Food hygiene

Are we really doing all we can?

Equality and diversity

Can we all be treated equally despite our differences?

Infection control

Billions of bugs, most of them good for us, what can we do?

Manual handling

As children we lift correctly, as adults we need to stop and think before we lift

Medication

Communication

Are we really communicating the best way we can?

 

Category Archives: Manual handling

Procedure for using a hoist


Introduction

Using a hoist to move a patient can be a hazardous manoeuvre for both nurses and patients. It is paramount that nurses undertake this procedure safely following best-practice guidelines (NMC, 2008).

Procedure

The procedure described here involves using a mobile sling hoist to move a patient. It is important to receive training on how to use the hoist. For guidance on preparing for any manual-handling procedure, see part 1.

Perform a risk assessment. Assess the patient for using a hoist – check their mobility care plan and consult colleagues. Determine how many staff (usually two) will be required and ascertain which hoist to use. Mobility care plans should document the hoist and sling type, including the sling size.

  • Explain the procedure to the patient. Advise them that staff will use the hoist to lift them safely and without hurting them, and that they may be asked, if they are able, to carry out simple instructions such as holding their arms crossed over their chest.
  • Ensure the environment is safe .
  • Wash and dry hands; don a plastic apron and gloves.
  • Reassure the patient. Some patients may fear being dropped when lifted in a hoist.
  • Prepare equipment. Always check the hoist before use . Check it has been maintained; there should be a sticker on the hoist indicating the date of the last maintenance check – this should be every six months. Check that the slings are the correct ones for the particular hoist. Inspect them for wear and tear, and the attachments. Check any maintenance stickers or labels on the slings – these should also be checked every six months. Do not use slings that
    are incompatible with the hoist.
  • Check the hoist’s weight limit. This will be indicated on the hoist, usually on the main boom. Ensure the hoist is suitable
    for the patient’s height and weight.
  • Select the correct sling for the patient, taking into account their body shape.
  • Ensure the patient’s privacy and dignity.
  • If the patient is in a chair or on a bed, ensure the brakes are on. If they are being moved to another chair or bed, check the brakes of these items are on.
  • Insert the sling. If the patient is on the floor or on a bed, assist them to roll over. If they are on a bed, raise it to an acceptable height so you can roll and insert the sling under them. If the patient is on the floor, staff may be required to kneel.
  • Insert the sling alongside the patient’s back and as far under as possible . It is important the bottom edge of the sling is as far as possible under the hip. Bunch the sling slightly before moving the patient on to their back, then ease the patient the other way to pull the sling through. Ensure that the leg slats are under the patient’s thighs . Care should be taken if they have a urinary catheter in situ.
  • If the patient cannot roll, two flat slide sheets can be concertinaed and eased into position under them and the hoist sling slid between the two slide sheets.
  • Once the sling is in place, check that the lower edge of the back of the sling is under the patient’s hips. If the sling is of the correct size, the crown of the patient’s head should be on the sling, if a high-back sling is being used. Follow manufacturers’ instructions for each sling type used.
  • Attach the leg and chest attachments to the hoist’s spread bar. Some attachments are passed through each other and crossed before they are attached to the spread bar.
  • Hoist the patient up a small distance, then check the sling attachments are secure, before continuing with the full hoisting action . If using a sling hoist, do not have the hoist brakes on when hoisting, except when hoisting a patient on a sloped surface or from the floor. The hoist will balance and find its own centre of gravity when the brakes are off. Do not hoist patients from an angle. This may cause the hoist to tilt, especially if the patient’s weight is close
    to the hoist’s limit.
  • Raise the patient for clearance, not to the hoist’s height capacity unless necessary (the patient may find it more fearful if raised to the highest position)
  • Observe the patient at all times while hoisting and provide encouragement and reassurance. Some patients may become distressed and staff should ease anxieties by talking to them and keeping close while they are in the hoist.
  • Manoeuvre the hoist and patient to the desired position, then lower
  • Once the patient is in position, unhook or unclip the attachments and move the hoist away from them. Then remove the sling.
  • Ensure the patient is comfortable and has the nurse call system close by.
  • Remove the hoist to its storage place.
  • Ensure the hoist is clean and on charge (some hoists have battery chargers and one of these should always be on charge).
  • Follow local laundry procedures for hoist slings after use.
  • Wash and dry hands according to local policy
  • Disposable (one-person slings) are useful as they can be allocated to a patient for their hospital stay and disposed of on discharge. This reduces infection risk.
  • Generally, slings are not left underneath a patient. Any decision to do this must be based on assessment and documented. Staff should seek advice on choice of sling in such cases and should try to resolve reasons for leaving a sling in situ, for example by a change of chair type.

Manual handling hoisting


DO YOU NEED TWO PEOPLE  TO USE A MOBILE HOIST?????

Well actually….according to British law – NO

But it has to be risk assessed!

CODE OF PRACTICE FOR USING HOISTS TO MOVE PATIENTS
INTRODUCTION:
Following the introduction of the Manual Handling Operations Regulations 1992, the use of equipment to move patients has become routine practice.
This Code of Practice is designed to ensure the safe use of hoists and minimise the risk of injury to staff and their patients and has been adapted from Leicestershire Partnership NHS Trust, Learning, Skills and Development Unit, with whom the PCT has a Shared Service Level Agreement for moving and handling training.
We aim to ensure that all services provided by Leicestershire County and Rutland Primary Care Trust conform to the requirements of the Human Rights Act and all equality legislation. As such all PCT policies and procedures are periodically audited to ensure conformity.

The Code of Practice details the following points:
1. General Principles of Using Hoists
2. Maintenance
3. Training
4. Infection Control
5. Compatibility of Hoist and Sling
6. Purchase and Disposal

CODE OF PRACTICE FOR USING HOISTS TO MOVE PATIENTS
1. General Principles of Using Hoists
1.1 Any use of hoists must be as specified by the patients’s Moving and Handling Risk Assessment / Care Plan.
1.2 Use a minimum of two carers when using a mobile hoist. This is not a ruling from any specific professional body, nor an instruction from the manufacturers; it is considered to be safe practice. Patients are at risk of being injured when being hoisted; particularly their head and feet, and one carer may find it difficult to facilitate the move as well as keeping an eye on all aspects of the patient’s
safety. Also, when moving a mobile hoist with a patient in situ, if there is not a second carer to keep the patient steady, there is a tendency for the patient to swing back and forth, making the hoist unstable and at risk of overbalancing with potentially catastrophic results.
1.3 Any use of a mobile hoist with a single carer must be risk assessed on an individual basis; the assessment showing that the use of only one carer does not increase the risk involved.
1.4 When using a ceiling track hoist, a gantry hoist, or a stand-aid, there may be circumstances where only one carer is needed, unless the patient’s risk assessment dictates otherwise.
1.5 When using a mobile hoist, the brakes should be OFF, except when the hoist is in storage/not in use; when hoisting on an incline; or when adjusting a patient’s clothing while they are suspended by the hoist.

READ MORE HERE