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

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Evaluation of Technology to Support Safe Patient Handling and Movement

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Evaluation of technology to support safe patient handling and movement l.jpg

Evaluation of Technology to Support Safe Patient Handling and Movement

Acknowledgements:

Andrea S. Baptiste, MA, CIE

John Lloyd, PhD, CPE

Audrey Nelson, PhD, RN, FAAN

Funded by

VISN 8 Patient Safety Center of Inquiry, Tampa, VAMC


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What Is a Friction Reducing Device?

  • Friction reducing devices provide a low cost technology solution for lateral transfers of patients E.g. Bed to stretcher transfers


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Equipment Applications

  • Nursing home/home care

  • General rehabilitation

  • Acute medical/surgical

  • Or/recovery

  • Spinal cord injury unit

  • Inpatient/outpatient clinic

  • Intensive care unit


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Types of Friction Reducing Devices:

  • There are 3 types :

    • Air Assisted

    • Lateral sliding aids

    • Mechanical lateral transfer aids


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Air Assisted Lateral Sliding Aids

  • A flexible mattress placed under patient; inflates by portable air supply.

  • Patient is moved on a cushioned film of air

  • This reduction in friction makes the lateral transfer much easier for the caregiver

  • Cost: $1200-$1600


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An example of an air assisted lateral sliding aid:

  • A waterproof, anti-bacterial anti-stain, nylon mattress that allows for lateral transfers.

  • Key strength: no weight limit


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Lateral Sliding Aids

  • Assists with bed to stretcher type transfers-transfer boards or fabric

  • Both devices are positioned under the patient providing a smooth surface to slide the patient


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Example: Lateral Sliding aid

  • Properly designed handles (fabric) reduce the forward reach as found in draw sheets

  • Cost: $80-$300


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Example: Lateral Sliding Aid

  • Used for transfers and repositioning patients in bed

  • Main advantages of this device are: portable, easily stored and lightweight (4 lbs)


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Mechanical Lateral Transfer Aids

  • This eliminates the need to manually slide patients

  • This reduces risk to the caregiver

  • Cost: $1800-$8000


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Example: Mechanical Lateral transfer aid

  • This device is used in lateral transfers of patients

  • Key advantage: no manual work done to slide patient


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An Evaluation of Technology

  • The purpose was to evaluate eleven commercially available lateral transfer aids.

  • Transfers were done from a hospital bed to a stretcher.


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Air assisted:

Airpal

Hovermatt

Lateral Transfer Study

Lateral sliding aids:

  • Slipp patient mover

  • Draw sheet

  • Disposable plastic bag (DPB)

  • Aqua flat sheet set

  • Lateral transfer Aid

  • Resident transfer assist

  • Maxi-slide

  • Maxi-trans

  • Easy transfer system


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Methodology:

  • Subject:A 200 pound mannequin was used to represent a dependent pt. in all lateral transfers.

  • Equipment:Chatillon force gauge, bed with non-inflating mattress, stretcher trolley.


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Methodology:

  • Measurement:A simple method was devised to capture maximum external forces applied during the transfer.

  • Results captured:

    • Force Mean results

    • % Population capable

    • Spinal Forces


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Force Mean Results:

  • Mean applied force was calculated across five trials.

  • Device yielding:

    • lowest mean force was the maxi slide (39.7lbf. or 176.6 N).

    • highest mean force was the draw sheet (145 lbf. or 645 N).


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% Population Capable Results:

  • 0% population able to sustain forces at the shoulder with a disposable plastic bag (DPB) or draw sheet.

  • > 70% would be able to do the transfer task using Airpal, Hovermatt, Slipp, Lateral transfer aid, Aqua flat sheet set, Resident transit assist and Maxi-Slide.


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Compression:

highest at L5/S1 with use of Maxi Trans (661lbf.)

lowest with use of aqua flat sheet set (216.9 lbf.)

Anterior/posterior shear forces:

highest with use of DPB (179 lbf)

lowest with use of Maxi Trans (6lbf)

Lateral shear force:

highest with use of lateral transfer aid (6 lbf.)

lowest with use of Aqua flat sheet set

Spinal Force Results:


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Top Five Products:

  • 1) Lateral transfer Aid

  • 2) Flat sheet set

  • 3) Maxislide

  • 4) Hovermatt

  • 5) Airpal


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Conclusions:

  • Key factors that affect spinal loading:

    • Caregiver’s stance and posture

    • Friction reducing properties

    • Relative height of transfer surfaces

    • Location of handles on device

    • Angle of pull

    • Extended pull straps and number of straps used

    • Patient mass


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Implications for Clinical Application:

  • These lateral transfer aids do have limitations-some are n/a for bariatric patients.

  • For patients over 200 lbs, use a mechanical device and two caregivers.

  • Other factors to consider are: storage, infection control, cleaning, ease of use.


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The subjective study

  • The purpose – to acquire feedback on usability of devices from nurses on the units.

  • Look at results of subjective data and biomechanical data

  • Eight devices were randomly distributed for evaluation


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Equipment Rating Survey

Product ______ Unit ______

  • How would you rate your OVERALL COMFORT during use of this product?

    0 1 2 3 4 5 6 7 8 9 10

  • What is your impression of this product’s OVERALL EASE-OF-USE?

    0 1 2 3 4 5 6 7 8 9 10

  • How EFFECTIVE do you think this product will be in reducing INJURIES?

    0 1 2 3 4 5 6 7 8 9 10

  • How EFFICIENT do you feel this product will be in use of your TIME?

    0 1 2 3 4 5 6 7 8 9 10

  • How SAFE do you feel this product would be for the PATIENT?

    0 1 2 3 4 5 6 7 8 9 10


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Conclusions

  • Use of Friction Reducing Devices has proven to be a better choice than using a draw sheet to laterally transfer a patient

  • These low cost devices should reduce risk of injury in healthcare workers


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