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CategoriesPatient Handling

Benefits of Early Patient Mobility

by sphmedicaladmin

According to a study published by the Johns Hopkins University School of Medicine, early patient mobility significantly improves patient outcomes. In the study, Dale M. Needham, M.D., Ph.D., the university’s lead researcher, notes that patients who spend less time in bed and start rehabilitation sooner are less likely to suffer from muscle weakness, physical impairments, or mental illness than those who do not. Another study published by the National Institutes of Health revealed that patients who spend less time in their hospital beds are also less likely to suffer from the following:

  • Pressure ulcers (bedsores)
  • Blood clots
  • Pneumonia
  • Urinary tract infections (UTIs)

While we could easily say that these health problems can be avoided by not spending less time in bed, we must also acknowledge that getting out of one’s bed and engaging in physical activity doesn’t come easy for some hospital patients.

Why Some Hospital Patients Are Bedridden

All hospitals are acutely aware of the issues that stem from allowing patients to stay in bed too long. But not all of them have a safe patient handling program that makes it easy for patients with neurological conditions, infections, and vitamin deficiencies, all of which can cause muscle weakness, to get out of bed when they want to or even have to for medical reasons. The same can be said of many other health problems as well.

What Hospitals Are Doing to Promote Early Patient Mobility

To promote early patient mobility and, as a byproduct of doing so, minimize the risk of many health problems correlated with being bedridden for too long, a lot of hospitals employ safe patient handling programs to ambulate patients.  These programs consist of trained medical teams and assistive mobility devices that help get patients moving.  And this could mean lifting, repositioning, or transferring them from one department to another.  Likewise, it could mean getting them out of bed to exercise so they can avoid many of the health problems mentioned earlier in this article.  And it does not end there; several evidence based studies show the combination of highly trained medical teams and assistive mobility devices can also offer the following benefits to long-term hospital patients:

  • Improved cardiac function
  • Improved muscle mass
  • Improved respiratory function
  • Minimizing the risk of delirium commonly associated with being bedridden

Why Many Hospitals Are Choosing the SPH Medical Rowalker

Safe Patient Mobility with SPH Medical RoWalker

There are many devices that hospitals can use to ambulate patients, but many are choosing to go with the SPH Medical Rowalker.  Along with getting patients up and moving, these devices can carry just about everything they might need while in a hospital.  Also referred to as an ambulation device or a platform walker, the SPH Medical Rowalker is capable of carrying the following:

  • An oxygen tank
  • An IV pole
  • A cardiac monitor
  • A portable ventilator

Early Patient Mobility, The Bottom Line

Because they help patients stand, walk, and feel a little more independent, it is easy to see why many hospitals have made the Rowalker by SPH Medical their ambulation device of choice. Of course, the ability of these devices to lower a patient’s chances of developing blood clots, UTIs, pneumonia, and much more is just icing on the proverbial cake. To learn more about the Rowalker by SPH Medical, consider speaking with one of our associates today.

CategoriesPatient Handling

A Nurses Story About Safe Patient Handling

by sphmedicaladmin

You went into nursing because you wanted to help people feel better and become healthy. You knew you’d need to take care of yourself to keep up with all the running around, standing, bending, stretching, lifting, and general patient care. You also knew that providing face-to-face, hands-on, eye-to-eye care was a calling of the soul, not just a career. No robotic technology can ever replace the human touch and ability to provide hands on patient care, this includes safe patient handling practices. Personal interaction gives reassurance, hope, warmth, and a feeling of safety. Numerous studies celebrate the benefits of feel-good endorphins relieving pain and promoting healing.

Early in their professional training, nurses and aides learn about the hazards of immobility: the physical and emotional dangers of staying in the same position for long periods of time. Movement during and after recovery is life-saving for patients. Another part of training is the necessity for aides and nurses to use good body mechanics to protect their own bodies. Bad backs end careers. Poor lifting techniques result in back injuries, but so does the accumulation of micro-injuries repeated over time. Instructors emphasize the necessity of prioritizing safety by getting help instead of trying to perform a risky task alone.

In the real world, though, new nurses and aides were in for a shock as they encountered the reality of working in the healthcare field.  In the past, tight budgets usually opted for physical labor over technology. As a new nurse, you didn’t realize how much manual lifting, limb holding, pushing, and pulling was required to perform general patient care tasks all day long. While working on the Medical floor, I cared for 5 patients that required boosting, turning, assistance out of bed, ambulation assistance, toilet transfers, dressing changes, linen changes, limb holding and more. These were all manual tasks that took their toll on my back, neck and shoulders. Even when we had help from a second nurse, one person seemed to be doing more of the work. Even with two people it wasn’t safe.

How do patients feel when they call for assistance but end up waiting long periods of time before anybody comes? How is it lying in cold urine until a lone staff member limps in, unable to find an available second helper? Statistics reveal that a major cause of falls in medical settings is patients trying to get up instead of waiting for help. Nurses and aides alike will agree that one of the things patients overwhelmingly want most is assistance getting comfortable or going to the bathroom. Sadly, patients often confess feeling guilty calling for help from their exhausted aides and nurses, confiding that they don’t want to be a burden, either emotionally or physically. And they don’t have to!

Innovative biomedical engineers have designed wonderful products that make life better for people with illnesses and disabilities. Considering the miracles that modern technology has achieved, nurses, aides, and patients benefit in the following ways when using the RoWalker for early Mobility, MiniLift200 for sit to stand transfers, the breathable repositioning sheet for boosting and turning, the EPD for help during epidurals and spinal blocks, and the SPH Medical Air Assisted Transfer System because lateral transfers and boosting occurs everywhere:

  • Improved patient mobility
  • Reduced Risk of falls
  • Improvement in strength and endurance
  • Reduction in delirium
  • Reduced risk of injury to hospital staff
  • Reduced friction on patients skin
  • Improved staff morale
  • Nursing retention and career longevity

Facilities such as hospitals, surgery centers, extended care facilities, rehab centers, day centers, and private homes also benefit.

Repositioning injuries from pulling patients up in bed or readjusting their joint alignment with pillows is common in nursing staff.  This boosting task is also one of the most frequent causes of injury to nurses.  The Lateral Transfer, that is helping with a patient move from the bed to a wheelchair, recliner, or stretcher, is often the riskiest because the patient’s full weight is involved.  Patients often move and shift during repositioning and lateral transfers. Newton’s Second Law of Motion (describing a force to equal to mass plus velocity over time) translates to Nursing Injury, staff reduction, compromise in patient care, and increased hospital costs.  Gait belts and draw sheets we thought were better than nothing but they can transmit infection, disturb wound dressings, and cause pinching and abrasion of delicate skin.  There are safer methods now to lift, move, transfer, hold, and ambulate patients using modern safe patient handling techniques that are simple and easy to use.

Not only can they save staff members time and energy, but they inspire patient confidence in medical facilities. Investing in equipment that protects staff and benefits patients offers a proven Return On Investment because it proves to staff and patients alike corporation recognizes and values their work, safety, and cares about their welfare.  Patients also see how the administration functions as a team instead of driving their workforce to exhaustion.

Assistive devices to aid in lateral transfers such as the SPH Medical Air Mat have the ability to save hospitals hundreds of thousands of dollars in direct medical expenses not to mention the indirect cost of staff injuries that are estimated to be three to ten times the cost of direct medical expenses.

This nurse for one is thankful that modern Safe Patient Handling has arrived.  I just wish it was here 30 years ago! I left the workforce with a severe back injury coupled with damaged shoulders and too many strains and sprains to count. Please investigate the appropriate assistive devices for your healthcare environment by consulting the experts at SPH Medical. I know they would be happy to help.

SPH Medical Repositioning Transfers and Ambulation
CategoriesPatient Handling

Safe Patient Mobility Today

by sphmedicaladmin

Today, Safe Patient Mobility means something different to every department in the hospital. But in general it means that we need to understand how patients move and how to safely handle them based upon their functional abilities. An important component is choosing the right assistive solution for each patient. There are a couple of tools now available that help assess a patient’s functional ability and then translate the results of that assessment to an assistive device recommendation. The first validated functional assessment tool of this kind for safe patient handling is the BMAT. We’ll go into greater detail about the history of the BMAT in another article but suffice it to say that nurses need to select use the right assistive tool based upon their functional ability to then mobilize our patients safely while maximizing the patients’ ability to move! The BMAT helps define the right tool. This article will focus on one of the highest frequency tasks that we see in hospitals today where a patient is totally dependent upon the hospital staff to be moved either up in bed or over to another surface laterally.

Mobility Solutions Matched to BMAT mobility levels

Safe Patient Mobility for Lateral Movement

A significant obstacle to providing therapeutic and safe environments of care is the practice handling patients manually. Sliding, lifting, positioning, and transferring patients without using assistive technology remains common in healthcare facilities. Notwithstanding, it is an unsafe practice for both patients and caregivers. Manual handling places caregivers at significant risk for nursing injury.

Scholars have established that more than eighty percent of caregivers’ work-related injuries result from a lack of safer ways to move or lift patients manually.

The increasing rate of morbidly obese, sicker, and predictable bariatric surgery patients that need to be moved around for multiple caregiving tasks amplifies the level of stress placed on caregivers’ bodies. It calls for some little imagination to understand that the nursing injury impacts organizational and staffing costs associated with workers’ compensation, lost time, and, most importantly, the quality of care. At the same time, manual patient handling increases the risk of pain, repositioning injury, and adverse health outcomes.

Risk Of Injury

According to research, of all professional groups, healthcare has the most significant number of work-related injuries. Globally, 50 to 60 percent of healthcare professionals are suffering from muscular-skeletal disorders. Repositioning, lateral transfer and movement are the most cited patient handling tasks in clinical facilities, and if performed manually, they endanger both patient and staff health. The air-assisted transfer system, such as the SPH Medical Air Transfer System, presents a practical approach to mitigating repositioning injury risks and physical effort related to the performance of transfers while reducing healthcare costs and work-related injuries. It allows the release of low-pressure air via the perforated chambers within its transfer mattress. The system creates a thin air cushion under an inflated mattress to lower friction and protect the patient’s skin, leading to improved care and injury risk reduction.

Reposition Turn and Transfer with the SPH Medical Air Transfer System

Cost Implications

According to International Labor Organization (ILO), the economic impact of not investing in health and worker safety is approximately equal to the collective gross domestic product of the one hundred and thirty poorest nations globally. The organization revealed that 2.78 million workers die annually due to occupational illnesses and injuries. An estimated 2.4 million of these deaths are associated with work-related illnesses. The annual aggregate cost of these injuries, diseases, and deaths is $2.99 trillion or approximately 4% of global GDP. There is a worldwide recognition that some OSHA challenges require global solutions.

Legislation

The HGRC Specialty Subcommittee on Patient Movement has studied the application of patient movement and handling equipment within health facilities. In sharing its expertise and research, ILO shockingly established a lack of information and knowledge on the issue and a growing recognition among regulatory agencies and the healthcare industry of the need to address this concern. The healthcare industry, nurses labor unions, nurses’ associations, state and federal regulators, and state legislatures have argued in favor of the capital costs associated with bills mandating minimal lift policies and the adoption of Air Transfer Systems to mitigate caregiver injuries.

Several states have enacted patient handling resolutions or legislation. Moreover, Washington and Minnesota have committed funds for loan or grant programs to help acquire these devices. American Nurses Association (ANA) standards on Safe Patient Handling and Mobility (SPHM) recommend that healthcare facilities focus on establishing a culture of safety, adopting and implementing the SPHM program, and installing and maintaining SPHM technology. Similarly, the Association of periOperative Registered Nurses (AORN) and Occupational Safety and Health Administration (OSHA) also recommends the use of lateral sliding to aid lateral transfer to support patient movement and repositioning.

Benefits

The benefits accrued from the Air Transfer devices include the following:

  • They enhance the quality of life for both caregivers and patients and better patient outcomes.SPH Medical Air Transfer Mat Single Patient Use
  • There are multiple economic benefits that are enormous, especially those associated with cost implications for direct medical expenses incurred due to injury, lost time, and workers’ compensation.
  • They address the top two high risk tasks that cause injury to nurses, repositioning and lateral transfers.
  • They assist in the transfer of patients with exceedingly less exertion, keeping patients well-positioned and comfortable.
  • The Single Patient Use design of the Air Transfer Mattress supports the hospitals infection prevention program and significantly reduces the risk of cross-contaminating other patients or surfaces with deadly pathogens.
  • The SPH Medical Air Transfer System addresses all lateral transfer needs in Surgery, ICU, Medical floors, imaging and in Labor and Delivery units.
  • Air Transfer Systems also assist transport staff and all departments to promote workplace efficiency by improving patient throughput while reducing risk of injury.

Integrating air-powered transfer and positioning solutions will benefit staff, patients, and the entire industry through improving efficiencies, reducing costs, and will fundamentally improve patient satisfaction and care.

Contact SPH Medical to discuss implementing evidence based safe patient mobility solutions in your facility or department.

Early Patient Mobility improves outcomes
Categoriesearly mobility

Safety Platform Walkers

by sphmedicaladmin

A Practical Solution for Early Mobility in the Acute Care Setting

By Amber Perez MHA, CSPHP

 

The benefits of early and progressive mobility programs are well-established in the acute care setting. Greater than a decade of published research validates the positive patient outcomes associated with implementing an early mobility (ICU-Based) and progressive mobility (acute care inpatient) program as an essential part of the patients plan of care. Marra and Ely of Vanderbilt University published the groundbreaking research establishing an intensive care patient protocol the ABCDE (now the ABCDEFG) method for reducing the risk of Delirium in ICU patients.  Delirium, once under-diagnosed and rarely treated, is now recognized as a primary indicator for mortality and identified early in most ICU’s in the United States. Vanderbilt University’s groundbreaking results contributed to drastic improvements in the quality of life and mortality rates of an immeasurable number of patients as a result of widespread adoption of the methods and tools published in the protocol. One of the key components of the ABCDE method is the ‘E’ or Early Mobility intervention. Subsequent research further identifies benefits of mobility (early and progressive) to include reduced risk of hospital acquired pressure injuries, ventilator acquired pneumonias, patient falls, hospital readmissions, and length of stay. In addition, patients experience an improved discharge disposition1.

Hospitals all over the world are prescribing mobility as a standard component of patient care. While mobility programs offer exciting and promising outcomes and quality improvements for patients, it is not without challenges and risk. Without proper planning and integration with a facility Safe Patient Handling & Mobility (SPHM) program, risk for patient handling injury and patient falls risk increase.

In an independent survey of ICU and Hospital nursing leaders – the barriers reported with early mobility protocol implementation include: lack of caregiver resources, increased risk of patient falls, and risk of patient handling injury. In addition, nursing leaders reported greatest concern with “out of bed activities” specifically, “standing and ambulation”. Many leaders reported having advanced ICU beds capable of assisting with many tasks of the early mobility protocols- including, tilt table/ hemodynamic training, sitting, edge of bed, and early weight bearing. The greatest concerns for staff and caregiver safety emerged around patient standing and walking. Of the nursing leaders surveyed, the equipment used to assist in standing and walking patients ranked as most preferred for mobility activities as follows:

  1. ICU/Inpatient Safety Walkers 66%
  2. Ceiling lift with walking sling 24%
  3. Mobile lift with walking sling 8%
  4. Mechanical stand aid with removable footplate 2%

The following are comments captured on the survey related to each category:

ICU/ inpatient Safety walkers:
“Safest option available”, “Fits well in crowded rooms”, “Allows us to walk patients out of the room”, “Staff prefer this option”, “Intuitive, easy to operate”, “O2, IV and devices have a place to go on the walker”

Ceiling lift with walking sling:
“Not all rooms have ceiling lifts”, “Only works well with a XY ceiling track”, “We do not have dedicated walking slings” “Great option if we can find the walking slings” “limited to in room activity”

Mobile lift with walking sling:
“Mobile lifts are too big and bulky in the ICU room” “Cumbersome”, “No place to put O2 or devices”, “Improved safety, prevents falls”

Mechanical stand aid with removable footplate:
“Footplate not removable on our device”, “Not a good option for an unsteady patient”, “no place to put oxygen or IV”

Based on the majority of feedback, utilizing a safety platform walker is the preferred equipment for accessibility, safety, function, and efficiency.

Below is a decision table to help you identify which safety platform walker is right for you.   

  • Walker
  • Features
  • Patient specific recommendations

RoWalker FeaturesMobilize Patients Early and Safely

  • 400lb weight capacity
  • Fixed seats that rotate and flip
  • Directional locking castors
  • Accessory basket
  • O2 tank and IV pole holder
  • Manual height adjustment
  • Width adjustable platform

RoWalker – Patient specific recommendations

  • Ideal for patients able to come to a standing position independently
  • Consider when sling management is a barrier
  • Simple and intuitive
  • Higher weight capacity
  • Conducive to therapy activities
  • Consider for patients with sternal precautions

Rise & Go Platform Walker Features

  • 330lb weight capacity
  • Safety sling with hygiene strap
  • Accessory basket
  • O2 tank and IV pole holder
  • Power stand assist
  • Directional locking castor available
  • Extra-wide adjustable platform
  • Swing away shin pads
  • Splash/water resistant design

Rise & Go Platform Walker – Patient specific recommendations

  • Ideal for deconditioned ICU level early mobility – power stand assist
  • Hygiene strap on sling allows OT’s to work with patient on ADL’s- water resistant design allows bathing therapy sessions with limited water spray
  • Swing away shin pads allow for progression in ambulation
  • Ideal for taller and smaller patients, longest stroke length on actuator
  • Small footprint for easy storage

XL Platform Walker Features

  • 500lb weight capacity
  • Extra wide frame adjustments
  • O2 tank and IV Pole holder
  • Accessory basket
  • Shin pad accessory- removable
  • Extra wide adjustable platform

XL Platform Walker – Patient specific recommendations

  • Ideal for ambulatory bariatric patients
  • Power rise assists with sit to stand
  • Ideal for patients who are not a high fall risk
  • Patients with O2 and IV’s may be useful with therapy.

References:

  1. Winkleman C, Johnson K, Hejal R, et al. Examining the positive effects of exercise in intubated adults in the ICU: a prospective repeated measure clinical study. Intensive Critical Care Nursing. 2012

 

  1. Vollman K. Early progressive mobility: strategies for successful and safe achievement to impact short and long-term outcomes. 

 

  1. Roberts M, Johnson LA, Lalonde TL. Early mobility in the intensive care unit: Standard equipment vs a mobility platform. American Journal of Critical Care.

 

  1. Marra A, Frimpong K, Ely EW. The ABCDEF Implementation Bundle. Korean Journal of Critical Care Medicine (2383-4870). 2016

 

  1. Pottenger BC, Pronovost PJ, Kreif J, et.al. Towards improving hospital workflows; an evaluation of resources to mobilize patients. Journal of Nursing Management. 2019
Early Patient Mobility
CategoriesPatient Handling

Rowalker Nurse Driven Early Mobility

by sphmedicaladmin

A Sustainable Process for Early Patient Mobility with RoWalker

When patients are critically ill, they may require a ventilator to support their breathing as they recover. Especially during the COVID-19 pandemic, ventilator assisted breathing is a standard treatment during the worst phases of the illness. While this treatment is necessary and life-saving, prolonged ventilation can have negative effects on patient outcomes. When medical procedures require sedation, the patient must rest in bed for days at a time. The human body is made to move, so extended periods of being bedridden will weaken the core muscles that sustain patient mobility. This is often referred to as deconditioning. Sedation and bedrest also disrupt the circadian rhythm of waking and sleeping. Patients may suffer from sleep deprivation and delirium after a time. These physical and mental side effects have the practical result of lengthening a patient’s hospital and rehabilitation stay. At hospitals under stress, patient beds are at a premium. When one patient is recovering at the facility, it prevents a new patient from receiving care. Also, a lengthy stay leads to higher medical bills and financial stress for patients and families. This is why team members need to collaborate to develop a nurse driven early mobility protocol.

Developing a Process for Early Patient Mobility

To improve patient outcomes a multi disciplinary approach including Nursing Leadership, Physical Therapy, and respiratory team members need to collaborate to develop a nursing driven early patient mobility protocol. No one wants to rush patients through the recovery process. However, if a patient can come off the ventilator and start moving, it will lead to an improved outcome. Determining if a patient is ready for early mobility takes several steps.

Reduced Sedation

It is difficult to evaluate patients who are deeply sedated. To measure progress, the staff should work to minimize the sedative dose so that it is easier to interrupt sedation. When the patient can handle the reduction safely, staff members can take the next step in evaluation.

Spontaneous Waking and Breathing

During an interruption in sedation, the medical staff can determine if the patient can breathe without assistance. They can also begin to assess the mental state of the patient.

Early Mobility Intervention

When a patient is mentally and physically stable, mobility therapy can begin while in the ICU. This treatment may only involve a few steps, but it is important progress for the patient.

RoWalker: Focusing on Patient and Staff Safety

Improving patient mobility involves a fall risk for patients, and it can create a personal safety risk for nursing staff. Without the right equipment, the patient will depend on a staff member for support. A sudden stumble can lead to strained muscles and other injuries for staff members. A serious fall will be a setback for the critical patient.

The SPH Medical RoWalker provides a sturdy framework with fall prevention in mind. The adjustable settings allow staff members to prepare the device for each patient. A cushioned platform gives the patient a place to support his or her upper body.

Lower body support belts and seating pads prevent patients from falling when tired.

The RoWalker can accommodate the needs of ICU patients. It has integrated features such as a telescoping IV pole, oxygen tank holder and a front-facing basket for cardiac monitors.

Seeking the Best Critical Patient Outcomes

A nurse driven early mobility supportive device like the SPH Medical RoWalker does more than provide an early physical therapy and nursing intervention. It offers a positive experience for the patient. When patients see that they can take a few assisted steps, it gives them a sense of hope for the future. Working with mobility also provides nursing staff with a metric for patient improvement as they extend the distance walked during each session.

The SPH Medical RoWalker combines fall prevention with early mobility intervention. Employing this device with a mobility protocol will decrease the length of hospital stays and increase positive patient outcomes.

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