On this Wellcast we speak to Mamie Williams, Director of Nurse Safety and Wellbeing, about safe patient handling at VUMC.
Occupational Health Smooth Moves Website
NIOSH Safe Patient Handling and Mobility
Shaina Farfel: Welcome to this edition of the Vanderbilt Health and Wellness Wellcast. I am Shaina Farfel with Occupational Health. Today we are speaking with Mamie Williams who is Director of Nurse Safety and Well-being here at Vanderbilt University Medical Center. Thank you so much for being with us today, Mamie.
Mamie Williams: Thank you, Shaina, for having me. I look forward to our discussion on patient handling.
Shaina Farfel: For so many of our employees here at the medical center a big part of their job is getting patients from one place or position to another, as it can be something as simple as just getting them out of bed to go to the bathroom or transporting them in a stretcher off the unit to get imaging. Can you tell me in your expert opinion why safe patient handling is so important and what the safe patient handling, also known as the Smooths Moves Program here at Vanderbilt, is?
Mamie Williams: At Vanderbilt to start with the Safe Patient Handling Smooths Moves Program was implemented in 2005. The program was put in place to really protect our nurses, patients, physical therapists, occupational therapists and patient transporters, anyone, as you mentioned who moves, mobilizes, and helps to ambulate patients here at VUMC. The program is three parts. First, there is a policy which points out that Vanderbilt Medical Center is a minimal lift facility, meaning in instances where you are moving, ambulating, or mobilizing a patient you should use the available patient handling equipment or use enough staff so that you are at minimum lifting no more than 35 pounds of a patient's weight. It also includes patient handling equipment, as we pointed out, and the patient handling equipment, and we will talk about that a little bit more, was put in place so that nurse staff, again PT, OT, anyone moving, mobilizing, and ambulating patients had the appropriate equipment so that they would not have to physically manually do those tasks without assistance, and then it includes physical training on the various pieces of patient handling equipment. Staff get it in orientation. There are different learning exchange modules over it and so those are all the components of the program. It is an important program so that our caregivers who are caring for our patients are not injured while they are trying to do so. It is a national trend with the focus on preventing nurse injury and others as well. It really is important that caregivers take the time to care about themselves as they are caring for patients and the Patient Handling Program helps them to do that, and that is one of the reasons that it is so important. It allows nurses and the like to care for patients and to care for themselves at the same time by protecting their backs and not being injured while performing their job duties.
Shaina Farfel: Mamie, what types of patient handling causes the majority of injuries in our staff members that you see?
Mamie Williams: Very good question. Very good question. The Patient Handling Program does include injury trending for those folks who come over to the Occupational Health Clinic and see one of the healthcare providers. We do talk to them about what caused their injury, and what we have learned over the years of having the Safe Patient Handling Program in place, and it continues to this day, is that the vast majority of patient handling injuries are what we term repositioning injuries. When a PT, OT, patient transporter, or nurse moves a patient either up or down in bed, or helps a patient to reposition themselves in bed that by far causes the largest number of injuries at VUMC. It is unfortunate because that is the particular piece of patient handling equipment, slippery sheets and the Sage TAP system, which are most readily available and which can be supplied by our linen services to any unit or department that requests it. We have more than 8,000 pair of the slippery sheets which are used to offload the patient's weight and prevent someone from being injured while repositioning a patient. So, unfortunately, we termed it Small Moves Repositioning a Patient in Bed, and often times it is with our adult standard, not the bariatric patient, up or down in bed causes the vast majority of the injuries at VUMC unfortunately.
Shaina Farfel: Yeah, that is really interesting because I think people would think otherwise. So, you know, someone would think maybe some of these larger transfers or heavier patients would be the cause of the majority of injuries, so that is important to bring awareness to that.
Mamie Williams: Absolutely. We think perhaps people are not like fully aware that even a smaller patient, that is too much torque on the back to bend over in that awkward position and move someone up or down, so you really still, even it is an adult standard nonbariatric patient, you really still need to use the available, the slippery sheets, you could even use the HoverMatt or the Sage TAP system. So, you are absolutely right, Shaina.
Shaina Farfel: Absolutely. You touched on this already, but anything to add? What are some important strategies for safe patient handling to prevent these types of injuries in the workplace?
Mamie Williams: I think, one, Occupational Health Clinic wants all of our nurse staff, all of our folks who are caring for our patients to care for themselves as well. And, using the patient handling equipment, the available patient handling equipment, taking time to reintroduce yourself to that equipment by either going to the Occupational Health Safe Patient Handling website and reviewing the videos of the different pieces of patient handling equipment, or reviewing one of the learning modules on the Safe Patient Handling Programs, and then using that equipment, is the absolute best way to prevent yourself from being injured while moving, mobilizing or ambulating a patient. It is also the safest thing for the patient as well. If patients, unfortunately, are being helped to ambulate and you have a nurse on your side and the patient starts to go down, unfortunately sometimes the patient could fall and the nurse could be injured as well. The way to prevent that would be to use something like the STEADI, which is as much a fall prevention tool as it is a safe patient handling tool. It protects the patient, and it protects the nurse who is helping to ambulate the patient. Caring for themselves, it really gets into that whole thing of taking your breaks, thinking about yourself, taking care of yourself, it really all meshes together.
Shaina Farfel: And Mamie, the patient handling equipment for staff, should that all be available on the units for them? What if something was not available or was not working? Who would they reach out to or what would they do?
Mamie Williams: Very good question. There are a couple of components to it. The first is that each unit and department manager decides which pieces of patient handling equipment they have on their unit. However, a number of CSLs, nurse educators and even nurse staff have gotten together and decided, well for our unit based on the patients that we work with, we would like to see, say the Maxi Move which lifts up to 500 pounds of a patient's weight. It will take a patient from the floor, bed, chair or anywhere in between. There are certain number of pieces of equipment that are available, but again each manager purchases it for their floor with the help of their staff deciding what it is that they need. So, every floor does not have every piece of equipment, but they can if they so desire. They could reach out to me. You can call Mamie Williams, and I can send them information on what pieces of equipment are available and which difference patient handling movements it covers. For instance, the Maxi Move is the one that takes a patient from a lying position to a seated position and vice versa and the STEADI is for folks who, you are unfamiliar on whether they are good with ambulation or they are a fall risk, and we touched on that. The other is if your equipment is not functioning you would reach out to facilities for repair. You would fill out a facilities repair form and they would come and repair the equipment. If there is a need to determine what is needed, I can help with that.
Shaina Farfel: Any additional resources that you would want VUMC staff to know about in terms of safe patient transport that we have not already talked about today?
Mamie Williams: I think we touched on it, but just that there are a number of learning modules in the Learning Exchange related to safe patient handling. Each unit has at least one safe patient handling champion who is a nurse or a care partner who has gone through some additional training to be able to tell their colleagues which pieces of equipment are appropriate for which movements that they are anticipating having to do with a patient or for a patient and how to use the patient handling equipment. We also have the Occupational Health Safe Patient Handling website which has each piece of equipment and instructions on how to use it and when to use it.
Shaina Farfel: Below this podcast there should be links to the Occupational Health Safe Patient Handling website for those resources as well. Thank you so much, Mamie, for your time today. These are really important discussions to have and to remind folks about the resources available here at the medical center, and please come back and join us again sometime soon.
Mamie Williams: I certainly will. Thank you. Everyone stay safe.
Shaina Farfel: Thanks for listening. If you have a story suggestion, you can use the Contact Us page on our website at www.vumc.org/help-wellness.