Amy R. Darragh, Marc A. Campo, Lenore Frost, Melissa Miller, Marissa Pentico, Heather Margulis; Safe-Patient-Handling Equipment in Therapy Practice: Implications for Rehabilitation. Am J Occup Ther 2013;67(1):45-53. doi: 10.5014/ajot.2013.005389.
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© 2019 American Occupational Therapy Association
OBJECTIVE. To determine how safe-patient-handling (SPH) equipment is used in rehabilitation and how it affects therapists, patients, and therapy practice.
METHOD. We used a qualitative, instrumental case study design. Thirty-five occupational and physical therapist practitioners from three facilities participated in the study.
RESULTS. Therapists reported a broad range of applications for equipment (e.g., functional mobility and neuromusculoskeletal function). They reported that SPH equipment increased treatment options for therapists and increased participation options for patients, although equipment limitations exist. Three themes emerged from the analysis: choice, potential, and safety.
CONCLUSION. SPH equipment has therapeutic applications in rehabilitation, especially for medically complex or bariatric patients. Therapists in this study engaged in a highly individualized, complex process of decision making when selecting and using SPH devices in rehabilitation. More research to refine and test therapeutic uses is necessary.
I had a patient, too, who was heavier, and we would not have been able to stand him up. He loved the overhead sling because we were able to work on sit to stand where physically there was no way that even with two or three therapists that we could get him up.
As far as mobilizing patients earlier, even patients weighing 600 pounds, we are able to mobilize fairly quickly, whereas previous jobs I have seen, bariatric patients are left in bed because they just don’t have the equipment to get them out of bed.
In rehab, I have used [sit-to-stand device] for walking with a patient who would go good distances, but his knee could buckle at any time without warning. Having [sit-to-stand device] in the room was much more assuring for both of us. He was a big guy, so if he buckled, there was no way I could hold him.
Going back to the [friction-reducing devices], . . . the Stage 4 ulcers, whatever skin integrity issues they have, they work 10 times better than using a Chuck. You can reposition them and have significantly less friction on somebody who has skin integrity issues.
They’re also more willing to do things that are a little riskier because they do have that sense of security, they’re willing to go a little out of their comfort zone as opposed to when we’re holding them up, they’re really not—they stand there and don’t do anything.
It promotes overall safety, and when we talk about the safety of everyone, I think there’s less strain on the therapist, and we can use our energy in assisting the patient in supported sitting or whatever the task might be, so it conserves our energy.
With the portable lift, you’re twisting and tweaking your back just moving it, depending on the size of the patient and if there’s any knee involvement. Trying to get their legs split between that bar is very difficult on the regular floor lift.
Sometimes it is an issue on our floor because [of]whatever you’re contending with—the commode, the bed, the wheelchair, and the four IV poles that they have. It’s terrible. It can be difficult to move patients in the [sit-to-stand device] with all that stuff.
Promote early and more mobilization of patients,
Provide more options for activities and therapeutic interventions among therapists with bariatric and dependent patients, and
Allow patients and therapists to more safely participate in therapy sessions.
Requires therapists to engage in complex clinical reasoning skills for appropriate and effective integration of the equipment into rehabilitation;
Has important limitations when used in therapy practice, such as maneuverability, patient positioning, and sling fit and adjustability, that require careful consideration before use; and
Should be used by therapists who have received training in how to use the equipment properly and safely, as was the case for the therapists included in this study.
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