Safe Patient Handling
Using a Hydraulic Lift
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- » Assisting with Moving a Patient in Bed
- » Assisting with Positioning a Patient in Bed
- » Transferring from a Bed to a Wheelchair Using a Transfer Belt
- » Transferring from a Bed to a Stretcher
- » Performing Passive Range-of-Motion Exercises
- » Applying Elastic Stockings
- » Assisting with Ambulation Using a Gait Belt
- » Using a Sequential Compression Device
- » Using a Hydraulic Lift
Take the Review Test:
Safety
- Verify the working order of the lift; lock wheels before using.
- Determine how many nurses are needed to safely move the patient with the lift. Do not begin move until required number of staff are in position.
- Know the pathological conditions that affect a patient’s body alignment and mobility. Postural abnormalities affect body mechanics.
- Control factors that indirectly affect body mechanics by altering the safety of the environment.
- Know the patient’s range of motion (ROM). Contractures or spasticity limit joint and muscle mobility.
- Determine the patient’s level of sensory perception.
- Remove the patient’s glasses, if he or she wears them, because the swivel bar is close to the patient’s head and could break eyeglasses.
Equipment
(Roll cursor over items to see labels)
Mechanical/Hydraulic lift
Hammock or sling with straps or chains
PrintableDelegation
The skill of using a hydraulic lift can be delegated to nursing assistive personnel (NAP). Be sure to inform NAP of the following:
- Explain what to observe and report back to the nurse, such as dizziness or the patient's ability to assist
- How to assist and supervise the movement of patients who are being transferred for the first time after prolonged bed rest, extensive surgery, critical illness, or spinal cord trauma
- The patient’s mobility restrictions, changes in blood pressure, or sensory alterations that may affect a safe transfer
Preparation
- Assess the patient’s physiological capacity to transfer and the need for special adaptive techniques.
- Assess for the following:
- Muscle strength (legs and upper arms)
- Joint mobility and contracture formation
- Paralysis or paresis (spastic or flaccid)
- Bone continuity (trauma, amputation)
- Assess for the presence of weakness, dizziness, or postural hypotension.
- Assess the patient’s level of endurance, including level of fatigue during activity and vital signs.
- Assess the patient’s proprioceptive function (awareness of posture and changes in equilibrium), including the following:
- Ability to maintain balance while sitting in bed or on the side of the bed
- Tendency to sway to one side or to position himself or herself to one side
- Assess the patient’s sensory status, including adequacy of central and peripheral vision, adequacy of hearing, and presence of peripheral sensation loss.
- Assess the patient for pain (e.g., joint discomfort, muscle spasm), and measure the level of pain using a scale from 0 to 10. Offer a prescribed analgesic 30 to 60 minutes before transfer.
- Assess the patient’s cognitive status, including the following:
- Ability to follow verbal instructions
- Short-term memory
- Recognition of physical deficits and movement limitations
- Assess the patient’s level of motivation, such as eagerness versus unwillingness to be mobile.
- Assess for conditions such as neuromuscular deficits, motor weakness, calcium loss from long bones, cognitive and visual dysfunction, and altered balance.
- Assess for previous modes of transfer (if applicable).
Follow-up
- Monitor the patient’s vital signs. Ask if the patient feels dizzy or fatigued.
- Note the patient’s behavioral response to the transfer.
- Ask if the patient experienced pain during the transfer.
Documentation
- Record the procedure, including pertinent observations such as patient weakness, ability to follow directions, balance, and amount of assistance (muscle strength) required.
- Report the patient’s transfer ability and the amount of assistance needed to the next shift or to other caregivers. Report the patient’s progress or remission to the rehabilitation staff (physical therapist, occupational therapist).
Review Questions
1. When preparing for safe patient transfer using a hydraulic lift, the nurse performs which action first?
Assesses the patient for weakness, dizziness, or postural hypotension
Arranges for at least three healthcare personnel to assist in the transfer- Makes sure the patient agrees to the intervention
- Applies clean gloves
CORRECT. Assessing the patient for weakness, dizziness, or postural hypotension will help ensure the patient's safety.
INCORRECT. Two nurses or NAP can safely transfer a patient with a hydraulic lift. The assistance of three healthcare personnel is not necessary.
INCORRECT. Securing the patient's agreement does not help the nurse prepare for a safe transfer.
INCORRECT. It is not necessary to wear gloves while transferring a patient with a hydraulic lift.
2. Which position is used when applying the sling to transfer a patient from the bed to a chair with a hydraulic lift?
INCORRECT. This is not the position used to transfer a patient with a hydraulic lift.
INCORRECT. This is not the position used to transfer a patient with a hydraulic lift.
CORRECT. The patient is placed in the supine position before he or she is transferred from the bed to a chair with a hydraulic lift.
INCORRECT. This is not the position used to transfer a patient with a hydraulic lift.
3. Which action would decrease a patient’s pain before a transfer with a hydraulic lift?
- Stop the transfer if the patient expresses or displays physical signs of pain.
- Explain the procedure to the patient before beginning the transfer.
- Administer a prescribed analgesic 30 to 60 minutes before the transfer.
- Postpone the transfer if the patient reports having physical pain or anxiety before the transfer.
INCORRECT. This action does not pertain to pain prevention.
INCORRECT. This action does not pertain to pain prevention.
CORRECT. Administering a prescribed analgesic 30 to 60 minutes before the transfer helps prevent unnecessary pain during transfer by allowing time for the medication to take effect before the patient is moved.
INCORRECT. This action does not pertain to pain prevention.
4. What does the nurse do after attaching the hooks to the holes in the sling on a hydraulic lift?
- Lower the head of the bed.
- Remove the patient’s eyeglasses.
- Have the patient cross the arms over the chest.
- Elevate the head of the bed.
INCORRECT. The head of the bed is lowered before the sling is placed under the patient.
INCORRECT. If the patient wears eyeglasses, they are removed before the hooks are attached to the sling.
INCORRECT. The patient's arms are crossed over the chest after the head of the bed is elevated.
CORRECT. The head of the bed is elevated immediately after the hooks are attached to the sling.
5. When using a hydraulic lift to transfer a patient from the bed to a chair, when does the nurse turn off the check valve?
- After the patient crosses the arms over the chest
- After the patient's eyeglasses are removed
- As soon as the patient has been placed in the chair
- When the nurse removes the straps
INCORRECT. At this point, the patient has not yet been moved to the chair, so the nurse does not turn off the check valve at this step.
INCORRECT. At this point, the patient has not yet been moved to the chair, so the nurse does not turn off the check valve at this step.
CORRECT. The nurse turns off the check valve as soon as the patient has been placed in the chair.
INCORRECT. By the time the nurse removes the straps, the check valve already will have been turned off.
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