SAFE SYSTEM OF WORK A9. HOISTING July 2019 safety/MHAS-SSW A9 - Am… · Lower the bed, move the hoist into position and lower the spreader bar. Raise the patient from the bed and

Author: P.Jalowiec / R.Anstee / G.Murray Date: July 2019

Job Title: Manual Handling Advisors / Physiotherapist Review Date: July 2021

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SAFE SYSTEM OF WORK - A9. HOISTING

July 2019

Liko- (Viking) – loop system Arjo- (Maxi Move) - clipped system

From the bed

Changing position in bed

From the chair

From the floor

This must be read in conjunction with Introduction to Manual Handling Risk Assessments.

Also includes hoisting an amputee patient (see pg. 8)

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Author: P.Jalowiec / R. Anstee / G.Murray Date: July 2019


POTENTIAL HAZARDS/RISKS

CONTROL MEASURES AND

CONSIDERATIONS

The patient falling to the floor.

Patient being unsuitable for hoisting, such as hip/back problems.

Patient might be frightened or feel unsafe.

The hoist tipping or becoming unstable.

Equipment unsuitable for the patient / move.

Equipment not functioning correctly.

Entrapment of patient’s limbs.

Damage to patient’s skin, or discomfort from hoist.

Musculoskeletal injury to staff when moving hoist and/, or positioning patient.

Hoist failure if battery or hoist not properly maintained.

Use of disposable sling in water or damaged sling will render it unfit.

Ensure you are trained /familiar with the hoist and competent in hoisting.

Check that the hoist is working before taking hoist to patient.

Ensure the patient agrees to being hoisted.

Assess the patient for appropriate size sling.

Ensure the brakes are OFF before hoisting.

Ensure that the patient’s weight is less than the SWL of the hoist.

Ensure adequate sling assessment and inspection & suitable SWL.

Ensure that the battery is charged and there is always a spare battery ready charged.

When Liko hoist not in use always keep plugged in to the socked for charging.

Minimum two handlers are required for using mobile hoists.

Parked hoists should be left with brakes ON.

Use a slide sheet to reduce friction on patient’s back, legs and heels.

Always check the hoist in date re: service

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Patient hoist slings –clipped system

Slings in use must be in good condition and the following basic checks should be

made prior to any use. These include:

• Assessment of need must be documented in patient care plan to include

specific sling details required ( size, swl etc.)

• Ensure sling is compatible with person and hoist

• All labels are legible showing SWL

• Fit for purpose – in good condition (no fraying or tears, not worn and stitching

intact)

• Buckles / clips are in good condition and connect securely to the relevant

spreader bar designed for use

The Select Pro-Lock Disposable Slings come in x-small, small, medium and large sizes.

Choose the sling size which most closely matches the patient size. Remove it from its packaging and unfold it. Check that the sling has a label and that the safe working load is visible. Check that the sling is not damaged and that it is safe to use.

Measurement of the size sling – clipped system: Slings can be measured with the patient either lying supine, lateral, prone or sitting.

Fold the sling in half from the top of the toileting aperture to the top of the head support.

Offer the folded sling to the patients back, so that the top of the toileting aperture is aligned with the base of the patient’s coccyx.

The patient head should be positioned within the slings head support. If the head is not within the head support a different size of sling should be used.

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Once the sling straps have been placed under the patients thighs, feed one leg strap of the sling through the black loop on the other leg strap as per photo below (this ensures dignity for the patient when hoisted and must be carried out before hoisting.)

Attach the clip onto the sling hoist bar and lock the clip onto the bar with the red tab by pushing it down the tab must be put into the lock position before hoisting any patients as per photo below.

After hoisting is completed unlock the red tab by pulling it up and remove the clip from the hoist and sling from the patient. In the unlikely event that a patients size falls exactly between two sizes it is recommended that the smaller of the two sizes is used

Disposable slings cannot be used in water - patients should therefore not be bathed using these slings.

Amputee slings are available as bilateral disposable clip system (compatible with Arjo hoists- from Select Health Care.) Measured in the same way as above.

Slings can be measured with the patient either lying supine, lateral, prone or sitting.

Fold the sling in half from the top of the toileting aperture to the top of the head support as per photo below.

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Liko Disposable slings – loop system

Disposable slings from Liko come in medium slim (30-50kg), medium (40-80kg), large (70-120kg) extra-large 110kg plus (all of them loop system). Assess the width, by measuring across the back of the patient from hip to hip, and always consider the weight of the patient, body shape etc.

If a patient is between two sizes, use the smaller size to reduce the risk of the patient falling through.

Check that the sling is not damaged, and replaces any damaged, wet or soiled slings.

Slide sheets can be used to help position the sling down the patient’s back, and under their legs. The slide sheet must be removed before hoisting.

Ensure that the sling shoulder straps are level with the patient’s shoulders, and that the sling base is at coccyx level.

Connect the leg loops ( make sure the loops are crossed over), and then the shoulder loops, to reduce the risk of the patient falling from seated positions, the leg straps need to interweave

After hoisting, remove the hoist sling to reduce pressure damage.

Write the patient’s name, hospital number or date of birth on the sling label to avoid using the wrong sling.

Always ensure that the sling stays with the patient, including any visits to other departments.

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SAFE SYSTEMS OF WORK

Hoist safety checks:

Hoisting equipment must be in full working order prior to use thus the following basic checks should be undertaken relevant to type of device being used. These include:

• Safe working load (SWL) clearly displayed and not exceeded

• Battery fully charged and correctly installed

• All leads safely/correctly connected for operation and avoidance of trip hazard

• No fluid leaks

• No signs of damage

• Service label clearly displayed and in date according to LOLER 1998 (i.e. carried

out every 6 months) and correct coloured LOLER tag

• Raise and lower mechanism fully functioning throughout its range

• Castors move freely

• Emergency stop button is correctly set

Each Technique must be read in conjunction with the information on hoist slings.

Hoisting from the bed

TECHNIQUE

ASK/GUIDE

Wherever possible, ask the patient for assistance with inserting the sling and operating the controls.

ASSIST

Raise the bed to waist / hip height of shortest handler.

Roll the patient from side to side to insert the sling or, if the patient is sitting up in bed, ask / facilitate them to sit forward and place the sling behind their back. Position the sling under the legs.

Lower the bed, move the hoist into position and lower the spreader bar.

Raise the patient from the bed and position the hoist over chair, commode, wheelchair etc, using the spreader bar. Do not manually force electric spreader

Always ensure that using the correct hoist system. ( Arjo-click system, Liko-loop system ).

Always get a correct / compatible sling system to the hoist.

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bars.

Hoisting from the chair

TECHNIQUE

ASK/GUIDE

Wherever possible, ask the patient for assistance with inserting the sling and operating the controls.

ASSIST

Insert the sling down the patient’s back.

Move the hoist into position and lower the spreader bar.

The patient can either be repositioned in the chair or transferred to bed / commode / wheelchair.

To position back in bed, lower the bed and ensure the spreader bar is moved to the correct position.

Hoisting from the floor

TECHNIQUE

Before hoisting from the floor, assess if the patient has any injuries. If in any doubt, seek medical assistance before attempting to move the patient.

It is not advisable to hoist patients in an emergency, due to the hazards of rushing the manoeuvre. Any life-saving interventions should take place on the floor, and the patient hoisted when stable. If the patient needs to be hoisted flat, a stretcher attachment can be used; or a cervical collar can help maintain the airway.

ASK/GUIDE

Wherever possible, ask the patient for assistance with inserting the sling.

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ASSIST

Roll the patient from side to side to insert sling.

Apply the sling under the patient as described above.

Once the sling is in place, move the hoist into position by asking / facilitating the patient to bend their knees, extend the legs of the hoist to maximum width and manoeuvre the hoist around the patient at an angle with one hoist leg placed under the patient’s knees while the other extends towards the patient’s head.

Raise the patient on to a bed or chair.

HOISTING AN AMPUTEE PATIENT

Please follow the above safe system of work for hoisting, as well as the following for hoisting amputee patients.

For all above -knee amputees and bilateral amputee patients (including bilateral below-knee) – an amputee hoist sling must be used.

Amputee Hoist Slings – clipped system compatible with Arjo Maxi move patient hoist

Disposable amputee hoist slings are available for the Arjo (clip system) hoist.

The Select Pro-Lock Disposable amputee hoist slings come in small, medium, and large sizes.

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Amputee Slings for Arjo maxi move patient hoist can be ordered via materials management using the following codes;

Pro Lock Small – Code: FER13766 (Box of 10)

Pro Lock Medium – Code: FER13767 (Box of 10)

Pro Lock Large – Code: FER13768 (Box of 10)

Liko patient hoist – loop system

Amputee slings for the Liko hoist are reusable and washable; there is not currently a disposable Liko sling option.

Please ensure service tag is clearly displayed and in date according to LOLER 1998 (i.e. carried out every 6 months)

For out of hours or emergencies, there is a central stock of the select pro-lock

disposable amputee hoist slings kept on AMU (small and medium sizes). These will be

kept on a labelled shelf in the AMU store room, please ask a member of staff for the store

room key. If you require one of these slings please send a staff member of the ward team

to AMU to get one. Then please let Gail Murray know which size has been used and by

which ward, by emailing: [email protected]. This will ensure that stock is

maintained.

There is also a small Liko amputee hoist sling kept in the store room on AMU. This is not

disposable, so in the event of needing to hoist an amputee patient on a ward with a Liko

hoist, the Liko amputee sling can be used from the AMU store room. If this is borrowed,

please return the sling to Manual Handling after use (Ext. 6805) so that laundering can be

arranged. This sling must not be sent to the main laundry. If a different sling size is

required, it may be necessary to use a select pro-lock disposable amputee sling, and

borrow an Arjo hoist from another ward. This is for an emergency situation only.

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The Select Pro-Lock disposable

amputee sling –Clipped system

Measuring this sling can be done in a sitting or lying position by measuring from the top of head to the base of the spine / hip. The lower measurement should be from the black seam on the hoist sling, and not from the yellow tape at the bottom of the sling. See in pictures below

The amputee hoist sling will cover further

round under the patient, to ensure the

patient does not slip through the sling.

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Liko washable/ fabric amputee loop hoist sling

Please follow the link below for full manufacturer instructions on how to use this amputee

sling;

http://www.liko.com/Documents/na/Lift_slings/AmputeeSling_70,75/AmputeeSling_InstrG_EN.pdf

http://www.liko.com/Documents/na/Lift_slings/AmputeeSling_70,75/AmputeeSling_InstrG_EN.pdf

Author: P.Jalowiec / R.Anstee / G. Date: July 2019

Job Title: Manual Handling Advisors /Physiotherpist Review Date: July 2021

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