aparatura mutat pacienti
TRANSCRIPT
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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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Section 7: equipment for moving and handling people
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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Section 7: equipment for moving and handling people
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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Section 7: equipment for moving and handling people
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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Section 7: equipment for moving and handling people
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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Section 7: equipment for moving and handling people
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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Section 7: equipment for moving and handling people
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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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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Section 7: equipment for moving and handling people
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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Section 7: equipment for moving and handling people
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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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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Section 7: equipment for moving and handling people
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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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
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215
Section 7: equipment for moving and handling people
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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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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Section 7: equipment for moving and handling people
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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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
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Section 7: equipment for moving and handling people
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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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
Section 7: equipment for moving and handling people
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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2
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
Section 7: equipment for moving and handling people
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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