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Use of Assistive Devices to Lift, Transfer, and Reposition Hospital Patients

Schoenfisch, Ashley L.; Kucera, Kristen L.; Lipscomb, Hester J.; McIlvaine, Jennifer; Becherer, Lori; James, Tamara; Avent, Susan

doi: 10.1097/NNR.0000000000000325
FEATURE ARTICLES
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Background Devices to lift, transfer, and reposition patients are recommended for healthcare workers' and patients' safety, but their intended use has yet to be fully realized.

Objective The aim of this study was to describe hospital nursing staff use of lift/transfer devices and the presence of factors at the time of lifts/transfers with potential to influence whether devices are used.

Methods Participants were 108 US nursing staff in a university-based medical center and two community hospitals. A self-completed questionnaire was used to collect demographic and work characteristics, typical frequency of patient lifts/transfers, training in and typical use of lift equipment, and specific factors that could influence use. Proportional distributions of lifting/transferring and repositioning frequencies in a typical shift, amount of equipment use, and factors present were examined overall and across worker and work-related characteristics.

Results Although trained in equipment use, only 40% used equipment for at least half of lifts/transfers. During lifts/transfers, factors often present included patient unable to help with lift/transfer (91.3%) or of a size/weight where participant needed assistance to help lift/transfer (87.5%); availability of others who could assist with manual lift (86.3%) or use of lift equipment (82.4%); and equipment functioning properly (86.4%), having supplies available (82.5%), and being easy to retrieve from storage (81.6%). During repositioning tasks, physical assistance was “always/almost always” provided from coworkers (83.3%) and often perceived as “very helpful” (92.6%) in reducing physical demands. Physical assistance from patients was less common (14.0% “always/almost always”) yet perceived as “very helpful” by 66.3%. One fifth always used friction-reducing devices.

Discussion Despite training in their use, nursing staff use of available lift equipment and assistive devices is limited. Factors present at the time of lifts/transfers that may influence equipment/device use reflect a complex mix of patient, worker, equipment, and situational characteristics.

Ashley Schoenfisch, PhD, MSPH, is Assistant Professor, Duke University School of Nursing, and Division of Occupational and Environmental Medicine, Department of Community and Family Medicine, Duke University School of Medicine, Durham, North Carolina.

Kristen L. Kucera, PhD, MSPH, ATC, LAT, is Assistant Professor, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, and Director, National Center for Catastrophic Sport Injury Research, University of North Carolina at Chapel Hill.

Hester J. Lipscomb, PhD, is Professor Emeritus, Division of Occupational and Environmental Medicine, Department of Community and Family Medicine, Duke University School of Medicine, Durham, North Carolina.

Jennifer McIlvaine, PT, MSPT, CSPHA, is Physical Therapist, Safe Patient Handling Specialist, Duke Occupational and Environmental Safety Office, Durham, North Carolina.

Lori Becherer, BS, is Staff Specialist, Duke Occupational and Environmental Safety Office, Durham, North Carolina, and Injury Prevention Research Center, University of North Carolina at Chapel Hill.

Tamara James, MA, CPE, CSPHP, is Director, Ergonomics, Duke Occupational and Environmental Safety Office, and Assistant Professor, Division of Occupational and Environmental Medicine, Department of Community and Family Medicine, Duke University School of Medicine, Durham, North Carolina.

Susan Avent, MSN, MBA, MHA, RN, NEA-BC, is Associate Chief Nursing Officer, Quality, Duke University Health System, Durham, North Carolina.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.nursingresearchonline.com).

Accepted for publication August 24, 2018.

The authors thank Yeu-Li Yeung, MS, OT/L, CPE, CSPHP, Patient Care Ergonomics Coordinator for Duke Health, for long-standing work around safety patient handling/mobility and insights related to project development. They also thank the nurses and NCAs who participated in this study.

Ashley Schoenfisch is now a consulting associate at Duke University School of Nursing, and Division of Occupational and Environmental Medicine, Department of Community and Family Medicine, Duke University School of Medicine, Durham, North Carolina.

Susan Avent is now retired.

This study was funded by a grant from the National Institute for Occupational Safety and Health (NIOSH, R21OH010542). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institute for Occupational Safety and Health, the Centers for Disease Control and Prevention, or the Department of Health and Human Services. The NIOSH had no role in conduct of the research other than funding it.

All study procedures were approved by the institutional review boards of the University of North Carolina at Chapel Hill (IRB 14-2480) and Duke University (Pro00061022).

Jennifer McIlvaine has no conflicts of interest to disclose; however, she discloses paid ongoing consulting work with HillRom/Liko beginning May 2017. The other authors have no conflicts of interest to disclose.

Corresponding author: Ashley L. Schoenfisch, Duke University School of Nursing, 307 Trent Drive, Box 3322, Durham, NC 27710 (e-mail: ashley.schoenfisch@duke.edu).

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