Safe Patient Handling and Movement: A Practical Guide for Health Care Professionals

Safe Patient Handling and Movement: A Practical Guide for Health Care Professionals: Medicine & Health Science Books @ Amazon. com.
Table of contents

The program was initiated in August , and its implementation lasted until March No patients admitted during the program implementation period were included.

Safe Patient Handling and Movement

We allowed for a wait period of 20 mo, ensuring that the program was fully integrated into the RSU and physical therapy PT and occupational therapy practice. The SPHM program included patient handling technologies, administrative policies, and a decision-making algorithm. Therapy staff members were trained and tested to use the equipment and decision-making guidelines when first hired and subsequently required to pass annual competency evaluations. Peer leaders were available as consultants for therapy units when necessary. Technologies used on the RSU included floor- and ceiling-based dependent patient lifts, sit-to-stand assists, motorized hospital beds, ambulation aides, multihandled gait belts, and powered shower chairs.

The primary outcome measure was self-care performance as measured by the self-care subscale of the FIM. For all categories and items contained in the FIM, see Figure 1. Admission and discharge FIM scores were recorded as the lowest score observed by any member of the care team in the first 3 days after admission and 3 days before discharge. Therapists received training and were certified in FIM scoring procedures when hired and then biannually. The self-care FIM was defined as the total of six self-care items, including eating, grooming, dressing upper body, dressing lower body, bathing, and toileting.

In each category, a score of 1 indicated total dependence and 7 indicated complete independence, with a possible total maximum score of The FIM has high interrater and test—retest reliability. We included several covariates in the analysis. Age in years was collected and coded continuously.

Length of stay was coded as days of hospital stay. Diagnoses were obtained from the FIM impairment—diagnostic codes and were collapsed into four diagnostic groups: Mobility was assessed using the mobility subscale of the motor FIM, defined as the total of the two locomotion and three transfer items see Figure 1 , and coded continuously. We computed descriptive statistics for all covariates. A series of independent-sample t tests and chi-square tests were run to evaluate group differences on the covariates.

The groups differed on most covariates see Table 1 and the Results section , precluding a direct computation of the intervention effect. A simple inclusion of covariates in the analysis would complicate the interpretation of the findings, because a treatment effect could only be computed for a certain level of covariates.

MSM is frequently used in observational studies in which no random assignment is possible. In a hypothetical scenario, the treatment effect would be computed by taking a difference in outcomes under the two conditions. In reality, every patient belongs only to one group, and only one outcome is observed. Thus, individual effects are not possible to compute; however, the average effect can be estimated by taking the difference between outcomes observed on the group level i.

When patients are randomly assigned to groups, this average effect is unbiased.


  • The Story Template: Conquer Writers Block Using the Universal Structure of Story (Great Ways to Writ.
  • Effects of a Safe Patient Handling and Mobility Program on Patient Self-Care Outcomes!
  • Related Products?
  • Electrokinetic Phenomena: Principles and Applications in Analytical Chemistry and Microchip Technolo.
  • Lavender Lady;
  • Tricks with Your Head: Hilarious Magic Tricks and Stunts to Disgust and Delight!

The effect is biased, however, in the no-random-assignment situation. Accordingly, patients were matched on the basis of their propensity to belong to the SPHM group, as predicted by all covariates. Thus, two patients from different groups but with similar propensity scores constituted a matched pair. Logistic regression was used to compute propensity scores for these data. Because the goal of the model was to predict members of the SPHM group, the p value was set at the liberal level of.

The final list of covariates included age, diagnosis, baseline FIM self-care scores, and baseline FIM mobility scores. Further, weights were computed based on estimated propensities by the following formula:. In other words, weights for patients in the SPHM group were computed as inverse probability of being in that group, given all the confounders.

Weights for patients in the no-SPHM group were computed as an inverse of 1 minus the probability of being in the SPHM group, given all the confounders.

Frequently bought together

In addition, sensitivity analysis was conducted to evaluate the success of the propensity model. Figure 2 displays standardized group differences an equivalent of effect sizes on study confounders. Group differences disappear in the matched sample, indicating a successful propensity model. Funnel plot for sensitivity analysis evaluating group differences on covariates for unweighted and weighted-by-propensity scores samples. Finally, a weighted logistic regression was run to estimate the effect of the SPHM program on the probability of scoring independent on self-care discharge score.

To account for the severe negative skew of the self-care data, we dichotomized the self-care outcome into independent and not independent. According to FIM scoring guidelines, scores of 6 modified independence and 7 independence are considered independent. We defined independent as a total score of 36, derived by summing scores across the six categories.

Twenty-three patients with a length of stay of less than 3 days were excluded. As a result, the final sample included 1, patients. Major patient characteristics are summarized in Table 1.


  • Safe Patient Handling and Movement: A Practical Guide for Health Care - Google Книги;
  • Firsting and Lasting: Writing Indians out of Existence in New England (Indigenous Americas).
  • Novel and Romance 1700-1800 (Routledge Revivals): A Documentary Record: Volume 1;
  • Life Bytes 2.0.
  • The Infinite Question;

The propensity model described above accounted for the group differences, and logistic regression was used to assess the likelihood that members of the SPHM and no-SPHM groups would achieve independence. In the SPHM group, The purpose of this study was to evaluate the effect of the SPHM program on self-care outcomes in patients receiving rehabilitation services.

Patients who underwent rehabilitation services after implementation of an SPHM program were just as likely to achieve independence as those who underwent rehabilitation without the SPHM program. Our study is the first to examine self-care outcomes and SPHM. The results add to the current body of literature on rehabilitation outcomes and provide preliminary evidence that the implementation of SPHM programs on inpatient rehabilitation units does not interfere with patient outcomes. Our previous work Campo et al.

In concert with the evidence that SPHM programs can reduce the physical demands of moving, lifting, and handling patients, these findings suggest that SPHM is a practical option for preventing injuries in therapists while preserving patient recovery. Therapists have expressed concern that using SPHM technologies will foster dependence and therefore slow the pace of recovery Nelson et al. This study can mitigate concerns about the effects of an SPHM program on global patient outcomes.

Patients appear to be able to achieve the same level of independence in self-care and, according to previous work, in functional mobility Campo et al. The process of rehabilitation also may benefit from the use of SPHM technologies. SPHM technologies, when used appropriately, can be used to increase rather than reduce patient effort in rehabilitation programs; may allow therapists to work with patients, regardless of their weight or diagnosis complexity, to provide a higher therapeutic dose of activity; and may also be used to mobilize patients earlier and at a higher frequency than would normally be possible Darragh et al.

These findings are particularly salient given current emphases on early mobilization Cumming et al. Patient recovery is not defined solely by functional independence or time. Recovery also includes the quality of movement and activity performance and the return of typical movement patterns. Therapist concerns often center on their ability to facilitate normal movement patterns when using SPHM devices. Investigation into the effects of SPHM technologies on task performance is a critical component of this area of inquiry. Several studies have examined movement patterns and muscle activation during transfers, and the conclusions are mixed.

Device-assisted, sit-to-stand transfers resulted in atypical movement patterns and lower overall muscle activation Burnfield et al. In their study of adults with stroke, Burnfield et al. Using kinematic analysis and electromyographic assessment, they found that device-assisted sit-to-stand transfers took twice as long as clinician-assisted transfers, and they resulted in reduced trunk and ankle motion in patients with stroke. But when device-assisted transfers were combined with clinician assistance clinicians were able to provide either verbal or physical cuing , lower-extremity muscle activity increased.

Also, although the device-assisted movement patterns differed from normal sit-to-stand movement patterns, so did the clinician-assisted transfers. Perhaps a combination of clinician assistance and SPHM devices is the best option for therapeutic application.

Related Specialties

Modification of existing devices to more closely approximate normal movement patterns, paired with clinician verbal and physical cueing, could result in an effective and safe way to facilitate activity performance, motor relearning, muscle strengthening, and joint mobility and could potentially be more effective than clinician facilitation alone. These studies demonstrate the importance of evaluating and modifying SPHM technologies for use in therapy and assessing the effects of such devices on patient activity performance.

Safe Patient Handling

It is critical that occupational therapists develop specific guidelines for the use of SPHM technologies as well as the frequency, duration, and dosage of SPHM technologies during rehabilitation. This study is the first to examine the effects of an SPHM on self-care outcomes in a large, diverse sample of patients receiving inpatient rehabilitation.

The SPHM program was completely integrated into the rehabilitation service, with readily available patient handling technologies and well-trained and invested staff. We noted several important limitations, however. The study was limited by use of the FIM as the outcome measure. The FIM, though widely used and administered in this case, by highly trained staff , is vulnerable to inconsistent or inaccurate scoring.

Alternative measures that specifically assess self-care activities would be a useful and important alternative for use in future studies. Additionally, the cutoff score used to indicate that self-care is performed with at least modified independence does not elucidate the effects of the technologies on performance of specific activities.

Occupational therapists are the professionals tasked with facilitating the highest level of independence in self-care for clients in rehabilitation. We as a profession must understand the most effective methods for supporting performance of self-care activities. SPHM programs, which require the use of SPHM technologies during most rehabilitative activities, have the potential to affect both the methods that occupational therapists use for self-care training and patient outcomes.

It is imperative that occupational therapy researchers carefully assess the effect of these technologies. This study is a first step in this process. Our results have the following implications for occupational therapy practice:. These findings support the assertion that effective rehabilitation services can be delivered within the context of an SPHM program.

Effects of a Safe Patient Handling and Mobility Program on Patient Self-Care Outcomes

It is possible, then, to protect occupational therapy practitioners from work-related injuries associated with the handling and movement of patients while preserving patient recovery. It is imperative, however, that more work on the most effective and efficient ways to use SPHM technologies in rehabilitation practice is completed. Closer evaluation of the effects of specific SPHM devices on activity performance also is needed. National Center for Biotechnology Information , U. Am J Occup Ther.

Safe Patient Handling and Movement: A Practical Guide for Health Care Professionals

Method Research Design In this retrospective, cohort study, we investigated self-care outcomes before and after the implementation of an SPHM program on an inpatient rehabilitation unit in the northeast region of the United States. Participants We used deidentified data from the electronic medical records of 1, patients admitted to a large hospital system. Measures The primary outcome measure was self-care performance as measured by the self-care subscale of the FIM.

Open in a separate window. Data Analysis We computed descriptive statistics for all covariates. Results Twenty-three patients with a length of stay of less than 3 days were excluded. Discussion The purpose of this study was to evaluate the effect of the SPHM program on self-care outcomes in patients receiving rehabilitation services. Study Limitations and Recommendations for Future Research This study is the first to examine the effects of an SPHM on self-care outcomes in a large, diverse sample of patients receiving inpatient rehabilitation.

Implications for Occupational Therapy Practice Occupational therapists are the professionals tasked with facilitating the highest level of independence in self-care for clients in rehabilitation.


  • Revenge of the Mummies (Adventures series Book 9).
  • ?
  • Un manual de Chan: conferencias sobre meditación (Spanish Edition)!
  • Customers who viewed this item also viewed?

Our results have the following implications for occupational therapy practice: You will come away from reading this book with information that you can employ in a variety of work environments--hospitals, nursing homes, home care, and other health care organizations--whatever your practice setting may be. Nelson has assembled a very up-to-date collection of important and relevant information which can provide support and direction necessary to formulate solutions for the many current problems related to patient handling and movement. An excellent reference and guide for anyone who wants to learn more about and make improvements to safe patient handling and movement programs.

Nelson has assembled a very up to date collection of important and relevant information which can provide support and direction necessary to formulate solutions for the many current problems related to patient handling and movement. Audrey Nelson's book, 'Safe Patient Handling and Movement' is a wonderful addition to the lexicon of protecting healthcare workers from devastating injury.

Would you like to tell us about a lower price? If you are a seller for this product, would you like to suggest updates through seller support? Learn more about Amazon Prime. Caregiver safety approaches include: Evidence-based standards for safe patient movement and prevention of musculoskeletal injuries An overview of available equipment and technology Architectural designs for ergonomically safe patient care space Institutional policies, such as use of lift teams.

Read more Read less. Add both to Cart Add both to List. These items are shipped from and sold by different sellers. Buy the selected items together This item: Safe Patient Handling and Movement: Ships from and sold by Amazon. Customers who viewed this item also viewed. Page 1 of 1 Start over Page 1 of 1.

Springer Publishing Company; 1 edition December 2, Language: Related Video Shorts 0 Upload your video. Try the Kindle edition and experience these great reading features: Share your thoughts with other customers. Write a customer review. There was a problem filtering reviews right now. Please try again later. Great price and product in perfect condition.