Injuries to residents and employees have been, and always will be, a concern within the healthcare industry. Over the past decade, the majority of healthcare facilities have placed significant emphasis on developing resident transfer programs that evaluate the capabilities of residents and determine the best way for the residents to be handled. OSHA even stepped forward a few years ago to present their “Ergonomic Guidelines For Nursing Homes” which included various recommendations regarding resident handling. Companies are spending big bucks to ensure they have the proper resident transfer and repositioning equipment needed to prevent injury and are providing employees with ongoing training.
Why then do resident transfer injuries, mostly to caregivers, continue to be a leading source of injury in healthcare? Due to the varying circumstances that arise during resident transfers, the answer is not cut and dry. In order to find out where employees and residents are “at risk”, resident transfer programs need to be audited much like a fire drill audits a company’s emergency action plan. The resulting process is called a resident transfer drill.
A resident transfer drill simulates a real life situation, using an employee or “extra” as the resident. The situation is set up unannounced and employees are asked to respond accordingly. The drill is documented and used for educational purposes with no negative repercussion. For example, an employee is placed on the floor next to a bed to simulate a fallen resident. The call bell is rung and the responding employees are greeted at the resident door by the drill coordinator. The drill is briefly explained to the employees and they are asked to respond appropriately without assistance from the drill coordinator. Once complete, the drill coordinator debriefs the employees on the results of their actions, explaining both the positive and negative. The drill is used to monitor the overall effectiveness of the resident transfer program, raise safety awareness, and provide the opportunity for retraining where necessary.
Some items to consider when conducting a resident transfer drill include:
§ Was the resident transfer conducted as indicated on the care plan or within the resident transfer program (i.e: 2-person assist, full sling lift, sit-to-stand lift, etc.)?
§ Was there proper communication between the caregivers and the resident prior to the transfer taking place?
§ If the drill involves a fallen resident, is a pre-transfer evaluation conducted by a nurse to ensure that an injury was not sustained during the fall?
§ If the drill involved a fallen resident in a tight area, did the staff properly clear the area for lift access? If this is not possible, did the staff use a slip sheet or draw sheet to safely move the resident to an area where a lift can be used?
§ If a lift is used, is the sling positioned and attached properly?
§ If a lift is used to transfer from the floor, have the lift legs been padded with pillows or other soft items to prevent skin tears where the residents’ legs may need to be temporarily rested?
§ If a lift is used, are the brakes left unlocked to allow the lift to continuously find the center of gravity?
§ If a lift is used, are employees familiar with the lift controls and it’s capabilities?
§ Where manual lifting is conducted, are employees practicing proper body mechanics?
Many companies wait to make changes to their resident transfer programs after accidents and injuries occur. Don’t assume your resident transfer program is operating without flaw. Audit your program using a resident transfer drill. You will be surprised at how much such a simple concept can uncover, all for the better of your employees and residents.
Author: John Kiefner, CSP, ARM