterialdesignedforXrays.

Stretcherattachmentsareusefulforspinal

andpostoperativeorthopaediccareasthe

clientscanbeimmobilisedduringtransfers.

Somehoistsofferthreewayclientangleadjustmentsforthestretchersling:flat,

headdown(Trendelenburg)andfeetdown.Notallhoistscanaccommodate

stretcher attachments.

Walking harness sling

Walkingharnessslingsaredesignedto

providecompleteorpartialsupportforclientswhocanwalk.Theseslingscan

beusedwithceilinghoists,butarealso

availablewithsomemobilehoistswherethe

boomscanberaisedhighenoughforclients

tostanddirectlyunderneaththeslingbars.

Stretchers

Stretchersareusedtotransportclientsin

lyingpositionbetweenlocationswithin

afacility.Theycomeinmanyshapes

andsizes.Allhospitalstretchershavewheelsorcastorsandtheymaybeheight

adjustable.Somestretchersarebatteryoperatedwithsimilarfunctionstoprofiling

Repositioning sling

figure 7.28

Example of a stretcher sling

figure 7.29

Mobile hoist with a walking

harness sling

figure 7.30


29/34

219


beds.Stretchersareastandarditemofequipmentinallhospitalsandhealthcare

facilitiesandservices.Specialiststretchersincludethosedesignedspecificallyfor

ambulanceuseandbariatricstretchersformorbidlyobeseclients.

Wheelchairs

Wheelchairsareanotherstandarditem

forequipmentinhospitalsandhealthcare

facilities.Differentversionsareavailable.

Somearedesignedtoprovideclientswith

independentmobilityandhavefeatures

suchasbeingfoldablefortransportin

cars.Othersaredesignedonlyforassisted

mobilitywherecarersarerequired.A

pointtonoteisthatdesignfeaturesthatareimportantforindividualuseinthe

community,suchascollapsiblefootrests

andprotrudingparts,mayincreasethelikelihoodofinjury,especiallyifusedregularly

byclients.Forsuchclients,purposebuilttransferandtransportchairsmaypresent

fewercontacthazardsthanwheelchairsdesignedforindependentmobility.Bariatric

chairsshouldhaveelectricmotors.

Standing and pivoting aids (nonelectric)

Thereareseveralnonelectricstandingtransferaidsandtrolleysforclientswhocan

standbuthavedifficultywalking.Theseaidsorpivotingdevicescanbeusedwith

clientswhocanstandbutwhoareunabletowalkwithoutassistance.

Standing transfer trolley

Astandingtransfertrolleyenablesacarertotransferaclientfromachairora

wheelchairtoatoilet.Itisintendedforpeoplewhocanstandbuthavedifficulty

walking.Theclientstandsonthefootrestandholdsthehandlebarforsupport.Some

standingtransfertrolleyshaveseatsthatcandropdownforclientstositonduring

transfers. Thetrolleysarethenmovedbycarerstothelocationsrequired.

Thestandingtrolleyisusefulforrehabilitation.Itiseasytouseandencouragessome

mobility.Itprovidesanoptionbetweenmobilisingwithsomeassistanceandasitto

standhoist.

Framed turning platform

Aframedturningplatformenablesa

clienttostandduringamovefromseat

toseat.Theframedturningplatformmay

havecushionedkneepadsfortheclient

tobraceagainstduringthemove.Theclientputstheirfeetontheturntableand

pullsthemselvesuptostandingusingthe

Wheelchair

figure 7.31

Framed turning platform

figure 7.32


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0

handholds.Thecarerthenturnstheplatformandtheclientsitsdowninthenew

position.Theclientsfeetmustbeplacedcentrallyontheturntableorframedturning

platformsothattherotationthroughthetransferissmooth.Careisneededasthese

itemscanrotateunpredictablyifnotcontrolled.Theturningplatformshouldhaveafootoperatedbrakethatisengagedwhenthecarerstepsdownontheouteredgeof

theturntable.

Shower and bath equipment

Therearemultipletypesofequipmenttoassistclientstomoveinshowersandbaths.

Twotypesofshowerequipmentaredescribedhere.

Wheeled shower chairs

Awheeledshowerchaircanbeusedtotransportaclienttoandfromashowerandcanbeusedintheshowerwhiletheclientremainsseated.Wheeledshowerchairs

mayhavebackrests,armrestsandfootreststhatcanberemovedorshifted.Some

alsohavetiltingfunctionstoalloweasiershowering.Wheeledshowerchairsare

usuallymadefromperforatedplastictoallowwatertodrainfromtheseat.Powered

orbatteryoperatedshowerchairsarepreferred,astheyreducetheriskinpositioning

clientsduringtheprocess.

Mobile shower trolleys

Mobileshowertrolleysarefullbodylength

sothataclientcanbeshoweredinalying

position.Thistypeoftrolleycanalsobe

usedasachangingtable.

Showertrolleystendtobeusedinopen

showerareasratherthaninshower

cubicles,astheyareusuallytoolongtofit

incubicles.Slidingequipmentcanbeused

totransferaclientontoashowertrolley,

ortheclientcanbehoisted.Manytrolleysareheightadjustablesothattheycanbe

positionedatthecorrectworkingheightsforcarers.

Emergency equipment

Thereisarangeofequipmentavailableforemergencies.Withinfacilities,emergency

equipmentmaybeusedfortherapidevacuationofimmobileclientstoanoutside

location,suchasduringafireorearthquake.Ambulancesandotheremergency

servicevehiclesgenerallycarrymultipletypesofspecialistemergencyequipmentfor

movingpeople.

Mobile shower trolley

figure 7.33


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221


Mostemergencyserviceshavestandardpickupandcarrytypesofstretcher.

Thesecanbeusedinemergenciestomovepeoplequicklytootherlocations.These

stretchersusuallyfoldintosmallpackagesforcompactstorage.Otherexamplesof

emergencyequipmentaredescribedbelow.Slide pads and sheets

Slidepadsandsheetsareanoptionfor

emergencyevacuationequipmentfor

immobileclients.Slidepadsaresimilarto

smallmattresses;theyhavestrapstosecure

clientsandslipperysurfacesunderneathso

theycanbedraggedalongfloorsanddown

stairswithclientslyingdown.Emergency

slidesheetsarefittedunderneathmattresses.Theyhavestrapsthatcanbe

fastenedovermattressestosecureclientstothemattresses,andslipperysurfacesso

thesheetswithclientsandmattressescanbedraggedalongthefloor.

Backboards or spine boards

Abackboardorspineboardisusedtoimmobiliseandtransportaclientwitha

suspectedspinalinjuryinanemergency.Itisarigid,fullbodylengthboardto

whichtheclientisstrapped.Theseboardsmaybemadefromsheetaluminium

withatubularaluminiumframe,woodwithaspecialwaterproofcoating,orcoated

plywood board.

Scoop stretchers

Ascoopstretcherisalightweight,concave

stretcherthatseparatesintotwosections

alongitslength(Figure7.35).Itcanbe

placedunderaclientfromeachsidewithout

theneedtorollorliftthem.Theconcave

surfacesupportstheclient,minimising

lateralmovementandreducingtheriskoffurtherinjury.Theclientcanthenbe

carriedtoalocationwherefurthermedical

treatmentcanbeadministered.

Thescoopstretchermayhaveanarrow

footendframeforhandlinginconfinedareas.Itfoldsupforstorageandhaslocking

lengthadjustmentlatchesthatsnapintoplace.Somecompaniesarenowproducing

combinedboards(combiboards)thatincludethefeaturesofbothspineboardsand

scoopstretchers.

Slide pad

figure 7.34

Scoop stretcher

figure 7.35


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Combination stretchers/chairs and

evacuation chairs

Acombinationstretcherandcarrychair

isanoptionfortransportingclientsinanemergency(Figure7.36).Itcanbe

configuredforuseasawheeledchair,astair

chairoraflatstretcher.

Anotheroptionisanemergencyevacuation

chair,whichcanbeusedfortransporting

clientsdownstairs(Figure7.37).

Other types of equipment and aids

Therearenumeroustypesofequipmentand

mobilityaidotherthantheonesdescribed

inearliersections.Ifaclientisabletobear

someoftheirownweightforashortperiod

oftime,therearevariousdevicesavailable

toassistintransfersbetweenbed,chair

andtoilet.Someoftheseaidscanbeused

tohelpclientsmoveshortdistances,orto

standinasupportedmanner.Theyrange

fromsimpletomoretechnical,suchas

walkers,transferbeltsandstandtositlifts.TheMinistryofHealthandtheAccident CompensationCorporation(ACC)both

publishlistsofapprovedequipmentforpeoplewithdisabilitiesandlimitedmobility

(seewww.accessable.co.nz).Notethattheselistscoveraverylimitedrangeofthe

movingandhandlingequipmentthatisavailable.

Emergency evacuation chair

figure 7.37

Combination stretcher/chair

figure 7.36


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223


References and resources

Collins,J.W.,Wolf,L.,Bell,J.,&Evanoff,B.(2004).Anevaluationofabestpractices

musculoskeletalinjurypreventionprograminnursinghomes.Injury Prevention,

10(4),206211.

MHRA(MedicinesandHealthcareProductsRegulatoryAgency).(2003).Evaluation:

Electrically powered profiling beds Part 1: Hospital beds(MHRA03038).London:

MHRA.Retrieved9September2010fromwww.mhra.gov.uk.

Nelson,A.(2003).Patient Care Ergonomics Resource Guide: Safe patient handling and

movement.Retrieved11August2010fromwww.anasafepatienthandling.org/

MainMenu/SPHBackground/SPHSolutions.aspx.

Nelson,A.,Collins,J.,Knibbe,H.,Cookson,K.,Castro,A.,&Whipple,K.(2007).Safer

patienthandling.Nursing Management,38(3),2633.

StandardsNew Zealand,AS/NZS3551:2004.Technical management programs for

medical devices

Seewww.standards.co.nz/touchstone/Issue+16/Electrical/Electricity+Safety+

Regulations+2010+Standards+for+hazardous+areas+and+electromedical

+equipment.htm.

VISN8PatientSafetyCenterofInquiry.(2010).Technology Resource Guide.Retrieved29

October2010fromwww.visn8.va.gov/patientsafetycenter.

WorkSafeBC.(2006).Transfer Assist Devices for Safer Handling of Patients: A guide for

selection and safe use.Retrieved9September2010from

www.worksafebc.com/publications/health_and_safety/by_topic/health_care/

default.asp.

Web resources: equipment3

BiomedicalServicesNZLtd

www.biomed.co.nz/medicaldevicelegislations.htmlSafeLiftingPortal

www.safeliftingportal.com/patientlifts/index.html

WorkSafeBC:WorkersCompensationBoardofBritishColumbia,Canada

www.worksafebc.com/publications/health_and_safety/by_topic/health_care/

default.asp

3. Note:IftheURLsshowndonotwork,doasearchontheorganisationtitle.Equipmentmanufacturersoftensponsororprovideequipmentwebsites.ACCandtheGuidelinesauthorsdonotspecificallyendorseanymanufacturer.


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