Kristen L Kucera1, Ashley L Schoenfisch2, Jennifer McIlvaine3, Lori Becherer4, Tamara James5, Yeu-Li Yeung3, Susan Avent6, Hester J Lipscomb7. 1. Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, United States. Electronic address: kkucera@email.unc.edu. 2. Duke University School of Nursing, Durham, NC, United States; Division of Occupational and Environmental Medicine, Department of Community and Family Medicine, Duke University School of Medicine, United States. 3. Duke Occupational and Environmental Safety Office, Durham, NC, United States. 4. Injury Prevention Research Center, University of North Carolina at Chapel Hill, United States; Duke Occupational and Environmental Safety Office, Durham, NC, United States. 5. Division of Occupational and Environmental Medicine, Department of Community and Family Medicine, Duke University School of Medicine, United States; Duke Occupational and Environmental Safety Office, Durham, NC, United States. 6. Duke University Health System, Durham, NC, United States. 7. Division of Occupational and Environmental Medicine, Department of Community and Family Medicine, Duke University School of Medicine, United States.
Abstract
BACKGROUND: Despite wide availability of patient lift equipment in hospitals to promote worker and patient safety, nursing staff do not consistently use equipment. OBJECTIVE: To determine the influence of factors on the use or non-use of lift equipment during patient lifts/transfers. DESIGN: Prospective observational cohort study. SETTING: One university teaching hospital and two community hospitals in a large health system in southeastern United States. PARTICIPANTS: 77 nurses and nursing care assistants with patient handling duties in critical care, step-down and intermediate care units. METHODS: Participants recorded information about all patient lifts/transfers during their shifts during a 1 week period per month for three months: type of lift/transfer, equipment use, type of equipment, and presence of 20 factors at the time of the lift/transfer. With the patient lift/transfer as the unit of analysis, the association (risk ratios (RR) and 95% confidence intervals (CI)) between factors and equipment use was examined using multivariate Poisson regression with generalized estimating equations. RESULTS: Seventy-seven participants (465 person-shifts) reported 3246 patient lifts/transfers. Frequent lifts/transfers included bed-to-toilet (21%), toilet-to-bed (18%), bed-to-chair (13%), chair-to-bed (13%), chair-to-toilet (6%), and toilet-to-chair (6%). Equipment was used for 21% of lifts/transfers including powered floor based dependent lift (41%), powered sit-to-stand lift (29%), non-powered sit-to-stand lift (17%), air-assisted lateral transfer device (6%), ceiling lift (3%), and air-assist patient lift (3%). Factors associated with equipment use included: availability of equipment supplies (RR = 9.61 [95%CI: 6.32, 14.63]), staff availability to help with equipment (6.64 [4.36, 10.12]), staff preference to use equipment (3.46 [2.48, 4.83]), equipment required for patient condition (2.38 [1.74, 3.25]), patient inability to help with lift/transfer (2.38 [1.71, 3.31]), equipment located in/by patient room (1.82 [1.08, 3.06]), sling already under patient (1.79 [1.27, 2.51]), and patient size/weight (1.38 [0.98, 1.95]). Lower patient mobility score (3.39 [2.19, 5.26]) and presence of physical or mental impairments (2.00 [1.40, 2.86]) were also associated with lift equipment use. Factors associated with non-use of equipment included: patient/family preference (0.31 [0.12, 0.80]), staff assisting with lift did not want to use equipment 0.34 ([0.17, 0.68]), patient condition (0.48 [0.20, 1.20]), and patient almost fell (0.66 [0.45, 0.97]). CONCLUSIONS: Patient, worker, equipment, and situational factors influence whether nursing staff used equipment to lift/transfer a patient. Quantifying and understanding these factors associated with lift equipment use and non-use provides specific information for hospitals and safety professionals to enhance effectiveness of future organizational and ergonomic intervention efforts to prevent work-related patient-handling injuries.
BACKGROUND: Despite wide availability of patient lift equipment in hospitals to promote worker and patient safety, nursing staff do not consistently use equipment. OBJECTIVE: To determine the influence of factors on the use or non-use of lift equipment during patient lifts/transfers. DESIGN: Prospective observational cohort study. SETTING: One university teaching hospital and two community hospitals in a large health system in southeastern United States. PARTICIPANTS: 77 nurses and nursing care assistants with patient handling duties in critical care, step-down and intermediate care units. METHODS:Participants recorded information about all patient lifts/transfers during their shifts during a 1 week period per month for three months: type of lift/transfer, equipment use, type of equipment, and presence of 20 factors at the time of the lift/transfer. With the patient lift/transfer as the unit of analysis, the association (risk ratios (RR) and 95% confidence intervals (CI)) between factors and equipment use was examined using multivariate Poisson regression with generalized estimating equations. RESULTS: Seventy-seven participants (465 person-shifts) reported 3246 patient lifts/transfers. Frequent lifts/transfers included bed-to-toilet (21%), toilet-to-bed (18%), bed-to-chair (13%), chair-to-bed (13%), chair-to-toilet (6%), and toilet-to-chair (6%). Equipment was used for 21% of lifts/transfers including powered floor based dependent lift (41%), powered sit-to-stand lift (29%), non-powered sit-to-stand lift (17%), air-assisted lateral transfer device (6%), ceiling lift (3%), and air-assist patient lift (3%). Factors associated with equipment use included: availability of equipment supplies (RR = 9.61 [95%CI: 6.32, 14.63]), staff availability to help with equipment (6.64 [4.36, 10.12]), staff preference to use equipment (3.46 [2.48, 4.83]), equipment required for patient condition (2.38 [1.74, 3.25]), patient inability to help with lift/transfer (2.38 [1.71, 3.31]), equipment located in/by patient room (1.82 [1.08, 3.06]), sling already under patient (1.79 [1.27, 2.51]), and patient size/weight (1.38 [0.98, 1.95]). Lower patient mobility score (3.39 [2.19, 5.26]) and presence of physical or mental impairments (2.00 [1.40, 2.86]) were also associated with lift equipment use. Factors associated with non-use of equipment included: patient/family preference (0.31 [0.12, 0.80]), staff assisting with lift did not want to use equipment 0.34 ([0.17, 0.68]), patient condition (0.48 [0.20, 1.20]), and patient almost fell (0.66 [0.45, 0.97]). CONCLUSIONS:Patient, worker, equipment, and situational factors influence whether nursing staff used equipment to lift/transfer a patient. Quantifying and understanding these factors associated with lift equipment use and non-use provides specific information for hospitals and safety professionals to enhance effectiveness of future organizational and ergonomic intervention efforts to prevent work-related patient-handling injuries.
Authors: Lars Louis Andersen; Jonas Vinstrup; Ebbe Villadsen; Kenneth Jay; Markus Due Jakobsen Journal: Int J Environ Res Public Health Date: 2019-11-15 Impact factor: 3.390