CNA logoSafe Lifting Techniques Reduce Liability

Home care clients are becoming both sicker and heavier. According to a National Center for Health Statistics report, the average hospital stay in 2010 was 4.8 days, compared with approximately 7.3 days in 1980. These significantly shorter stays mean that home care clients are often more dependent on caregivers to assist them with such tasks as getting in or out of a chair, bathtub or car. At the same time, average body weight is increasing, with 35.7 percent of adults in the U.S. qualifying as obese. As caregivers do more lifting and transferring of more overweight clients, the potential for injury increases. By implementing sound client assessment and safe handling programs, home care companies can reduce injury risk for both employees and clients.

Client Assessment
Upon initial screening, clients should undergo a transfer assessment that includes the following questions, among others:

  • Balance – Does the client have a history of falls or require assistive devices?
  • Mobility – Can the client move about easily, or is his or her range of motion restricted?
  • Medical history – Does the client’s medical history (e.g., brittle bones) indicate any special handling procedures? Should the client be gradually elevated prior to transfer, in order to avoid a drop in blood pressure?
  • Height/weight – Is obesity an issue?
  • Communication/cognition – Is the client able to hear and understand simple requests and instructions?
  • Motivation – Is the client inclined to be cooperative, or is he or she passive or combative?

Upon completion, the results of the screening should be included in the client’s service plan and periodically updated.

Minimizing the Risk
The process of transferring or repositioning clients can result in repetitive bending or exertion of force, as well as excessive and potentially hazardous lifting. Less mobile clients may rely on the caregiver to bear most of their
weight when rising or sitting, increasing the potential for injury to caregiver and client. The following strategies can enhance the safety of both:

Make use of assistive devices or equipment. Lifts, mechanical beds, shower chairs, bedside commodes and other devices–when properly used and maintained–can reduce the potential for client or staff injury. Equipment
should be carefully evaluated and utilized, based upon each client’s individual handling needs.

Implement appropriate transfer procedures. Some procedures are considerably safer than others, with manual lifting of clients deemed the riskiest technique. Home caregivers can obtain a measure of protection for themselves and clients by using walking belts or gait belts, in which the client’s weight is largely supported by the floor, bed, chair or other anchor point. The belts can either be pulled upon or lifted like handles. Of the available methods, the two-person walking belt used with a pulling technique seems to present the lowest risk of injury. Two-person gait belts also present a safer alternative to manual lifting.

Provide comprehensive staff training. No matter which lifting technique is utilized, it must be performed correctly to minimize risk of injury. Train newly hired staff in the proper use of assistive devices and equipment, and provide periodic refresher sessions for all caregivers to evaluate and maintain competence.

Carefully document assessment findings. Clients’ specific handling requirements should be clearly described in written form, made available to their caregivers and updated as needed.

Additional Resources

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