Healthcare organizations around the world recognize the risks that manual lifting poses for healthcare workers. Canada and the United Kingdom, for example, have national programs focused on safe-patient handling. Momentum has been slow in the U.S. since the American Nurses Association launched its Handle With Care Campaign in 2003. However, as of April 2012, ten states have enacted ”safe patient handling” legislation. Key factors that are responsible for the current focus include the aging population, growing obesity epidemic, and prevention of patient injury. A major driver, however, is the need to prevent injuries to healthcare workers ― particularly with the aging of the nursing work force.
In the new healthcare facilities standards issued by the Canadian Standards Association in September 2011 (CSA Z8000-11), all medical/surgical inpatient bed-rooms are required to have ceiling-mounted tracks to accommodate a patient mechanical lift device ― including the necessary structural, mechanical, and electrical systems. Ceiling lifts must have a minimum vertical lift capacity of 441 pounds (200 kilograms) and rooms designed for bariatric patients must have a lift with a capacity of 1,000 pounds (453 kilograms). The means to provide mechanical lifting for patients in all other clinical areas must also be provided (e.g., physical therapy and diagnostic imaging).
A new section on safe patient handling was added to the 2010 Guidelines for Design and Construction of Health Care Facilities (published by the Facilities Guidelines Institute with assistance from the U.S. Department of Health and Human Services). It is now recommended that a patient handling and movement needs assessment (PHAMA) be performed to help the design team identify what is needed. The assessment should identify the types of patients and frequency of patient-handling tasks that is performed for each patient area or unit to determine the type and quantity of patient-handling equipment needed. Options include fixed ceiling-mounted tracks and lifts, mobile patient lifts, sit-to-stand lifts, lateral transfer devices, wheelchairs, and transfer chairs.
FACILITY PLANNING IMPLICATION
Although U.S. healthcare organizations are still deliberating over the most appropriate equipment to be used, the impact on space planning and design to ac-accommodate various types of patient handling and movement equipment is significant.
Specific considerations applicable to both bariatric and non-bariatric patient care needs include:
- Origination and destination points for patient transfers and the movement path ― including inpatient bedrooms, and exam and procedure rooms
- Accommodation for mobile carts in waiting areas
- Sizes and types of door openings through which patient handling and movement equipment ― and the accompanying staff ― must pass
- The appropriate mix of fixed versus mobile patient lifting and movement equipment
- Space for the staging and storage of mobile patient handling equipment
- Structural considerations to accommodate the current and/or future fixed patient handling and movement equipment ― such as installation of ceiling-mounted tracks
- Electrical and mechanical considerations ― particularly recharging areas for mobile equipment
- Types of floor finishes, surfaces, and transition points needed to facilitate safe and effective use of the patient handling and movement equipment
It should be noted that, in addition to the determination and specification of safe patient handling and movement equipment, staff training and education are paramount to preventing patient and staff injuries.
Source: “Safety First: Protect Important Resources by Planning for Safe-Patient Handling” by Kathryn M Pelczarski, Medical Design & Construction, July/August 2011.