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Patient Care Ergonomics Resource Guide: Safe Patient Handling ...

Patient Care Ergonomics Resource Guide: Safe Patient Handling ...

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Patient Assessment, Care Planning & Algorithms Department of Veterans Affairs PURPOSE OF ALGORITHMS This chapter provides assessment criteria to assist health care staff in the planning for safe handling and movement of each patient. The following algorithms should be used as guides when planning the following patient transfer and repositioning tasks. These algorithms are targeted for persons directly involved with patient handling and movement, such as registered nurses, licensed practical nurses, nursing assistants, orderlies, physical/occupational therapists, radiology technicians, and patient care technicians. �BACKGROUND The algorithms are designed to assist health care employees in selecting the safest equipment and techniques based on specific patient characteristics. These guidelines were prepared based on scientific and professional information available in March 2001. Users of this guideline should periodically review this material to ensure the advice herein is consistent with current reasonable clinical practice. As with any guideline, this content provides general direction; professional judgment is needed to assure safety of patients and caregivers. These algorithms were tested with different patient populations in six clinical areas (Intensive Care Units; Acute Care Units; Nursing Home Care Units; Outpatient Areas and Clinics, and Emergency Rooms; Operating and Recovery Rooms; and Spinal Cord Injury Units and Rehabilitation Units). The algorithms were reviewed and approved for use by Veterans Health Administration (VHA) nurse executives. 72

Patient Assessment, Care Planning & Algorithms Department of Veterans Affairs Algorithm 1: Transfer to and From: Bed to Chair, Chair to Toilet, Chair to Chair, or Car to Chair Last rev. 4/1/05 Start Here No Is the patient cooperative? Yes Does the patient have upper extremity strength? Yes Seated transfer aid; may use gait/transfer belt until the patient is proficient in completing transfer independently. Can patient bear weight? Partially Is the patient cooperative? Use full body sling lift and 2 caregivers. No No Fully Yes Caregiver asssitance not needed; Stand by for safety as needed. Stand and pivot technique using a gait/transfer belt (1 caregiver) or powered standing assist lift (1 caregiver). For seated transfer aid, must have chair with arms that recess or are removable. For full body sling lift, select a lift that was specifically designed to access a patient from the car (if the car is the starting or ending destination). If patient has partial weight bearing capacity, transfer toward stronger side. Toileting slings are available for toileting. Bathing besh slings are available for bathing. 73

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