**Unit Based Hazard Assessment Forms: Table of Contents**

[A -- 1: Unit Ergonomic Evaluation Data Collection Tool
3](#a-1-unit-ergonomic-evaluation-data-collection-tool)

[A-2a: Patient Care Ergonomic Evaluation Data Collection Tool
11](#a-2a-patient-care-ergonomic-evaluation-data-collection-tool)

[A-2b. PATIENT CARE ERGONOMIC EVALUATION DATA COLLECTION TOOL
13](#a-2b.-patient-care-ergonomic-evaluation-data-collection-tool)

[A-3a. Unit Ceiling Lift System Coverage Practice Worksheet
17](#a-3a.-unit-ceiling-lift-system-coverage-practice-worksheet)

[A-3b. Unit Ceiling Lift System Coverage Practice
19](#a-3b.-unit-ceiling-lift-system-coverage-practice)

[A-4: UNIT INCIDENT/INJURY PROFILE 21](#a-4-unit-incidentinjury-profile)

[A-5: Tool for Prioritizing High-Risk Resident Handling Tasks
23](#a-5-tool-for-prioritizing-high-risk-resident-handling-tasks)

[A-6. SLING SELECTION CHART 25](#a-6.-sling-selection-chart)

[A-7. Patient Care Ergonomic Evaluation Report
30](#a-7.-patient-care-ergonomic-evaluation-report)

#   {#section .unnumbered}

# A -- 1: Unit Ergonomic Evaluation Data Collection Tool

***Type of Unit: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Facility:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_***

**Part I -- SPACE/MAINTENANCE/STORAGE**

a\. Describe Unit, including \# beds, room configurations (private,
semi-private, 4-bed, etc.), and bathrooms:

\# rooms w/ 2 beds:\_\_\_\_\_\_ w/ 3 beds:\_\_\_\_\_\_\_ w/ 4 beds:
\_\_\_\_\_\_\_\_\_ private:\_\_\_\_\_\_\_\_

Bathrooms: In room?\_\_\_ Community?\_\_\_ Use Tub?\_\_\_ Bathing Chair?
\_\_\_Other?\_\_\_

Draw/describe room configuration (on back, if needed).

b\. Describe current storage conditions and problems you have with
storage. If new equipment were purchased, where would it be stored?

c\. Identify anticipated changes in the physical layout of your unit,
such as planned unit renovations *in next 2 yrs*.

d\. Describe space constraints for patient care tasks & use of portable
equipment; focus on patient rooms, bathrooms, shower/bathing areas. *Are
typical room doorways narrow or wide?? Is the threshold uneven?*

e\. Describe any routine equipment maintenance program or process for
fixing broken equipment. What is the Reporting Mechanism/ procedure for
identifying, marking, and getting broken equipment to shop for repair?
*Is equipment on a PM schedule?*

f.  If potential for installation of overhead lifting equipment exists,
    describe any structural factors that may influence this
    installation, such as structural load limits, lighting fixtures, AC
    vents, presence of asbestos, etc.

**Part II - STAFFING**

a\. Peak Lift Load Times (Think about the time of day that's the
busiest. What is the \# of staff that would be lifting at same time):

b\. What are the typical patient care assignments?

Single Staff Member?\_\_\_\_\_ Team\_\_\_\_\_ Shower/Lifting/Tech?
\_\_\_\_\_

c\. Discuss projected plans or upcoming changes in staffing, patient
population, or bed closures in next two years.

**Part III - PATIENTS/RESIDENTS**

a\. Describe the patients/residents on your unit.

b\. Average Unit population characteristics (# hospice beds, Alzheimer
beds, TBI beds,

etc.) and variability in this.

c\. Discuss proposed changes in the average daily census over the next
two years.

d\. Identify typical distribution of patients by physical dependency
level according to the definitions below. ***(Base on PHYSICAL
LIMITATIONS not on clinical acuity)***

Note: This is not the same as patient acuity. The total for the 5
categories should equal your average daily census.

**\_\_\_\_ Total Dependence --** Cannot help at all with transfers, full
staff assistance for activity during entire seven-day period. Requires
total transfer at all times.

**\_\_\_\_ Extensive Assistance --** Can perform part of activity,
usually can follow simple directions, may require tactile cueing, can
bear some weight, sit up with assistance, has some upper body strength,
or may be able to pivot transfer. Over the last seven-day period, help
provided three or more times for weight-bearing transfers or may have
required a total transfer.

**\_\_\_\_ Limited Assistance --** Highly involved in activity, able to
pivot transfer and has considerable upper body strength and bears some
weight on legs. Can sit up well, but may need some assistance. Guided
maneuvering of limbs or other non-weight bearing assistance three or
more times, or help provided one or two times during the last seven
days.

**\_\_\_\_ Supervision** -- Oversight, encouragement, or cueing provided
three or more times during the last seven days or physical assistance
provided only one or two times during the last seven days.

**\_\_\_\_ Independent** -- Can ambulate normally without assistance in
unusual situations may need some limited assistance. Help or oversight
may have been provided only one or two times in the last seven days.

**e. Have ALL staff complete & collate by UNIT & SHIFT: *Tool for
Prioritizing High-Risk Patient Handling Tasks***

**Part IV - PATIENT HANDLING INJURIES**

Please have each UNIT **Complete: *Patient Care Incident/Injury
Profile***

**Part V - EQUIPMENT**

a\. Provide inventory of all patient care equipment; describe working
condition and how frequently equipment is used. **Complete: *Unit
Patient Handling Equipment Inventory***

b\. What percent of high-risk tasks are completed using proper
equipment? Why?

c\. Perception of Problem Areas -- what do you think are your problem
areas?

d\. What equipment do you think you need?

Person Completing
Report:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Date: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Title: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Contact #:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Tool for Prioritizing High-Risk Patient Handling Tasks

**Directions:** Assign a rank (from 1 to 10) to the tasks you consider
to be the highest risk tasks contributing to musculoskeletal injuries
for persons providing direct patient care. A "10" should represent the
highest risk, "9" for the second highest, etc. For each task, consider
the frequency of the task (high, moderate, low) and musculoskeletal
stress (high, moderate, low) of each task when assigning a rank. Delete
tasks not typically performed on your unit. You can have each nursing
staff member complete the form and summarize the data, or you can have
staff work together by shift to develop the rank by consensus.

+------------+------------+-----------+-------------------------------+
| #########  | ########   | #         | ######### [Patien             |
|  [Task Fre | # [Stress  | ########  | t Handling Tasks]{.smallcaps} |
| quency]{.s | of]{.small | [Rank]{.s |                               |
| mallcaps}  | caps} Task | mallcaps} |                               |
|            |            |           |                               |
| **H=       | **H=       | **10=     |                               |
| high**     | high**     | hi        |                               |
|            |            | gh-risk** |                               |
| **M=       | **M=       |           |                               |
| moderate** | moderate** | **1= low  |                               |
|            |            | risk**    |                               |
| **L= low** | **L= low** |           |                               |
+============+============+===========+===============================+
|            |            |           | Transferring patient from     |
|            |            |           | bathtub to chair              |
+------------+------------+-----------+-------------------------------+
|            |            |           | Transferring patient from     |
|            |            |           | wheelchair or shower/commode  |
|            |            |           | chair to bed                  |
+------------+------------+-----------+-------------------------------+
|            |            |           | Transferring patient from     |
|            |            |           | wheelchair to toilet          |
+------------+------------+-----------+-------------------------------+
|            |            |           | Transferring a patient from   |
|            |            |           | bed to stretcher              |
+------------+------------+-----------+-------------------------------+
|            |            |           | Lifting a patient up from the |
|            |            |           | floor                         |
+------------+------------+-----------+-------------------------------+
|            |            |           | Weighing a patient            |
+------------+------------+-----------+-------------------------------+
|            |            |           | Bathing a patient in bed      |
+------------+------------+-----------+-------------------------------+
|            |            |           | Bathing a patient in a shower |
|            |            |           | chair                         |
+------------+------------+-----------+-------------------------------+
|            |            |           | Bathing a patient on a shower |
|            |            |           | trolley or stretcher          |
+------------+------------+-----------+-------------------------------+
|            |            |           | Undressing/dressing a patient |
+------------+------------+-----------+-------------------------------+
|            |            |           | Applying antiembolism         |
|            |            |           | stockings                     |
+------------+------------+-----------+-------------------------------+
|            |            |           | Lifting patient to the head   |
|            |            |           | of the bed                    |
+------------+------------+-----------+-------------------------------+
|            |            |           | Repositioning patient in bed  |
|            |            |           | from side to side             |
+------------+------------+-----------+-------------------------------+
|            |            |           | Repositioning patient in      |
|            |            |           | geriatric chair or wheelchair |
+------------+------------+-----------+-------------------------------+
|            |            |           | Making an occupied bed        |
+------------+------------+-----------+-------------------------------+
|            |            |           | Feeding bed-ridden patient    |
+------------+------------+-----------+-------------------------------+
|            |            |           | Changing absorbent pad        |
+------------+------------+-----------+-------------------------------+
|            |            |           | Transporting patient off unit |
+------------+------------+-----------+-------------------------------+
|            |            |           | Other Task:                   |
+------------+------------+-----------+-------------------------------+

Adapted from Owen, B.D. & Garg, A. (1991). *AAOHN Journal*, *39*, (1).

**PATIENT CARE INCIDENT/INJURY PROFILE**

## FACILITY: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ UNIT: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 

## DATES INCLUDED: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ DATE COMPLETED: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

+---------+-------------+-------+---------+-------+-------+---------+
| **      | **Cause of  | *     | **Body  | **    | *     | **M     |
| Patient | Injury**    | *Type | P       | Locat | *Lost | odified |
| Care    |             | of    | art/s** | ion** | T     | Duty**  |
| Act     | (pull,      | Inj   |         |       | ime** |         |
| ivity** | push,reach, | ury** | **(**u  | (pt.  |       | **(#    |
|         | struck,     |       | pper/mi | room, | **(#  | days)** |
| (repo   | etc.)       | (stra | d/lower | hall, | da    |         |
| sition, |             | in/sp | back,   | sun-  | ys)** |         |
| bathe,  |             | rain, | legs,   | room, |       |         |
| tr      |             | contu | neck,   | etc.) |       |         |
| ansfer, |             | sion, | etc.)   |       |       |         |
| etc.)   |             | st    |         |       |       |         |
|         |             | ruck, |         |       |       |         |
|         |             | etc.) |         |       |       |         |
+---------+-------------+-------+---------+-------+-------+---------+
| Ex:     | Reaching,   | S/S   | S       | #     | No    | 4 days  |
| Reposi  | pulling     |       | houlder | ## Pt |       |         |
| tioning | residents   |       |         |  Room |       |         |
| (side   | all night   |       |         |       |       |         |
| to      | -- shoulder |       |         |       |       |         |
| side)   | hurting     |       |         |       |       |         |
+---------+-------------+-------+---------+-------+-------+---------+
|         |             |       |         |       |       |         |
+---------+-------------+-------+---------+-------+-------+---------+
|         |             |       |         |       |       |         |
+---------+-------------+-------+---------+-------+-------+---------+
|         |             |       |         |       |       |         |
+---------+-------------+-------+---------+-------+-------+---------+
|         |             |       |         |       |       |         |
+---------+-------------+-------+---------+-------+-------+---------+
|         |             |       |         |       |       |         |
+---------+-------------+-------+---------+-------+-------+---------+

**#1 Activity: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ #1 Cause:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Modified Duty Trend?
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**#2 Activity \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ #2 Cause:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Lost Time Trend?
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

## UNIT PATIENT CARE EQUIPMENT INVENTORY 

Unit:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Facility:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Date Completed:\_\_\_\_\_\_\_\_\_\_\_

+-------------------+------------+------+-----+--------------+------+
| **PATIENT CARE**  | **Manuf    | **I  | *   | **Use (%     | *    |
| **EQUIPMENT**     | acturer/St | nven | *In | being used   | *[\# |
|                   | yle/Name** | tory | w   | now)         | Requ |
|                   |            | (T   | ork | Comment:**   | este |
|                   | **(Ex:     | otal | ing |              | d]{. |
|                   | Arjo Maxi  | \#   | or  |              | unde |
|                   | Move)**    | you  | der |              | rlin |
|                   |            | have | ?** |              | e}** |
|                   |            | no   |     |              |      |
|                   |            | w)** |     |              |      |
+-------------------+------------+------+-----+--------------+------+
| ## [              |            |      |     |              |      |
| FULL BODY SLING L |            |      |     |              |      |
| IFTS]{.underline} |            |      |     |              |      |
|                   |            |      |     |              |      |
| ## Floor-bas      |            |      |     |              |      |
| ed, Powered Lifts |            |      |     |              |      |
|                   |            |      |     |              |      |
| ##  **Ex:         |            |      |     |              |      |
|  Arjo Maxi Move** |            |      |     |              |      |
+-------------------+------------+------+-----+--------------+------+
| ## Floor-based, N |            |      |     |              |      |
| on-Powered Lifts  |            |      |     |              |      |
|                   |            |      |     |              |      |
| ## **Ex: Hoyer**  |            |      |     |              |      |
+-------------------+------------+------+-----+--------------+------+
| ### *Ceili        |            |      |     |              |      |
| ng Mounted* Lifts |            |      |     |              |      |
|                   |            |      |     |              |      |
| Ex: BHM Voyager   |            |      |     |              |      |
+-------------------+------------+------+-----+--------------+------+
| ##                |            |      |     |              |      |
| # *Bathing Lifts* |            |      |     |              |      |
+-------------------+------------+------+-----+--------------+------+
| [LATERAL TRANSFER |            |      |     |              |      |
| AIDS]{.underline} |            |      |     |              |      |
|                   |            |      |     |              |      |
| *Mechanical*      |            |      |     |              |      |
| Lateral Transfer  |            |      |     |              |      |
| Aids              |            |      |     |              |      |
|                   |            |      |     |              |      |
| Ex: Mobilizer,    |            |      |     |              |      |
| TotaLift II, On-3 |            |      |     |              |      |
+-------------------+------------+------+-----+--------------+------+
| ##  Fric          |            |      |     |              |      |
| tion Reducing Lat |            |      |     |              |      |
| eral Sliding Aids |            |      |     |              |      |
|                   |            |      |     |              |      |
| Ex: Sliding/Surf  |            |      |     |              |      |
| Boards, RTA,      |            |      |     |              |      |
| Phili slide       |            |      |     |              |      |
+-------------------+------------+------+-----+--------------+------+
| ##                |            |      |     |              |      |
| Air Assisted Late |            |      |     |              |      |
| ral Transfer Aids |            |      |     |              |      |
|                   |            |      |     |              |      |
| ##  **Ex: A       |            |      |     |              |      |
| irPal; Hovermat** |            |      |     |              |      |
+-------------------+------------+------+-----+--------------+------+

UNIT PATIENT CARE EQUIPMENT INVENTORY Unit:\_\_\_\_\_\_\_\_\_\_

+-------------------+--------------+-----+-----+--------------+------+
| **PATIENT CARE**  | **M          | *   | *   | ##### Use    | *    |
| **EQUIPMENT**     | anufacturer/ | *In | *In |              | *[\# |
|                   | Style/Name** | ven | w   | **(% being   | Requ |
|                   |              | tor | ork | used now)    | este |
|                   | **(Ex: Arjo  | y** | ing | Comment:**   | d]{. |
|                   | Maxi Move)** |     | or  |              | unde |
|                   |              | **  | der |              | rlin |
|                   |              | (To | ?** |              | e}** |
|                   |              | tal |     |              |      |
|                   |              | \#  |     |              |      |
|                   |              | you |     |              |      |
|                   |              | h   |     |              |      |
|                   |              | ave |     |              |      |
|                   |              | now |     |              |      |
|                   |              | )** |     |              |      |
+-------------------+--------------+-----+-----+--------------+------+
| ## [TRANSFER CH   |              |     |     |              |      |
| AIRS]{.underline} |              |     |     |              |      |
|                   |              |     |     |              |      |
| Ex: Transitchair  |              |     |     |              |      |
+-------------------+--------------+-----+-----+--------------+------+
| ####              |              |     |     |              |      |
| DEPENDENCY CHAIRS |              |     |     |              |      |
|                   |              |     |     |              |      |
| Ex: Broad,        |              |     |     |              |      |
| Geri-chair        |              |     |     |              |      |
+-------------------+--------------+-----+-----+--------------+------+
| ## [POWERED       |              |     |     |              |      |
|  STANDING ASSIST  |              |     |     |              |      |
| & REPOSITIONING L |              |     |     |              |      |
| IFTS]{.underline} |              |     |     |              |      |
|                   |              |     |     |              |      |
| ## Ex: Tran       |              |     |     |              |      |
| slift, Raisa Lift |              |     |     |              |      |
+-------------------+--------------+-----+-----+--------------+------+
| ## [STANDING ASS  |              |     |     |              |      |
| IST & REPOSITIONI |              |     |     |              |      |
| NG AIDS (Non-Powe |              |     |     |              |      |
| red)]{.underline} |              |     |     |              |      |
|                   |              |     |     |              |      |
| [Ex: Super/Pivot  |              |     |     |              |      |
| Pole,             |              |     |     |              |      |
| Bed               |              |     |     |              |      |
| -Bar]{.underline} |              |     |     |              |      |
+-------------------+--------------+-----+-----+--------------+------+
| ### [GAIT BE      |              |     |     |              |      |
| LTS]{.underline}  |              |     |     |              |      |
|                   |              |     |     |              |      |
| ###               |              |     |     |              |      |
|  **With Handles** |              |     |     |              |      |
+-------------------+--------------+-----+-----+--------------+------+
| #### OTHER        |              |     |     |              |      |
+-------------------+--------------+-----+-----+--------------+------+

# A-2a: Patient Care Ergonomic Evaluation Data Collection Tool

+-------------------------------+--------+----------------+----------+
| **Unit/Description:**         |        | **Facility:**  | *        |
|                               |        |                | *Date:** |
+-------------------------------+--------+----------------+----------+
| **Patient Care Ergonomic      | **P    |                |          |
| Issues**                      | atient |                |          |
|                               | Ha     |                |          |
| **Existing/Ordered Unit       | ndling |                |          |
| Equipment**                   | Equ    |                |          |
|                               | ipment |                |          |
|                               | /Sling |                |          |
|                               | Recom  |                |          |
|                               | mendat |                |          |
|                               | ions** |                |          |
+-------------------------------+--------+----------------+----------+
| Vertical Transfers/Lifts      | -      |                |          |
| (dependent/extensive          |        |                |          |
| assistance pts)               |        |                |          |
+-------------------------------+--------+----------------+----------+
| Vertical Transfers/Lifts      | -      |                |          |
| (partial assistance pts)      |        |                |          |
+-------------------------------+--------+----------------+----------+
| Ambulation Training           | -      |                |          |
+-------------------------------+--------+----------------+----------+
| Transportation                | -      |                |          |
+-------------------------------+--------+----------------+----------+
| Lateral transfers             | -      |                |          |
+-------------------------------+--------+----------------+----------+
| Repositioning Side to Side    | -      |                |          |
+-------------------------------+--------+----------------+----------+
| Pulling up to head of bed     | -      |                |          |
+-------------------------------+--------+----------------+----------+
| Repositioning in Chair        | -      |                |          |
+-------------------------------+--------+----------------+----------+
| Wound care                    | -      |                |          |
+-------------------------------+--------+----------------+----------+
| TED Hose Application          | -      |                |          |
+-------------------------------+--------+----------------+----------+
| Toileting                     | -      |                |          |
+-------------------------------+--------+----------------+----------+
| Showering/Bathing             | -      |                |          |
+-------------------------------+--------+----------------+----------+
| \# beds: \_\_\_\_ Average     |        |                |          |
| Census:\_\_\_\_\_ %           |        |                |          |
| bariatric:\_\_\_\_\_ % total  |        |                |          |
| dependent/extensive           |        |                |          |
| assistance:\_\_\_\_\_\_\_ %   |        |                |          |
| total partial                 |        |                |          |
| assistance:\_\_\_\_\_\_       |        |                |          |
|                               |        |                |          |
| Room configurations:          |        |                |          |
|                               |        |                |          |
| Storage:                      |        |                |          |
|                               |        |                |          |
| Notes:                        |        |                |          |
+-------------------------------+--------+----------------+----------+

# A-2b. PATIENT CARE ERGONOMIC EVALUATION DATA COLLECTION TOOL

Unit: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Facility:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Date:
\_\_\_\_\_\_\_\_\_\_\_\_

Unit
Description:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\# Beds/Average Daily Census: \_\_\_\_\_\_\_\_\_\_Bariatric population:
\_\_\_\_\_\_\_\_\_\_\_\_ Storage:\_\_\_\_\_\_\_\_\_\_\_\_

\% Total Dependent/Extensive Assistance Pts: \_\_\_\_\_\_\_\_\_\_\_ %
Partial Assistance Pts:\_\_\_\_\_\_\_\_\_\_

Room Configurations (# private
etc.):\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

+-------------+--------------------+----------------------------------+
| **High Risk | **                 | **Patient Handling               |
| Patient     | Existing/Ordered** | Equipment/Sling                  |
| Handling    |                    | Recommendations**                |
| Tasks**     | **Unit Equipment** |                                  |
+-------------+--------------------+----------------------------------+
| Vertical    | FBL                | FBL                              |
| Transfers   |                    |                                  |
| (dependen   |                    |                                  |
| t/extensive |                    |                                  |
| assistance  |                    |                                  |
| pts)        |                    |                                  |
+-------------+--------------------+----------------------------------+
|             | CL                 | CL                               |
+-------------+--------------------+----------------------------------+
|             | Other              |                                  |
+-------------+--------------------+----------------------------------+
| Vertical    | SS                 | SS                               |
| Transfers   |                    |                                  |
| (partial    |                    |                                  |
| assistance  |                    |                                  |
| pts)        |                    |                                  |
+-------------+--------------------+----------------------------------+
|             | TA                 | TA                               |
+-------------+--------------------+----------------------------------+
|             | Other              |                                  |
+-------------+--------------------+----------------------------------+
| Ambulation  | SS                 | SS                               |
| Training    |                    |                                  |
+-------------+--------------------+----------------------------------+
|             | CL,                | CL,                              |
+-------------+--------------------+----------------------------------+
|             | FBL                | FBL                              |
+-------------+--------------------+----------------------------------+
| Lateral     | FRD                | FRD                              |
| Transfers   |                    |                                  |
+-------------+--------------------+----------------------------------+
|             | AA                 | AA                               |
+-------------+--------------------+----------------------------------+
|             | MLD                | MLD                              |
+-------------+--------------------+----------------------------------+
|             | Other              |                                  |
+-------------+--------------------+----------------------------------+
| Re          | FRD                | FRD                              |
| positioning |                    |                                  |
| Up in Bed   |                    |                                  |
+-------------+--------------------+----------------------------------+
|             | RA                 | RA                               |
+-------------+--------------------+----------------------------------+
|             | CL                 | CL                               |
+-------------+--------------------+----------------------------------+
|             | FBL                | FBL                              |
+-------------+--------------------+----------------------------------+
|             | Other              |                                  |
+-------------+--------------------+----------------------------------+
| Re          | CL                 | CL                               |
| positioning |                    |                                  |
| Side to     |                    |                                  |
| Side        |                    |                                  |
+-------------+--------------------+----------------------------------+
|             | FBL                | FBL                              |
+-------------+--------------------+----------------------------------+
|             | RA                 | RA                               |
+-------------+--------------------+----------------------------------+
|             | Other              |                                  |
+-------------+--------------------+----------------------------------+
| Re          | FRD                | FRD                              |
| positioning |                    |                                  |
| in Chair    |                    |                                  |
+-------------+--------------------+----------------------------------+
|             | FBL                | FBL                              |
+-------------+--------------------+----------------------------------+
|             | CL                 | CL                               |
+-------------+--------------------+----------------------------------+
|             | Other              |                                  |
+-------------+--------------------+----------------------------------+
| Wound care  | CL                 | CL                               |
+-------------+--------------------+----------------------------------+
|             | FBL                | FBL                              |
+-------------+--------------------+----------------------------------+
|             | Other              |                                  |
+-------------+--------------------+----------------------------------+
| Tra         | Motorized Bed      | Motorized Bed                    |
| nsportation |                    |                                  |
| in          |                    |                                  |
| Be          |                    |                                  |
| d/Stretcher |                    |                                  |
+-------------+--------------------+----------------------------------+
|             | Bed Mover          | Bed Mover                        |
+-------------+--------------------+----------------------------------+
|             | Other              |                                  |
+-------------+--------------------+----------------------------------+
| Tra         | Motorized W/C      | Motorized W/C                    |
| nsportation |                    |                                  |
| in W/C      |                    |                                  |
+-------------+--------------------+----------------------------------+
|             | W/C Mover          | W/C Mover                        |
+-------------+--------------------+----------------------------------+
|             | Other              |                                  |
+-------------+--------------------+----------------------------------+
| Bathin      | Shower Chair       | Ergonomic Shower Chair           |
| g/Showering |                    |                                  |
+-------------+--------------------+----------------------------------+
|             | Shower Trolley     | Shower Trolley                   |
+-------------+--------------------+----------------------------------+

Notes:

Key:

AA-Air Assisted Lateral Transfer Device CL-Ceiling Lift FBL-Full Body
Sling Lift

FRD-Friction Reducing Device SS-Sit to Stand Lift TA-Transfer Aid

MLD-Mechanical Lateral Transfer Device RA-Repositioning Aid

# A-3a. Unit Ceiling Lift System Coverage Practice Worksheet

(Assume structural status allows for CL installation)

**A. [NHCU Unit ]{.underline}**

-   85% dependent and extensive assistance patients

-   30 bed ward w/ 12 semi-private rooms & 6 private rooms

1.  **How many (#) patients/beds should be covered?**

2.  **In what rooms would you place ceiling lifts on this unit?**

3.  **How many ceiling lifts would you purchase/install for this unit?**

**B. [Med/Surg (Tele) Unit ]{.underline}**

-   50% dependent and extensive assistance patients

-   24 bed ward w/ 3 -- 3 bed rooms, 5 semi-private rooms, and 5 private
    rooms

1.  **How many (#) patients/beds should be covered?**

2.  **In what rooms would you place ceiling lifts on this unit?**

3.  **How many ceiling lifts would you purchase/install for this unit?**

**C.** **[Med/Surg (Rehab) Unit]{.underline}**

-   40% dependent and extensive assistance patients

-   50% partial assistance (requiring ambulation training)

-   10% independent

-   20 bed ward w/ 5 semi-private rooms and 10 private rooms (rehab
    patients)

1.  **How many (#) patients/beds should be covered?**

2.  **In what rooms would you place ceiling lifts on this unit?**

3.  **How many ceiling lifts would you purchase/install for this unit?**

# A-3b. Unit Ceiling Lift System Coverage Practice

(Assume structural status allows for CL installation)

**A. [NHCU Unit ]{.underline}**

-   85% dependent and extensive assistance patients

-   30 bed ward w/ 12 semi-private rooms & 6 private rooms

4.  **How many (#) patients should be covered? [#=30 (100%)]{.mark}**

5.  **In what rooms would you place ceiling lifts on this unit?
    [All]{.mark}**

6.  **How many ceiling lifts would you purchase/install for this unit?
    [18 CL]{.mark}**

> []{.mark}

**B. [Med/Surg (Tele) Unit ]{.underline}**

-   50% dependent and extensive assistance patients

-   24 bed ward w/ 3 -- 3 bed rooms, 5 semi-private rooms, and 5 private
    rooms

4.  **How many (#) patients should be covered? [12 (50% x 24)]{.mark}**

> []{.mark}

5.  **In what rooms would you place ceiling lifts on this unit?**

> **[Many options]{.mark}**
>
> **[2 -- 3 bed room = 6 patients/beds]{.mark}**
>
> **[2 semi-private rooms = 4 patients/beds]{.mark}**
>
> **[2 private = 2 patients/beds]{.mark}**

6.  **How many lifts would you purchase/install for this unit?**

> **[If use horseshoe configuration in 3 bed rooms = 6 CLs]{.mark}**
>
> **[If use two straight track units (TV/light issues) = 8 CLs]{.mark}**

**C.** **[Med/Surg (Rehab) Unit]{.underline}**

-   40% dependent and extensive assistance patients

-   50% partial assistance (requiring ambulation training)

-   10% independent

-   20 bed ward w/ 5 semi-private rooms and 10 private rooms (rehab
    patients)

4.  **How many (#) patients should be covered? [20 (100%)]{.mark}**

5.  **In what rooms would you place ceiling lifts on this unit?
    [All]{.mark}**

6.  **How many lifts would you purchase/install for this unit? [15
    CLs]{.mark}**

# ![](media/image1.png){width="1.5in" height="1.25in"}A-4: UNIT INCIDENT/INJURY PROFILE

## UNIT:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ FACILITY: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

+---------+-------------+-------+---------+-------+-------+---------+
| R       | **Cause of  | *     | **Body  | **    | *     | **Mod   |
| esident | Injury**    | *Type | P       | Locat | *Lost | ified** |
| Care    |             | of    | art/s** | ion** | T     |         |
| A       | (pull,      | Inj   |         |       | ime** | *       |
| ctivity | push,       | ury** | (upp    | (res  |       | *Duty** |
|         |             |       | er/mid/ | ident | (#    |         |
| (repo   | reach,      | (stra |         | room, | days) | (#      |
| sition, | struck,     | in/sp | lower   |       |       | days)   |
|         | etc.)       | rain, | back,   | hall, |       |         |
| bathe,  |             |       | legs,   | sun-  |       |         |
| transfe |             | contu | neck,   |       |       |         |
| r,etc.) |             | sion, | etc.)   | room, |       |         |
|         |             |       |         | etc.) |       |         |
|         |             | st    |         |       |       |         |
|         |             | ruck, |         |       |       |         |
|         |             | etc.) |         |       |       |         |
+---------+-------------+-------+---------+-------+-------+---------+
| Reposi  | Reaching,   | S/S   | S       | #     | No    | 4 days  |
| tioning | pulling     |       | houlder | ## Pt |       |         |
|         | residents   |       |         |  Room |       |         |
| (side   | all night   |       |         |       |       |         |
| to      | -- shoulder |       |         |       |       |         |
| side)   | started     |       |         |       |       |         |
|         | hurting     |       |         |       |       |         |
+---------+-------------+-------+---------+-------+-------+---------+
| Trans   | Twisted     | S/S   | Mid     | Bath  | 2     | 10 days |
| ferring | while       |       | Back    | Room  | days  |         |
| from    | lifting     |       |         |       |       |         |
| W/C to  | resident    |       | lumbar  |       |       |         |
| Toilet  | onto toilet |       |         |       |       |         |
+---------+-------------+-------+---------+-------+-------+---------+
| Trans   | Resident    | S/S   | Lower   | Hall  | No    | No      |
| ferring | made sudden |       |         |       |       |         |
| from    | movement    |       | back    |       |       |         |
| Bed to  |             |       |         |       |       |         |
| Chair   |             |       |         |       |       |         |
+---------+-------------+-------+---------+-------+-------+---------+
| Reposi  | Pulling     | S/S   | Lower   | Pt    | No    | No      |
| tioning | over large  |       |         | Room  |       |         |
|         | dependent   |       | back    |       |       |         |
| (side   | resident    |       |         |       |       |         |
| to      |             |       |         |       |       |         |
| side)   |             |       |         |       |       |         |
+---------+-------------+-------+---------+-------+-------+---------+
| Pulling | Pulling up  | S/S   | Upper   | Pt    | No    | No      |
| up in   | large       |       | back,   | Room  |       |         |
| Bed     | dependent   |       | neck    |       |       |         |
|         | resident    |       |         |       |       |         |
+---------+-------------+-------+---------+-------+-------+---------+
| Trans   | Resident    | S/S   | Lower   | Pt    | 5     | 34 days |
| ferring | collapsed   |       |         | Room  | days  |         |
| from    | as          |       | back    |       |       |         |
| Bed to  | t           |       |         |       |       |         |
| Chair   | ransferring |       |         |       |       |         |
|         | to chair    |       |         |       |       |         |
+---------+-------------+-------+---------+-------+-------+---------+
| Trans   | Leaning     | S/S   | Lower   | Pt    | 1 day | 7 days  |
| ferring | down to     |       |         | Room  |       |         |
| from    | pick up     |       | back    |       |       |         |
| Whe     | resident,   |       |         |       |       |         |
| elchair | hurt back   |       |         |       |       |         |
| to Bed  |             |       |         |       |       |         |
+---------+-------------+-------+---------+-------+-------+---------+

**#1 Activity: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ #1 Cause:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Lost Time Trend?
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**#2 Activity \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ #2 Cause:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Modified Duty Trend?
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**Intervention Prioritization:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

# A-5: Tool for Prioritizing High-Risk Resident Handling Tasks

**Directions:** Assign a rating (from 1 to 10) to the tasks that you
consider to be high risk for contributing to musculoskeletal injuries. A
"10" should represent highest risk and "1" for lowest risk. For each
task, consider the frequency and duration of the task (high, moderate,
low), and musculoskeletal stress (high, moderate, low). Delete tasks not
typically performed on your unit. Add tasks you perceive as high risk
but not included.

Have each nursing staff member on a unit complete the form. Summarize
the data by unit and shift. An alternative is to have staff work
together by shift to develop the ratings by consensus.

+----------+---------+--------+---------------------------------------+
| #######  | #####   | ####   | #########                             |
| ## [Task | #### [S | #####  | [Resident Handling Tasks]{.smallcaps} |
|  Frequen | tress o | [Rank] |                                       |
| cy/]{.sm | f]{.sma | {.smal |                                       |
| allcaps} | llcaps} | lcaps} |                                       |
|          |         |        |                                       |
| ######## | ####### | **10=  |                                       |
| # [Durat | ## [Tas | high-  |                                       |
| ion]{.sm | k]{.sma | risk** |                                       |
| allcaps} | llcaps} |        |                                       |
|          |         | **1=   |                                       |
| **H=     | **H=    | low    |                                       |
| high**   | high**  | risk** |                                       |
|          |         |        |                                       |
| **M=     | **M=    |        |                                       |
| mo       | mod     |        |                                       |
| derate** | erate** |        |                                       |
|          |         |        |                                       |
| **L=     | **L=    |        |                                       |
| low**    | low**   |        |                                       |
+==========+=========+========+=======================================+
|          |         |        | Transferring patient from bathtub to  |
|          |         |        | chair                                 |
+----------+---------+--------+---------------------------------------+
|          |         |        | Transferring patient from wheelchair  |
|          |         |        | or shower/ commode chair to bed       |
+----------+---------+--------+---------------------------------------+
|          |         |        | Transferring patient from wheelchair  |
|          |         |        | to toilet                             |
+----------+---------+--------+---------------------------------------+
|          |         |        | Transferring a patient from bed to    |
|          |         |        | stretcher                             |
+----------+---------+--------+---------------------------------------+
|          |         |        | Lifting a patient up from the floor   |
+----------+---------+--------+---------------------------------------+
|          |         |        | Weighing a patient                    |
+----------+---------+--------+---------------------------------------+
|          |         |        | Bathing a patient in bed              |
+----------+---------+--------+---------------------------------------+
|          |         |        | Bathing a patient in a shower chair   |
+----------+---------+--------+---------------------------------------+
|          |         |        | Bathing a patient on a shower trolley |
|          |         |        | or stretcher                          |
+----------+---------+--------+---------------------------------------+
|          |         |        | Undressing/dressing a patient         |
+----------+---------+--------+---------------------------------------+
|          |         |        | Applying antiembolism stockings       |
+----------+---------+--------+---------------------------------------+
|          |         |        | Lifting patient to the head of the    |
|          |         |        | bed                                   |
+----------+---------+--------+---------------------------------------+
|          |         |        | Repositioning patient in bed from     |
|          |         |        | side to side                          |
+----------+---------+--------+---------------------------------------+
|          |         |        | Repositioning patient in geriatric    |
|          |         |        | chair or wheelchair                   |
+----------+---------+--------+---------------------------------------+
|          |         |        | Making an occupied bed                |
+----------+---------+--------+---------------------------------------+
|          |         |        | Feeding bed-ridden patient            |
+----------+---------+--------+---------------------------------------+
|          |         |        | Changing absorbent pad                |
+----------+---------+--------+---------------------------------------+
|          |         |        | Transporting patient off unit         |
+----------+---------+--------+---------------------------------------+
|          |         |        | Other Task:                           |
+----------+---------+--------+---------------------------------------+
|          |         |        | Other Task:                           |
+----------+---------+--------+---------------------------------------+
|          |         |        | Other Task:                           |
+----------+---------+--------+---------------------------------------+

Adapted from Owen, B.D. & Garg, A. (1991). *AAOHN Journal*, *39*, (1).

# A-6. SLING SELECTION CHART

+-------------+----------+------------------+-------------------------+
| *           | **Sling  | **Criteria**     | **Special               |
| *Activity** | C        |                  | Considerations**        |
|             | hoices** |                  |                         |
+-------------+----------+------------------+-------------------------+
| Vertical    | SEATED   | Patient can      | Consider presence of    |
| Transfers   |          | tolerate sitting | wounds for sling        |
|             |          | position and has | application and patient |
| (to/from    |          | adequate hip &   | positioning.            |
| bed/        |          | knee flexion     |                         |
| wheelchair/ |          |                  | Consider precautions of |
|             |          |                  | total hip replacement   |
| commode/    |          |                  | patients.               |
| dependency  |          |                  |                         |
| chair/etc.) |          |                  |                         |
+-------------+----------+------------------+-------------------------+
|             | STANDING | Patient can      | Consider presence of    |
|             |          | grasp & hold     | wounds for sling        |
|             |          | handle with at   | application and patient |
|             |          | least one hand,  | positioning.            |
|             |          | has at least     |                         |
|             |          | partial weight   |                         |
|             |          | bearing          |                         |
|             |          | capability, has  |                         |
|             |          | upper body       |                         |
|             |          | strength, and is |                         |
|             |          | cooperative &    |                         |
|             |          | can follow       |                         |
|             |          | simple commands  |                         |
+-------------+----------+------------------+-------------------------+
| Lateral     | SUPINE   | Patient cannot   | Do NOT use if patient   |
| Transfers   |          | tolerate sitting | has respiratory         |
|             |          | position and has | compromise or if wounds |
| (to/from    |          | restricted hip & | present may affect      |
| bed/        |          | knee flexion.    | transfers/positioning   |
| stretcher/  |          | Patient can      |                         |
|             |          | tolerate supine  |                         |
| Shower      |          | position.        |                         |
| trolley/    |          |                  |                         |
| gurney)     |          |                  |                         |
+-------------+----------+------------------+-------------------------+
| Bathing     | SUPINE   | Patient cannot   | Do NOT use if patient   |
|             |          | tolerate sitting | has respiratory         |
|             |          | position and has | compromise or if wounds |
|             |          | restricted hip & | present may affect      |
|             |          | knee flexion.    | transfers/positioning   |
|             |          | Patient can      |                         |
|             |          | tolerate supine  |                         |
|             |          | position.        |                         |
+-------------+----------+------------------+-------------------------+
|             | SEATED   | Patient can      | Consider presence of    |
|             |          | tolerate sitting | wounds for sling        |
|             |          | position and has | application and patient |
|             |          | adequate hip &   | positioning.            |
|             |          | knee flexion     |                         |
|             |          |                  | Consider precautions of |
|             |          |                  | total hip replacement   |
|             |          |                  | patients.               |
+-------------+----------+------------------+-------------------------+
|             | LIMB     | Sustained        | Consider wounds,        |
|             | SUPPORT  | holding of any   | comfort, circulation,   |
|             |          | extremity while  | neurovascular and joint |
|             |          | bathing in bed   | conditions, if task is  |
|             |          |                  | of long duration        |
+-------------+----------+------------------+-------------------------+
| Toileting   | SEATED   | Patient can      | Consider presence of    |
|             |          | tolerate sitting | wounds for sling        |
|             |          | position and has | application and patient |
|             |          | adequate hip &   | positioning.            |
|             |          | knee flexion     |                         |
|             |          |                  | Consider precautions of |
|             |          |                  | total hip replacement   |
|             |          |                  | patients.               |
+-------------+----------+------------------+-------------------------+
|             | STANDING | Patient can      | Consider presence of    |
|             |          | grasp & hold     | wounds for sling        |
|             |          | handle with at   | application and patient |
|             |          | least one hand,  | positioning.            |
|             |          | has at least     |                         |
|             |          | partial weight   |                         |
|             |          | bearing          |                         |
|             |          | capability, has  |                         |
|             |          | upper body       |                         |
|             |          | strength, and is |                         |
|             |          | cooperative &    |                         |
|             |          | can follow       |                         |
|             |          | simple commands  |                         |
+-------------+----------+------------------+-------------------------+
| *           | **Sling  | **Criteria**     | **Special               |
| *Activity** | C        |                  | Considerations**        |
|             | hoices** |                  |                         |
+-------------+----------+------------------+-------------------------+
| Re          | SEATED   | Patient can      | Consider presence of    |
| positioning |          | tolerate sitting | wounds for sling        |
| in Chair    |          | position and has | application and patient |
|             |          | adequate hip &   | positioning.            |
|             |          | knee flexion     |                         |
|             |          |                  | Consider precautions of |
|             |          |                  | total hip replacement   |
|             |          |                  | patients.               |
+-------------+----------+------------------+-------------------------+
| Re          | SUPINE   | Patient cannot   | Do NOT use if patient   |
| positioning |          | tolerate sitting | has respiratory         |
| UP in Bed   |          | position and has | compromise or if wounds |
|             |          | restricted hip & | present may affect      |
|             |          | knee flexion.    | transfers/positioning   |
|             |          | Patient can      |                         |
|             |          | tolerate supine  |                         |
|             |          | position.        |                         |
+-------------+----------+------------------+-------------------------+
|             | SEATED   | Patient can      | Consider presence of    |
|             |          | tolerate sitting | wounds for sling        |
|             |          | position and has | application and patient |
|             |          | adequate hip &   | positioning.            |
|             |          | knee flexion     |                         |
|             |          |                  | Consider precautions of |
|             |          |                  | total hip replacement   |
|             |          |                  | patients.               |
+-------------+----------+------------------+-------------------------+
|             | REPOS    | Patient can      | Do NOT use if patient   |
|             | ITIONING | tolerate supine  | has respiratory         |
|             |          | position.        | compromise or if wounds |
|             |          |                  | present may affect      |
|             |          |                  | transfers/positioning   |
+-------------+----------+------------------+-------------------------+
| Turning a   | SUPINE   | Patient cannot   | Do NOT use if patient   |
| patient in  |          | tolerate sitting | has respiratory         |
| bed         |          | position and has | compromise or if wounds |
|             |          | restricted hip & | present may affect      |
|             |          | knee flexion.    | transfers/positioning   |
|             |          | Patient can      |                         |
|             |          | tolerate supine  |                         |
|             |          | position.        |                         |
+-------------+----------+------------------+-------------------------+
|             | REPOS    | Patient can      | Do NOT use if patient   |
|             | ITIONING | tolerate supine  | has respiratory         |
|             |          | position.        | compromise or if wounds |
|             |          |                  | present may affect      |
|             |          |                  | transfers/positioning   |
+-------------+----------+------------------+-------------------------+
| Making an   | SUPINE   | Patient cannot   | Do NOT use if patient   |
| Occupied    |          | tolerate sitting | has respiratory         |
| Bed         |          | position and has | compromise or if wounds |
|             |          | restricted hip & | present may affect      |
|             |          | knee flexion.    | transfers/positioning   |
|             |          | Patient can      |                         |
|             |          | tolerate supine  |                         |
|             |          | position.        |                         |
+-------------+----------+------------------+-------------------------+
|             | SEATED   | Patient can      | Consider presence of    |
|             |          | tolerate sitting | wounds for sling        |
|             |          | position and has | application and patient |
|             |          | adequate hip &   | positioning.            |
|             |          | knee flexion     |                         |
|             |          |                  | Consider precautions of |
|             |          |                  | total hip replacement   |
|             |          |                  | patients.               |
+-------------+----------+------------------+-------------------------+
| Functional  | STANDING | Patient can      | Consider presence of    |
| Sit-Stand   |          | grasp & hold     | wounds for sling        |
| train       |          | handle with at   | application and patient |
| ing/support |          | least one hand,  | positioning.            |
|             |          | has at least     |                         |
|             |          | partial weight   |                         |
|             |          | bearing          |                         |
|             |          | capability, has  |                         |
|             |          | upper body       |                         |
|             |          | strength, and is |                         |
|             |          | cooperative &    |                         |
|             |          | can follow       |                         |
|             |          | simple commands  |                         |
+-------------+----------+------------------+-------------------------+
| *           | **Sling  | **Criteria**     | **Special               |
| *Activity** | C        |                  | Considerations**        |
|             | hoices** |                  |                         |
+-------------+----------+------------------+-------------------------+
| Dressing    | STANDING | Patient can      | Consider presence of    |
|             |          | grasp & hold     | wounds for sling        |
|             |          | handle with at   | application and patient |
|             |          | least one hand,  | positioning.            |
|             |          | has at least     |                         |
|             |          | partial weight   |                         |
|             |          | bearing          |                         |
|             |          | capability, has  |                         |
|             |          | upper body       |                         |
|             |          | strength, is     |                         |
|             |          | cooperative &    |                         |
|             |          | can follow       |                         |
|             |          | simple commands  |                         |
+-------------+----------+------------------+-------------------------+
|             | LIMB     | Sustained        | Consider wounds,        |
|             | SUPPORT  | holding of any   | comfort, circulation,   |
|             |          | extremity while  | neurovascular and       |
|             |          | dressing in bed  | joints, if task is of   |
|             |          |                  | long duration           |
+-------------+----------+------------------+-------------------------+
| Pericare    | STANDING | Patient can      | Consider presence of    |
|             |          | grasp & hold     | wounds for sling        |
|             |          | handle with at   | application and patient |
|             |          | least one hand,  | positioning.            |
|             |          | has at least     |                         |
|             |          | partial weight   |                         |
|             |          | bearing          |                         |
|             |          | capability, has  |                         |
|             |          | upper body       |                         |
|             |          | strength, and is |                         |
|             |          | cooperative &    |                         |
|             |          | can follow       |                         |
|             |          | simple commands  |                         |
+-------------+----------+------------------+-------------------------+
| Ambulation  | WALKING  | Partial weight   | Do NOT use if wounds    |
| training    |          | bearing, level   | present that affect     |
| and support |          | of cooperation,  | transfers and           |
|             |          | consult Dr. &    | positioning             |
|             |          | therapist for    |                         |
|             |          | readiness        |                         |
+-------------+----------+------------------+-------------------------+
|             | STANDING | Patient can      | Consider presence of    |
|             |          | grasp & hold     | wounds for sling        |
|             |          | handle with at   | application and patient |
|             |          | least one hand,  | positioning.            |
|             |          | has at least     |                         |
|             |          | partial weight   |                         |
|             |          | bearing          |                         |
|             |          | capability, has  |                         |
|             |          | upper body       |                         |
|             |          | strength, and is |                         |
|             |          | cooperative &    |                         |
|             |          | can follow       |                         |
|             |          | simple commands  |                         |
+-------------+----------+------------------+-------------------------+
| Wound       | LIMB     | Sustained        | Consider wounds,        |
| Ca          | SUPPORT  | holding of any   | comfort, circulation,   |
| re/Dressing |          | extremity while  | neurovascular and       |
|             |          | dressing/caring  | joints, if task is of   |
|             |          | for wounds while | long duration           |
|             |          | patient in bed   |                         |
+-------------+----------+------------------+-------------------------+
| Surgical    | LIMB     | Sustained        | Consider wounds,        |
| Procedures  | SUPPORT  | holding of any   | comfort, circulation,   |
|             |          | extremity while  | neurovascular and       |
|             |          | performing       | joints, if task is of   |
|             |          | surgical         | long duration           |
|             |          | procedure in bed |                         |
+-------------+----------+------------------+-------------------------+
| Fall Rescue | SUPINE   | Patient cannot   | Do NOT use if patient   |
|             |          | tolerate sitting | has respiratory         |
|             |          | position and has | compromise or if wounds |
|             |          | restricted hip & | present may affect      |
|             |          | knee flexion.    | transfers/positioning   |
|             |          | Need for patient |                         |
|             |          | to remain flat.  |                         |
|             |          | Patient can      |                         |
|             |          | tolerate supine  |                         |
|             |          | position.        |                         |
+-------------+----------+------------------+-------------------------+
|             | SEATED   | Patient can      | Consider presence of    |
|             |          | tolerate sitting | wounds for sling        |
|             |          | position and has | application and patient |
|             |          | adequate hip &   | positioning.            |
|             |          | knee flexion     |                         |
|             |          |                  | Consider precautions of |
|             |          |                  | total hip replacement   |
|             |          |                  | patients.               |
+-------------+----------+------------------+-------------------------+

# A-7. Patient Care Ergonomic Evaluation Report

The following relays recommendations for attainment of 'Minimal Patient
Lift' or 'Safe Patient Handling & Movement' environments for clinical
areas surveyed during a patient care ergonomic evaluation of your
facility. Attainment of a patient handling Minimal Lift environment
takes time and the efforts of many, but know that it can be
accomplished, and the benefits will be for patients as well as staff,
for when staff are working safely, patients are safer.

The key recommendation for attainment of Minimal Patient Lift status is
use of ceiling lifts throughout the facility. Research has found ceiling
lifts have biomechanical advantages over floor-based lifts. As well,
their accessibility facilitates staff compliance with use. New sling
designs are expanding the use of lifts, so lifts are not just for moving
patients from one sitting position to another. New sling designs are
taking the patient 'load' off of caregivers during very high risk
repositioning tasks as well as while bathing, toileting, lifting limbs,
and others. For these reasons, the ultimate patient care ergonomic goal
should be to provide ceiling lifts throughout all patient care and
procedure areas. Certainly, phase-in of ceiling lifts will take place
over time, but provision of as many lifts as possible, as soon as
possible, will only benefit your facility. When deciding on ceiling lift
track configuration, if possible, install traverse (H-track) systems
that cover entire patient/procedure rooms and also include a scale on
any lift purchased.

Support of patient care ergonomics is evident at the management as well
as the staff level as demonstrated by providing time and resources for a
significant number of staff to attend the Patient Care Ergonomics
training. Also, requesting patient care ergonomic evaluations, and
familiarity with patient care ergonomic concepts and technology
demonstrate a commitment to and support of safe patient handling. As
enhancements to the direction your facility is progressing in providing
safe patient handling environments, I recommend selection of a facility
champion and formation of a safe patient handling implementation team or
advisory group. As well, I strongly suggest institution of a patient
handling unit peer leader program with representatives from each
clinical area including therapy, nursing, and radiology, and,
appointment of a peer leader 'leader' has been found to facilitate
success. Nurse educators and therapy staff have been found to be
appropriate for this leadership role.

I have noted the following issues for consideration.

1)  As soon as possible, implement Unit Peer Leader Program to aid in
    implementation of safe patient handling program on clinical units.
    For most success, one peer leader per unit per shift is suggested.

2)  I suggest a phase-in of patient handling equipment over the next
    several months, beginning with sit to stand lifts and floor-based
    lifts, as the sit to stand lifts have already been introduced in
    many areas. Next, introduce air assisted lateral transfer devices,
    then when the time comes to occupy the new building, the ceiling
    lifts can be introduced to the staff.

3)  I suggest taking advantage of the 'momentum' from the recent patient
    handling training by providing Patient Care Ergonomics Awareness
    Training as soon as possible. Educate staff on the risks and
    interventions for these risks from patient handling activities. Also
    include unit information on existing equipment, perception of high
    risk tasks, and injury trends. Provide continual training to staff
    as implementation progresses to facilitate their understanding and
    acceptance.

4)  Whenever escort/transportation staff are involved in patient
    handling or patient movement, I have a concern that they may become
    the sacrificial lambs of patient movement. Escort/transportation
    staff must be provided the same protection from patient handling
    risk as any other staff member who handles patients. If their
    function is to only transport patients I suggest providing them with
    motorized stretchers and/or robotic bed or wheelchair movers. If
    they are also performing lateral transfers or vertical lifts, they
    must be provided with and adequately trained on use of the
    appropriate patient handling equipment.

5)  Although I did not visit the morgue, patient handling in this area
    can be quite strenuous, and there are good lifting and moving
    systems available to address unique morgue issues to decrease the
    risk of injury for those involved, or provision of a lift
    (preferably a ceiling lift system) with a supine sling can help.

6)  Although I did not visit the PT clinics, a general recommendation to
    reduce ergonomic stressors during ambulation training and patient
    lifting includes the installation of a ceiling lift traverse track
    system, with two lifts contained within the system. Each ceiling
    lift could be operated simultaneously, and one would function over
    the parallel bars and another over the treatment tables or wherever
    needed.

General and specific ergonomic recommendations are included below.

-   Use injury data, staff perceptions of high risk tasks, and
    information from ergonomic evaluations to determine high risk tasks
    on each unit. Use this to determine unit patient handling technology
    needs. Please let me know if you would like me to supply you tools
    to accomplish this.

-   Utilize equipment logs in order to have a facility-wide inventory of
    patient handling equipment. This will also provide a record of the
    location, working order, utilization, and reason for non-utilization
    if appropriate. Make this equipment information available to all
    units for easy reference if equipment is needed. There may be
    equipment available that may not be appropriate for it's current
    location and may be what is needed elsewhere. Please let me know if
    you would like me to supply you tools to accomplish this.

-   Although I foresee ceiling lifts as the answer to most patient
    handling tasks, there are few slings available that modify ceiling
    lifts to function as sit to stand lifts, and this may take some
    time. For those units that perform many tasks for which sit to stand
    lifts are applicable (long term care, post-op, med/surg areas, etc.)
    I recommend provision of sit to stand lifts with ambulation
    capability.

-   Lateral transfers are high risk tasks that are common throughout the
    facility in most clinical areas. Ceiling lifts using supine and
    seated slings can decrease risk from these tasks, but at this time I
    suggest using air assisted lateral transfer devices throughout
    facility for two reasons. One is that ceiling and portable lifts are
    not operational in many procedure areas such as radiology due to
    pedestal tables and overhead equipment tracks. The second reason is
    that presently ceiling lifts are in the process of being phased in
    the facility and the air assisted lateral transfer devices can
    provide safe lateral transfers in those areas while phase-in occurs.

> I suggest the sharing of air assisted lateral transfer devices between
> clinical areas. For example, a patient being transported to radiology
> can be transferred laterally on the unit using the air assisted air
> supply canister and mattress on the unit. Then, leaving the mattress
> under the patient, he is transported to the destination location
> (radiology). The mattress can then be inflated with the canister in
> radiology and used to laterally transfer the patient to the
> destination surface (x-ray table). The mattress would then remain
> under the patient during transport back to the unit and the unit air
> supply canister would be used to then inflate the mattress for
> laterally transferring the patient back to bed. Some Emergency
> Departments are opting to have these available for every ED admission
> and some Operating Rooms are keeping these under patients from the
> first lateral transfer onto the OR table to the last one on the unit.

-   Develop a bariatric program including identification of rooms on
    each unit appropriate for such patients as well as a bariatric
    admissions flow chart and protocol for the facility and unit.
    Determine best route to obtain needed equipment, through purchase or
    rental. Ensure a procedure is in place on off-shifts to quickly
    obtain bariatric equipment, especially expanded capacity
    gantry-design full body sling lifts. Provide each unit with unit
    bariatric binder with all bariatric information specific for the
    unit and facility. Utilize other suggestions from training.

-   In order to facilitate staff compliance with use of equipment, they
    must be brought into the equipment selection process. I suggest
    allowing staff to trial all equipment prior to purchase. This can be
    accomplished by having equipment fairs, one-day trials, or two week
    or more trials of equipment on each unit. Information and survey
    forms to assist in the equipment evaluation are found in the VA
    Patient Care Ergonomic Resource Guide at
    [www.patientsafetycenter.com](http://www.patientsafetycenter.com/).

-   Refer to the patient handling Technology Resource Guide, Bariatric
    Technology Resource Guide, and Ch. 4 of the Patient Care Ergonomics
    Resource Guide for information on equipment options. These resources
    are found under 'Safe Patient Handling & Movement" on the website:
    [www.visn8.med.va.gov/visn8/patientsafetycenter](http://www.visn8.med.va.gov/visn8/patientsafetycenter).

Below, please find other recommendations from my ergonomic site visit.

+-------------------------------+--------------------------------------+
| **Unit: 6 South -- Rehab,     |                                      |
| transitional care unit**      |                                      |
+-------------------------------+--------------------------------------+
| **Patient Care Ergonomic      | **Patient Handling Assistive         |
| Issues**                      | Technology                           |
|                               | Solutions/Recommendations**          |
+-------------------------------+--------------------------------------+
| Vertical lifts                | -   Provide coverage of 75 - 100% of |
| (dependent/extensive          |     patient population with ceiling  |
| assistance pts)               |     lifts                            |
|                               |                                      |
| Manual lifting is the norm.   | -   During Ceiling lift phase-in,    |
|                               |     trial/provide 1 floor-based      |
|                               |     sling lift                       |
|                               |                                      |
|                               | -   Consider installing track down   |
|                               |     hall for ambulation of patients  |
|                               |                                      |
|                               | -   Educate staff on rationale for & |
|                               |     use of lifts                     |
+-------------------------------+--------------------------------------+
| Vertical Lifts (partial       | -   Trial/provide 2 sit to stand     |
| assistance pts)               |     lift w/ ambulation capability    |
|                               |                                      |
|                               | -   Educate staff on rationale for & |
|                               |     use of lifts                     |
+-------------------------------+--------------------------------------+
| Transportation - Frequent --  | -   Consider battery-powered         |
| use w/c, 2 cardiac chars,     |     wheelchair and bed/stretcher     |
| total lift 2 by escort &      |     movers &/or provide 1 motorized  |
| staff                         |     stretcher                        |
+-------------------------------+--------------------------------------+
| Lateral transfers - Frequent  | -   Trial/Provide a minimum of 2 air |
|                               |     assisted lateral transfer        |
| Performing manually           |     devices or other friction        |
|                               |     reducing device                  |
+-------------------------------+--------------------------------------+
| Repositioning Side to Side -  | -   Use air assisted lateral         |
| Frequent                      |     transfer device or other         |
|                               |     friction reducing device         |
| Performing manually           |                                      |
|                               | -   When ceiling lifts installed,    |
|                               |     provide repositioning slings for |
|                               |     use w/ CLs                       |
|                               |                                      |
|                               | -   In the interim, trial            |
|                               |     repositioning slings for use w/  |
|                               |     new floor-based lift. (Note:     |
|                               |     staff will prefer use of repo    |
|                               |     slings w/ ceiling lifts)         |
+-------------------------------+--------------------------------------+
| Pulling up to head of bed -   | -   Use air assisted lateral         |
| Frequent                      |     transfer device or other         |
|                               |     friction reducing device         |
| Performing manually           |                                      |
|                               | -   When ceiling lifts installed,    |
|                               |     provide repositioning slings for |
|                               |     use w/ CLs                       |
|                               |                                      |
|                               | -   In the interim, trial            |
|                               |     repositioning slings for use w/  |
|                               |     new floor-based lift. (Note:     |
|                               |     staff will prefer use of repo    |
|                               |     slings w/ ceiling lifts)         |
+-------------------------------+--------------------------------------+
| Wound care - Frequent         | -   When Floor-based lift on unit    |
|                               |     and when ceiling lifts           |
|                               |     installed, provide limb support  |
|                               |     strap/slings                     |
+-------------------------------+--------------------------------------+
| Toileting - varied            | -   Use sit to stand lift for        |
|                               |     appropriate patients             |
+-------------------------------+--------------------------------------+
| Showering/Bathing             | -   Trial/Provide 1-2 ARJO Carrendo  |
|                               |     shower chairs                    |
+-------------------------------+--------------------------------------+
| TED hose application          | -   Provide TED hose applicator      |
+-------------------------------+--------------------------------------+
| \# beds: 35 Average Census:   |                                      |
| 32-35 % total                 |                                      |
| dependent/extensive           |                                      |
| assistance: 75% & ambulatory  |                                      |
| 10%                           |                                      |
|                               |                                      |
| Proportion bariatric: 2-3 at  |                                      |
| a time/occasionally           |                                      |
|                               |                                      |
| Room configurations:          |                                      |
|                               |                                      |
| Notes: Rehab/ambulate in      |                                      |
| rooms and down hall           |                                      |
+-------------------------------+--------------------------------------+

+-------------------------------+--------------------------------------+
| **Unit: 6 North -- tele, step |                                      |
| down**                        |                                      |
+-------------------------------+--------------------------------------+
| **Patient Care Ergonomic      | **Patient Handling Assistive         |
| Issues**                      | Technology                           |
|                               | Solutions/Recommendations**          |
+-------------------------------+--------------------------------------+
| Vertical lifts                | -   Provide coverage of 75 - 100% of |
| (dependent/extensive          |     patient population with ceiling  |
| assistance pts)               |     lifts                            |
|                               |                                      |
| Manual lifting is the norm.   | -   During Ceiling lift phase-in,    |
|                               |     trial/provide 1 floor-based      |
| Lots ambulation down hall &   |     sling lift                       |
| in rooms                      |                                      |
|                               | -   Consider installing track down   |
|                               |     hall for ambulation of patients  |
|                               |                                      |
|                               | -   Educate staff on rationale for & |
|                               |     use of lifts                     |
+-------------------------------+--------------------------------------+
| Vertical Lifts (partial       | -   Trial/provide 1 sit to stand     |
| assistance pts)               |     lifts w/ ambulation capability   |
|                               |                                      |
|                               | -   Educate staff on rationale for & |
|                               |     use of lifts                     |
+-------------------------------+--------------------------------------+
| Transportation                | -                                    |
+-------------------------------+--------------------------------------+
| Lateral transfers             | -   Trial/Provide 1 air assisted     |
|                               |     lateral transfer devices or      |
| Performing manually           |     other friction reducing device   |
+-------------------------------+--------------------------------------+
| Repositioning Side to Side -  | -   Use air assisted lateral         |
| Frequent                      |     transfer device or other         |
|                               |     friction reducing device         |
| Performing manually           |                                      |
|                               | -   When ceiling lifts installed,    |
|                               |     provide repositioning slings for |
|                               |     use w/ CLs                       |
|                               |                                      |
|                               | -   In the interim, trial            |
|                               |     repositioning slings for use w/  |
|                               |     new floor-based lift. (Note:     |
|                               |     staff usually prefer use of repo |
|                               |     slings w/ ceiling lifts)         |
+-------------------------------+--------------------------------------+
| Pulling up to head of bed -   | -   Use air assisted lateral         |
| Frequent                      |     transfer device or other         |
|                               |     friction reducing device         |
| Performing manually           |                                      |
|                               | -   When ceiling lifts installed,    |
|                               |     provide repositioning slings for |
|                               |     use w/ CLs                       |
|                               |                                      |
|                               | -   In the interim, trial            |
|                               |     repositioning slings for use w/  |
|                               |     new floor-based lift. (Note:     |
|                               |     staff usually prefer use of repo |
|                               |     slings w/ ceiling lifts)         |
+-------------------------------+--------------------------------------+
| Wound care - Rare             | -                                    |
+-------------------------------+--------------------------------------+
| Toileting                     | -   Use sit to stand lift for        |
|                               |     appropriate patients             |
+-------------------------------+--------------------------------------+
| Showering/Bathing -- in bed   | -   Trial/Provide 1 ARJO Carrendo    |
|                               |     shower chairs                    |
+-------------------------------+--------------------------------------+
| \# beds: 21 Average Census:   |                                      |
| 21 % total                    |                                      |
| dependent/extensive           |                                      |
| assistance: varies - 50% +    |                                      |
|                               |                                      |
| Proportion bariatric: few     |                                      |
|                               |                                      |
| Room configurations:          |                                      |
|                               |                                      |
| Notes: Rehab/ambulate in      |                                      |
| rooms and down hall           |                                      |
+-------------------------------+--------------------------------------+

+-------------------------------+--------------------------------------+
| **Unit: 7 North -- Medical    |                                      |
| Oncology**                    |                                      |
+-------------------------------+--------------------------------------+
| **Patient Care Ergonomic      | **Patient Handling Assistive         |
| Issues**                      | Technology                           |
|                               | Solutions/Recommendations**          |
+-------------------------------+--------------------------------------+
| Vertical lifts                | -   Provide coverage of 70% of       |
| (dependent/extensive          |     patient population with ceiling  |
| assistance pts)               |     lifts                            |
|                               |                                      |
| Manual lifting is the norm.   | -   During Ceiling lift phase-in,    |
|                               |     trial/provide 1 floor-based      |
|                               |     sling lift                       |
|                               |                                      |
|                               | -   Educate staff on rationale for & |
|                               |     use of lifts                     |
+-------------------------------+--------------------------------------+
| Vertical Lifts (partial       | -   Trial/provide 1-2 sit to stand   |
| assistance pts)               |     lift w/ ambulation capability    |
|                               |                                      |
|                               | -   Educate staff on rationale for & |
|                               |     use of lifts                     |
+-------------------------------+--------------------------------------+
| Transportation - Frequent --  | -   Consider battery-powered         |
| use w/c, cardiac chars,       |     wheelchair and bed/stretcher     |
| stretcher by escort & staff.  |     movers &/or provide 1 motorized  |
| Beds are easy to move         |     stretcher                        |
+-------------------------------+--------------------------------------+
| Lateral transfers - Frequent  | -   Trial/Provide a minimum of 2 air |
|                               |     assisted lateral transfer        |
| Performing manually           |     devices or other friction        |
|                               |     reducing device                  |
+-------------------------------+--------------------------------------+
| Repositioning Side to Side -  | -   Use air assisted lateral         |
| Frequent                      |     transfer device or other         |
|                               |     friction reducing device         |
| Performing manually           |                                      |
|                               | -   When ceiling lifts installed,    |
|                               |     provide repositioning slings for |
|                               |     use w/ CLs                       |
|                               |                                      |
|                               | -   In the interim, trial            |
|                               |     repositioning slings for use w/  |
|                               |     new floor-based lift. (Note:     |
|                               |     staff usually prefer use of repo |
|                               |     slings w/ ceiling lifts)         |
+-------------------------------+--------------------------------------+
| Pulling up to head of bed -   | -   Use air assisted lateral         |
| Frequent                      |     transfer device or other         |
|                               |     friction reducing device         |
| Performing manually           |                                      |
|                               | -   When ceiling lifts installed,    |
|                               |     provide repositioning slings for |
|                               |     use w/ CLs                       |
|                               |                                      |
|                               | -   In the interim, trial            |
|                               |     repositioning slings for use w/  |
|                               |     new floor-based lift. (Note:     |
|                               |     staff usually prefer use of repo |
|                               |     slings w/ ceiling lifts)         |
+-------------------------------+--------------------------------------+
| Wound care - Frequent         | -   When Floor-based lift on unit    |
|                               |     and when ceiling lifts           |
|                               |     installed, provide limb support  |
|                               |     strap/slings                     |
+-------------------------------+--------------------------------------+
| Toileting - varied            | -   Use sit to stand lift for        |
|                               |     appropriate patients             |
+-------------------------------+--------------------------------------+
| Showering/Bathing             | -   Trial/Provide 1-2 ARJO Carrendo  |
|                               |     shower chairs                    |
+-------------------------------+--------------------------------------+
| \# beds: 30 (new) Average     |                                      |
| Census: 30 % total            |                                      |
| dependent/extensive           |                                      |
| assistance: 60-70%            |                                      |
|                               |                                      |
| Proportion bariatric: 1/      |                                      |
| month for few weeks           |                                      |
|                               |                                      |
| Room configurations:          |                                      |
|                               |                                      |
| Notes:                        |                                      |
+-------------------------------+--------------------------------------+

+-------------------------------+--------------------------------------+
| **Unit: 7 South -- med/surg,  |                                      |
| total hips, knees, neruo,     |                                      |
| strokes, vascular**           |                                      |
+-------------------------------+--------------------------------------+
| **Patient Care Ergonomic      | **Patient Handling Assistive         |
| Issues**                      | Technology                           |
|                               | Solutions/Recommendations**          |
+-------------------------------+--------------------------------------+
| Vertical lifts                | -   Provide coverage of 50 - 60% of  |
| (dependent/extensive          |     patient population with ceiling  |
| assistance pts)               |     lifts                            |
|                               |                                      |
| Manual lifting is the norm.   | -   During Ceiling lift phase-in,    |
|                               |     trial/provide 1 floor-based      |
|                               |     sling lift                       |
|                               |                                      |
|                               | -   Consider installing track down   |
|                               |     hall for ambulation of patients  |
|                               |                                      |
|                               | -   Educate staff on rationale for & |
|                               |     use of lifts                     |
+-------------------------------+--------------------------------------+
| Vertical Lifts (partial       | -   Trial/provide 1- 2 sit to stand  |
| assistance pts)               |     lift w/ ambulation capability    |
|                               |                                      |
|                               | -   Educate staff on rationale for & |
|                               |     use of lifts                     |
+-------------------------------+--------------------------------------+
| Transportation -- w/ cardiac  | -   Consider battery-powered         |
| chair - Beds are easy to move |     wheelchair and bed/stretcher     |
|                               |     movers                           |
|                               |                                      |
|                               | -                                    |
+-------------------------------+--------------------------------------+
| Lateral transfers - Frequent  | -   Trial/Provide 1-2 air assisted   |
| -- to cardiac chair           |     lateral transfer devices or      |
|                               |     other friction reducing device   |
+-------------------------------+--------------------------------------+
| Repositioning Side to Side -  | -   Use air assisted lateral         |
| Frequent                      |     transfer device or other         |
|                               |     friction reducing device         |
| Performing manually           |                                      |
|                               | -   When ceiling lifts installed,    |
|                               |     provide repositioning slings for |
|                               |     use w/ CLs                       |
|                               |                                      |
|                               | -   In the interim, trial            |
|                               |     repositioning slings for use w/  |
|                               |     new floor-based lift. (Note:     |
|                               |     staff usually prefer use of repo |
|                               |     slings w/ ceiling lifts)         |
+-------------------------------+--------------------------------------+
| Pulling up to head of bed -   | -   Use air assisted lateral         |
| Frequent                      |     transfer device or other         |
|                               |     friction reducing device         |
| Performing manually           |                                      |
|                               | -   When ceiling lifts installed,    |
|                               |     provide repositioning slings for |
|                               |     use w/ CLs                       |
|                               |                                      |
|                               | -   In the interim, trial            |
|                               |     repositioning slings for use w/  |
|                               |     new floor-based lift. (Note:     |
|                               |     staff usuallly prefer use of     |
|                               |     repo slings w/ ceiling lifts)    |
+-------------------------------+--------------------------------------+
| Wound care - Frequent         | -   When Floor-based lift on unit    |
|                               |     and when ceiling lifts           |
|                               |     installed, provide limb support  |
|                               |     strap/slings                     |
+-------------------------------+--------------------------------------+
| Toileting -- use commode      | -   Use sit to stand lift for        |
|                               |     appropriate patients             |
+-------------------------------+--------------------------------------+
| Showering/Bathing             | -   Trial/Provide 1-2 ARJO Carrendo  |
|                               |     shower chairs                    |
+-------------------------------+--------------------------------------+
| \# beds: 28 Average Census:   |                                      |
| 26-28 % total                 |                                      |
| dependent/extensive           |                                      |
| assistance: 40 -- 50 %        |                                      |
|                               |                                      |
| Proportion bariatric: 2-3/    |                                      |
| month -- more & more seen     |                                      |
|                               |                                      |
| Room configurations: private  |                                      |
|                               |                                      |
| Notes:                        |                                      |
+-------------------------------+--------------------------------------+

+-------------------------------+--------------------------------------+
| **Unit: SICU/MICU/CCU --**    |                                      |
| This unit will be combination |                                      |
| unit in new bed tower         |                                      |
|                               |                                      |
| In MICU/CCU -- most pts in    |                                      |
| bed, many on ventilators.     |                                      |
+-------------------------------+--------------------------------------+
| **Patient Care Ergonomic      | **Patient Handling Assistive         |
| Issues**                      | Technology                           |
|                               | Solutions/Recommendations**          |
+-------------------------------+--------------------------------------+
| Vertical lifts                | -   Provide 100% ceiling lift        |
| (dependent/extensive          |     coverage                         |
| assistance pts)               |                                      |
|                               | -   During Ceiling lift phase-in,    |
| Manual lifting is the norm.   |     trial/provide 1 floor-based      |
| Philosophy -- get pts out of  |     sling lift                       |
| bed into chair, thus not      |                                      |
| utilizing chair positioning   | -   Use 'seated slings' to transfer  |
| feature of beds               |     dependent patients from seated   |
|                               |     to seated positions              |
|                               |                                      |
|                               | -   When admit bariatric patients,   |
|                               |     when ordering bariatric beds,    |
|                               |     order gantry lift for ALL        |
|                               |     dependent/extensive assistance   |
|                               |     bariatric patients               |
|                               |                                      |
|                               | -   Educate staff on rationale for & |
|                               |     use of lifts                     |
+-------------------------------+--------------------------------------+
| Vertical Lifts (partial       | -   Trial/provide 1- 2 sit to stand  |
| assistance pts)               |     lift w/ ambulation capability    |
|                               |                                      |
| Philosophy -- get pts out of  | -   Educate staff on rationale for & |
| bed into chair, thus not      |     use of lifts                     |
| utilizing chair positioning   |                                      |
| feature of beds but also      |                                      |
| transfer some pts laterally   |                                      |
| into cardiac chair, then      |                                      |
| place in seated position.     |                                      |
+-------------------------------+--------------------------------------+
| Transportation -- beds are    | -   Consider battery-powered         |
| easy to move -- staff and     |     wheelchair and bed/stretcher     |
| docs go w/ escort staff       |     movers                           |
+-------------------------------+--------------------------------------+
| Lateral transfers - Frequent  | -   Trial/Provide 6 air assisted     |
| -- use draw sheets & roller   |     lateral transfer devices or      |
| board occasionally            |     other friction reducing device   |
+-------------------------------+--------------------------------------+
| Repositioning Side to Side -- | -   Use air assisted lateral         |
| Frequent -- bed w/ lateral    |     transfer device or other         |
| rotation feature.             |     friction reducing device         |
|                               |                                      |
|                               | -   When ceiling lifts installed,    |
|                               |     provide repositioning slings for |
|                               |     use w/ CLs                       |
+-------------------------------+--------------------------------------+
| Pulling up to head of bed -   | -   Use air assisted lateral         |
| Frequent                      |     transfer device or other         |
|                               |     friction reducing device         |
|                               |                                      |
|                               | -   When ceiling lifts installed,    |
|                               |     provide repositioning slings for |
|                               |     use w/ CLs                       |
|                               |                                      |
|                               | -   In the interim, trial            |
|                               |     repositioning slings for use w/  |
|                               |     new floor-based lift. (Note:     |
|                               |     staff usually prefer use of repo |
|                               |     slings w/ ceiling lifts)         |
+-------------------------------+--------------------------------------+
| Wound care - Frequent         | -   When Floor-based lift on unit    |
|                               |     and when ceiling lifts           |
|                               |     installed, provide limb support  |
|                               |     strap/slings                     |
+-------------------------------+--------------------------------------+
| Toileting -- in bed           | -   Use sit to stand lift for        |
|                               |     appropriate patients             |
+-------------------------------+--------------------------------------+
| Showering/Bathing -- in bed   | -                                    |
+-------------------------------+--------------------------------------+
| Making occupied bed           | -   Trial supine sling w/ 6 point    |
|                               |     hanger bar with floor based      |
|                               |     and/or ceiling lifts             |
+-------------------------------+--------------------------------------+
| \# beds: 20 Average Census:   |                                      |
| 20 % total                    |                                      |
| dependent/extensive           |                                      |
| assistance:                   |                                      |
|                               |                                      |
| Proportion bariatric:         |                                      |
| presently rare but            |                                      |
| considering providing         |                                      |
| bariatric surgery Room        |                                      |
| configurations: private       |                                      |
+-------------------------------+--------------------------------------+

+-------------------------------+--------------------------------------+
| **Unit: DIALYSIS-- Inpatient  |                                      |
| AND Outpatient**              |                                      |
|                               |                                      |
| Primarily performed in        |                                      |
| chairs, rarely beds           |                                      |
+-------------------------------+--------------------------------------+
| **Patient Care Ergonomic      | **Patient Handling Assistive         |
| Issues**                      | Technology                           |
|                               | Solutions/Recommendations**          |
+-------------------------------+--------------------------------------+
| Vertical lifts                | -                                    |
| (dependent/extensive          |                                      |
| assistance pts)               |                                      |
+-------------------------------+--------------------------------------+
| Vertical Lifts (partial       | -   outpatient dialysis - Provide 1  |
| assistance pts)               |     sit to stand lift                |
|                               |                                      |
| Have 1 EZ Stand               | -   inpatient dialysis - Share sit   |
|                               |     to stand lift w/ ICU             |
+-------------------------------+--------------------------------------+
| Lateral transfers - rare      | -                                    |
+-------------------------------+--------------------------------------+

+-------------------------------+--------------------------------------+
| **Unit: EMERGENCY DEPT.**     |                                      |
+-------------------------------+--------------------------------------+
| **Patient Care Ergonomic      | **Patient Handling Assistive         |
| Issues**                      | Technology                           |
|                               | Solutions/Recommendations**          |
+-------------------------------+--------------------------------------+
| Vertical lifts                | -   Provide 4 ceiling lifts w/ at    |
| (dependent/extensive          |     least 600 lb. weight capacity    |
| assistance pts)               |                                      |
|                               | -   If provide car extraction lift   |
|                               |     with other lift functions (as w/ |
|                               |     the Golvo) provide a supine      |
|                               |     sling w/ hanger bar for lifting  |
|                               |     patients from floor              |
+-------------------------------+--------------------------------------+
| Car extraction                | -   Trial/provide floor-based sling  |
|                               |     lift (EZ-Out, LIKO Golvo, etc.)  |
|                               |                                      |
|                               | -                                    |
+-------------------------------+--------------------------------------+
| Vertical Lifts (partial       | -   Trial sit to stand lift          |
| assistance pts)               |                                      |
|                               | -                                    |
+-------------------------------+--------------------------------------+
| Transportation                | -   Consider battery-powered         |
|                               |     wheelchair and bed/stretcher     |
|                               |     movers &/or provide 1 motorized  |
|                               |     stretcher                        |
+-------------------------------+--------------------------------------+
| Lateral transfers             | -   Trial/provide air assisted       |
|                               |     lateral transfer devices         |
|                               |                                      |
|                               | -                                    |
+-------------------------------+--------------------------------------+
| Repositioning Side to Side    | -   Use air assisted lateral         |
|                               |     transfer devices                 |
|                               |                                      |
|                               | -   When ceiling lifts installed,    |
|                               |     provide repositioning slings for |
|                               |     use w/ CLs                       |
+-------------------------------+--------------------------------------+
| Pulling up to head of bed     | -   Use air assisted lateral         |
|                               |     transfer devices                 |
|                               |                                      |
|                               | -   When ceiling lifts installed,    |
|                               |     provide repositioning slings for |
|                               |     use w/ CLs                       |
+-------------------------------+--------------------------------------+
| Wound care                    | -   When ceiling lifts installed,    |
|                               |     provide limb support             |
|                               |     strap/slings for use w/ CLs      |
|                               |                                      |
|                               | -   If provide car extraction lift   |
|                               |     with other lift functions (as w/ |
|                               |     the Golvo), provide limb support |
|                               |     strap/slings for use w/          |
|                               |     floor-based sling lift           |
+-------------------------------+--------------------------------------+
| Room configurations: 14:      |                                      |
| Proportion bariatric:         |                                      |
+-------------------------------+--------------------------------------+

+-------------------------------+--------------------------------------+
| **Unit: RADIOLOGY (In patient |                                      |
| & Outpatient)**               |                                      |
+-------------------------------+--------------------------------------+
| **Patient Care Ergonomic      | **Patient Handling Assistive         |
| Issues**                      | Technology                           |
|                               | Solutions/Recommendations**          |
+-------------------------------+--------------------------------------+
| Vertical lifts                | -   Install 1 ceiling lift in CT     |
| (dependent/extensive          |                                      |
| assistance pts)               | -   Install 1 ceiling lift in the    |
|                               |     angio suite                      |
+-------------------------------+--------------------------------------+
| Lateral transfers             | -   Trial/provide air assisted       |
|                               |     lateral transfer devices for:    |
|                               |                                      |
|                               |     -   in patient radiology (1-2)   |
|                               |                                      |
|                               |     -   outpatient radiology (1-2)   |
|                               |                                      |
|                               |     -   CT (1)                       |
|                               |                                      |
|                               |     -   Angio suite (1)              |
|                               |                                      |
|                               | -   1 friction reducing device for   |
|                               |     MRI                              |
+-------------------------------+--------------------------------------+