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Musculoskeletal disorders exact an unacceptable toll on the health and
military readiness of our personnel. Typical nursing tasks include
transferring patients from bed to wheelchair, rolling patients in bed and
lateral transfers from bed to stretcher. Nursing staff are forced to adopt
and maintain extreme postures to perform these tasks, increasing risk of
injuries.
In November 2001, the U.S. Army Center for Health Promotion and Preventive
Medicine Ergonomics Program performed a 24-hour snapshot survey of all
inpatient units at Walter Reed Army Medical Center (WRAMC). The overall
goals of this project were to describe the patient handling demands based
on patient dependency level and type of ward that occur on inpatient units
at a major military medical facility and implement an intervention plan
accordingly.This provides a basis for patient handling demand models and equipment
recommendations for the Department of Defense.
Using the surveys, descriptions were developed of the patient dependency
levels, types of wards, types of transfers and types of equipment on
inpatient units at WRAMC. In addition, physiological effects of transfers
were assessed. These descriptions and assessments have allowed
identification of the most appropriate and cost-effective patient handling
equipment required for specific wards and patients.
In January of 2003, five units at WRAMC were selected for an intervention
project based on the high number of lateral and repositioning transfers
reported during the survey phase. Lateral and repositioning transfers on
these units stood out as occurring most frequently, taking the longest
amounts of time based on person minutes and requiring the greatest amount of exertion.
In September 2003, lateral transfer and repositioning equipment had been
purchased and was placed on each of the five units. The five units included
three critical care units, general medicine and general surgery. The staff
were trained by the equipment vendors in use of equipment and encouraged to
perform “train the trainer” education sessions. Staff was provided with a
high-risk lift notification system. This consists of a matrix to determine
whether a patient is high risk based on dependency, weight bearing, upper
extremity strength and ability to cooperate. Magnets were also used to
distinguish these patients on nursing information boards. Posters were
provided to display on the unit featuring preferred methods of patient
transfer. This intervention phase is currently underway.
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These two Ergonomics Working Group newsletters provide information on the U.S. Army Center for
Health Protection and Preventive Medicine (USACHPPM) Ergonomics Program
Patient Handling Study.
Issue 9 is a background resource, offering information on the study goals, process,
findings, and results.
Issue 17 underscores the importance of safe patient handling and provides additional details regarding the Walter Reed Army Medical Center pilot program. |
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A USACHPPM ergonomist conducted a special program to prevent nursing injuries at Walter Reed Army Medical Center. This one-page
fact sheet explains how the two-phase program works. If you are interested
in a similar program at your medical facility, contact the USACHPPM
Ergonomics Program at
services@ergoworkinggroup.org |
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No doctors or paramedics interviewed for this story could actually recall any cases of overweight
people breaking a stretcher or falling off one. But they know of paramedics
who have gotten hurt lifting heavy patients. |
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This 18” x 24”
full-color poster shows you how to
eliminate the road blocks to safe patient handling. To request a
poster, contact the USACHPPM Ergonomics Program at
publications@ergoworkinggroup.org |
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Veterans Affairs/Department of Defense Patient Care Ergonomics Resource Guide
click here
Click here to download Part I (revised 11/20/03)
Click here to download Part II (revised 11/20/03)
There is also a Web-based version that you can view:
click here |
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This 18” x 24”
full-color poster shows you how to
eliminate the road blocks to safe patient handling. To request a
poster, contact the USACHPPM Ergonomics Program at
publications@ergoworkinggroup.org |