Evaluation of Technology to Support Safe Patient Handling and Movement

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

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

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

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

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

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

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

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

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

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

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

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

13. 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

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

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

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

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

18. 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:

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

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

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

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

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

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