standing hoists: to stand or not to stand?
TRANSCRIPT
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STANDING HOISTSTo Stand or Not to Stand
AIDEEN GALLAGHER AND
EMMA SMALL© Risk Managed Pty Ltd 2016
AAMHP – 7TH BIENNIAL CONFERENCE, FREMANTLE, WA
23 MAY 2016
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ACTIVE TRANSFER
EASE DRESSING, TOILETING
REDUCED TIME
REDUCED MANUAL HANDLING
REDUCED COST OF CARE
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15FALLSin 4 years(HSE, 2015)
Some due to Standing hoists
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ALLIED HEALTH CULTURE (Darragh, Campo and Olson, 2009)
GOAL REHABILITATION – CHALLENGING PARTICIPANT
(Darragh, Campo and Olson, 2009)
WEANING OFF EQUIPMENT
HEALTH PROFESSIONAL NOT EQUIPMENT
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INJURY AVOIDANCE – GOOD BIOMECHANICS? (Darragh, Campo and Olson, 2009)
MANY TECHNIQUES ABOVE SAFETY THRESHOLD (Marras, Davis, Kirking and Bertsche, 1999)
SUPPORT WORKER FILLING THE GAP
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THE STAND OFF
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BACKGROUND
DARK DAY WHEN WE HAVE TO TAKE
THE HOIST AWAY
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WHAT SKILLS DOES A CARE RECEIVER NEED TO DISPLAY, FOR THE USE OF A STANDING HOIST TO BE SAFE FOR THE CARE RECEIVER AND CARE GIVER?
OUR RESEARCH QUESTION
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DELPHI STYLE STUDY
EXPERT PANEL – DEFINE AND DIFFERENTIATE VIEWS (Crisp, Pelletier, Duffield, Adams & Nagy, 1997)
DECLARATION OF HELSINKI - Ethics
Open Ended
Exploratory
ExploreRange
Explore Importanc
e
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Open Ended
Exploratory
Identify all the skills you feel a care receiver needs in standing hoist transfers ensuring the health and safety of the care giver and receiver. Identify all the skill deficits a care receiver would display for you to conclude standing hoist transfers are unsafe for care giver and receiver
STAGE 1
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ANAL
YSIS
QUALITATIVE METHODSDEFINITION-themes and subthemes29 CRITERIA
STAGE 1Open Ended
Exploratory
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ExploreRange
EXAMPLE: “WEIGHT BEARING”
MINIMUM TIMEMINIMUM PERCENTAGEMINIMUM NUMBER OF LEGS
STAGE 2
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ANAL
YSISQUANTITIVE METHODS
DESCRIPTIVE STATISTICS
ExploreRange STAGE 2
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Explore Importanc
e
29 CRITERIA
ESSENTIAL SKILLSDESIRABLE SKILLS
STAGE 3
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RESULTS
18 PARTICIPANTS – STAGE 1
83% ALLIED HEALTH (n=15)
11%NURSING (n=2)
6% WHS PROFESSIONAL (n=1)
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RESULTS
83% OVER 11 YEARS EXPERIENCE(n=15)
94%FEMALE (n=17)
29 CRITERIA
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RESULTS
29 CRITERIA
MINIMUM REQUIRMENT FOR CARE RECEIVER TO DISPLAY FOR BOTH CARE RECEIVER AND GIVER TO BE SAFE
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Minimum as-sistance from care giver (CG)
SUPINE TO SITTING ON THE BED
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MAINTAINED SITTING ON THE SIDE OF THE BED- SKILL LEVEL AND TIME
2 minutes5 minutes Other
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WEIGHT BEARING CAPACITYSKILL LEVEL AND TIME
%60-100
MINUTES
1.5-5
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SECURE SLING UNDER ARM
IndependentMinimum assistance by CG
MAINTAIN HANDS ON GRIP
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MAINTAIN FEET ON FOOTREST
IndependentlyMinimum assis-tance from SW
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MINIMAL TO UNIMPAIREDRECEPTIVE COMMUNICATIONCAPACITY TO FOLLOW INSTRUCTIONSLEVEL OF UNDERSTANDINGCO-OPERATIONALERTNESSPREDICTABILITY
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DISCUSSION
LYING TO SITTING TRANSFER MATTERS
Roll and sit 171.0 – 263.2N30 degree raise111.2 – 151N
(Fray & Hignett, 2015)
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DISCUSSION
1.5-5 MINUTESWHEN IS IT REHABILITATION?
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25%
ASSISTANCE WITH FEET
KEY POSITION OF SUPPORT?
50%
ASSISTANCE WITH HANDS
63%
ASSISTANCE WITH SLING
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INFORMED CONSENT?
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AGREEMENT ON PRESCRIPTION
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LIMITATIONS
LOW RESPONSE RATE
FUTURE RESEARCH
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REFERENCES Fray, M. & Hignett, S. (2015). An evaluation of the biomechanical risks
for a range of methods to raise a patient from supine lying to sitting in a hospital bed. Proceedings 19th Triennial Congress of the IEA, Melbourne 9-14 August 2015.
Crisp, J., Pelletier, D., Duffeild, C., Adams, A. & Nagy, S. (1997). The Delphi Method? Nursing Research, 46, 116-118.
National Health Service (2015). Patient Safety Alert: Risk of death and serious harm by falling from hoists. Alert reference number: NHS/PSA/W/2015/010. Retrieved from: ww.england.nhs.uk/patientsafety.
Depoy, E. & Gitlin, L.N. (1998). Introduction to Research: Understanding and Applying Multiple Strategies (2nd ed.). USA: Mosby.
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Marras, W. S., Davis, K. G., Kirking, B. C., & Bertsche, P. K. (1999). A comprehensive analysis of low-back disorder risk and spinal loading during the transferring and repositioning of patients using different techniques. Ergonomics, 42, 904–926.
McGrath, M., Taaffe, C. & Gallagher, A. (2015). An exploration of knowledge and practice of patient handling among undergraduate occupational therapy students. Disability Rehabilitation. Mar 4:1-7
Darragh AR, Campo M, Olsen D. Therapy practice within a minimal lift environ- ment: perceptions of therapy staff. Work. 2009;33:241–253.
REFERENCES
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MEDIAHoist 1 By
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