When a 200-pound patient needed to be moved from the hospital bed to a chair, registered nurse Rose-Annie Ofori called on Opera, the unit’s strongest and newest staff member. “Opera,� a powered lift, safely and securely did the job that usually takes three staff members.

Operated by Ofori alone, the Opera played an important role on the health care team. It allowed other nurses on 8300 patient care unit to attend to their patients, prevented staff members from placing themselves at risk for physical injury, and provided maximal safety and comfort to the patient.

The traditional way of manually lifting or moving patients by calling for help from all available staff members on a floor will be going the way of the dinosaurs soon at Duke University Hospital (DUH) thanks to Opera and three other types of the latest generation of patient lifts, along with the use of new transfer aids.

The hospital has begun moving toward a “minimal-manual lift environment� in which manual lifting of patients will be avoided except in an emergency. Instead, nursing staff will use patient lift equipment.

Pairing Ergonomics with Nursing
The program began in July after the hospital bought 44, or $252,000 worth, of mobile lifts and fixed lift devices (those mounted in the ceiling) from ARJO, Inc. of Roselle, IL, for staff use in all adult inpatient care areas. The project began on 4th, 6th and 8th floors and will be rolled out across the hospital over the next eight months.

The lifts or transfer devices can be used for transferring a patient between bed, chair, wheelchair, bedside commode, and stretcher; picking up a fallen patient; assisting a patient to stand; making an occupied bed; switching beds; weighing a patient; and repositioning a patient in bed.

“It’s really about changing our culture around how we move and transfer patients from the old ‘all hands on deck’ to using mechanical aids or transfer devices that can make our patients andour employees safer,� says Jessica Palmer, R.N., M.S.N., clinical operations director for General Medicine.

Palmer and Tamara James, director of the Ergonomics Division in the Occupational & Environmental Safety Office, developed the program after a 90-day pilot project on 8100 and 8300 patient care units (General Medicine) last year. The study showed that the lifts and transfer aids could be a tremendous benefit to nursing staff, who have an increased risk of injury because of manually lifting patients, and that the lifts also could increase patient satisfaction.

“The program is a unique pairing of ergonomics and nursing to provide safety for both patients and employees,� said James, who approached nursing leadership in General Medicine about participating in the pilot being funded by a Press Ganey grant.

Creating a Safer Environment
After the pilot proved successful, Mary Ann Fuchs, DUH chief nursing officer, brought the results to the full hospital leadership, which quickly supported the financial commitment and training time required for implementing the program hospital-wide.

“We are particularly challenged as our workforce is facing increasingly strenuous work due to the changes in our patient population, primarily with the rising rates of obesity,� said Fuchs. “Duke is specifically investing in the lift equipment to prevent staff injuries by reducing the work intensity. We know that from the pilot study that both patients and staff were more satisfied when lift equipment was used to assist in moving or lifting patients. This equipment not only will improve the work environment but will aid staff retention by making the workplace safer for staff and patients.�

Nursing is one of the few professions where it’s acceptable and expected that someone lift 100 or more pounds, James said. So it’s no surprise that nursing has one of the highest occupation injury rates of any profession. (See sidebar)

Training on the new lifts has been completed on 4th, 6th and 8th floors and is continuing in other inpatient areas of the hospital. Occupational and physical therapists also are learning to use the new equipment to help with their work.
The Division of Occupational and Environmental Medicine, the Ergonomics Division and nursing leadership will evaluate the program later through a series of questionnaires to determine its effectiveness and whether it would be appropriate for other areas of the hospital, such as Radiology or the Operating Room.

“Lifting has always been a part of nursing, but not much longer. Back injuries do not have to be part of the job,� Palmer says. “It’s no longer necessary to use brute strength or an all hands on deck approach to moving or relocating patients. The minimal-manual lift environment is a culture change that has the potential to increase safety, decrease work intensity, and reduce turnover related to on the job injuries.�