Safe Lifting Policy

Effective Date: [Original NPP Date]
Revised Date: [Current Date]

Purpose and Scope

Safe resident lifting policy is one part of a comprehensive program to prevent musculoskeletal injuries to frontline caregivers, one of our most valuable resources. The policy recommends guidelines to ensure that the transferring needs of all residents are assessed. All healthcare personnel responsible for transferring residents shall be aware and trained on the correct procedures for lifting and moving residents. Adherence to this policy ensures that residents are being lifted and transferred safely while encouraging resident mobility and independence.

Staff Responsibilities

I. Administrator Responsibilities:

1. Supporting the implementation of this policy.
2. Providing training opportunities for all staff affected by the safe-lifting policy.
3. Furnishing sufficient lifting equipment and repositioning aids.
4. Identifying acceptable storage locations for lifting equipment/aids.
5. Providing resources needed for the medical management program and the evaluation of the safe-lifting program.

II. Unit/Nurse Manager, Physical and Occupational Therapy Departments, and Frontline Caregivers Responsibilities:

1. Assessing the transferring needs of each resident and prescribing lifting and transferring method(s) consistent with the resident’s care plan and rehabilitation goals, ability to ambulate, bear weight, and follow verbal instructions. Residents should be reassessed if their condition changes.

III. Unit/Nurse Manager and Supervisors Responsibilities:

1. Ensuring that all staff affected by the policy completes initial and annual training.
2. Ensuring that the transferring needs of residents are assessed and all high-risk resident handling tasks are completed safely using mechanical lifting devices or other appropriate equipment or techniques.
3. Ensuring that mechanical lifting devices, slings, and other equipment are available, maintained in proper working order, and stored conveniently and safely.
4. Ensuring that resident transfers are being performed as prescribed.
5. Maintaining training records.

IV. Nursing Staff and Frontline Caregivers Responsibilities:

1. Being knowledgeable of the procedures to follow when transferring residents.
2. Using proper techniques, mechanical lifting devices, and other approved equipment/aids when performing high-risk resident handling tasks.
3. Notifying the supervisor if a change has occurred in a resident’s condition.
4. Notifying the supervisor if retraining is needed in the use of mechanical lifting devices, other equipment/aids, and lifting/moving techniques.
5. Notifying the supervisor if mechanical devices, slings, or equipment/aids are damaged or in need of repair.
6. Notifying the supervisor of any injury sustained to staff or residents.

V. Maintenance Personnel Responsibilities:

1. Inspecting the resident lifting equipment, slings, and batteries each month.
2. Maintaining lifting devices and other equipment in good working order.
3. Establishing procedures for removing damaged equipment from service.

Resident Assessment

I. The transferring needs of each resident should be assessed, and the most appropriate lifting and transferring method(s) should be prescribed based on the resident’s rehabilitation goals, ability to ambulate, bear weight, and follow verbal instructions. Resident algorithms may be used to assess a resident’s transferring needs and to identify the most appropriate methods to lift and move the resident.

Workplace Assessment

I. The resident care environment should be assessed to examine the layout of resident care rooms, bathrooms, and bathing areas to identify factors that might contribute to resident handling incidents, such as furniture that might interfere with transfers, the adjustability of bed height, the size of the bathrooms and bathing areas, and physical barriers such as thresholds that are not level with the floor that might restrict the movement of lifting equipment.

Training Requirements

I. Training should be provided to all staff affected by the safe resident lifting program; this should include administrators, nursing staff, physical and occupational therapists, maintenance staff, and housekeeping and laundry staff. All nursing staff and caregivers who lift and transfer residents should be trained and made competent in the use of resident lifting equipment and procedures to follow while transferring residents. Training should be provided during employee orientation, and whenever there is a change in job assignment, equipment, or procedures. Refresher training should be conducted annually and upon the request of staff.

Infection Control Considerations

I. All resident lifting equipment, slings, and assistive devices should be cleaned and laundered to comply with infection control procedures and policies. If possible, disposable slings should be used on residents who pose an infection control risk. If reusable slings are used, the residents’ names should be marked on the sling, and the sling should be stored at their bedside. Resident lifting equipment should be cleaned regularly and after each use with a resident who poses an infection control risk.

Equipment Requirements

I. The employer will provide mechanical resident lifts, slings, batteries, and repositioning aids that are made of durable quality and intended for commercial use. The number of lifts required to ensure the safety of residents and caregivers depends on the level of physical dependency of the residents, the number of staff assigned to the unit, and the geographical location of rooms.

Full-Body Lifts:

1. Full-body lifts are intended for residents that cannot bear weight during any resident handling task. If any caregiver is required to lift more than 35 lbs of a resident’s weight or the resident is unpredictable or prone to lose balance, that resident should be considered fully dependent and assistive devices should be used for the transfer. Full-body lifts can be equipped with a weighing scale.
2. Should be able to lift residents from bed height as well as pick a resident up from the floor.
3. Should be stored with slings in a convenient location.
4. Batteries should be charged when the lift is not in use.

Stand-Assist Lifts:

1. Stand-assist lifts are intended for residents with partial weight-bearing ability that require the caregiver to lift no more than 35 lbs of a resident’s weight. The resident should require no more help than stand-by, cueing, or coaxing, and the resident should have the mental capacity to follow simple commands when prompted. The stand-up lift is useful for toileting residents and for bed-to-chair transfers.
2. Should be stored in a convenient location with slings.
3. Batteries should be charged when the lift is not in use.

Slings Used with Mechanical Lifts:

1. Should be available in a range of sizes.
2. Should be stored in a convenient location that is readily accessible to caregivers.
3. Back-up slings should be available for use when slings are being laundered.
4. Should be washable or disposable.
5. Should be laundered on-site if possible; laundering off-site can result in lost slings.

Repositioning Aids:

1. Surface friction-reducing devices, slide sheets, and lateral transferring devices should be available to assist with repositioning residents in bed.
2. Should be made of durable quality.
3. Should be capable of adjusting residents in bed, regardless of resident size.

Medical Management Program

I. If an employee is injured on the job, the employee should report the injury to his/her supervisor immediately. Every injury should be treated promptly and each incident should be investigated so that preventive measures can be implemented.

Record Keeping

I. Training records shall be maintained by the training coordinator. All injury and illness records and incident investigations should be maintained and periodically examined to evaluate the effectiveness of the safe resident lifting program. Periodic analysis of these data will make it possible to identify and understand persistent injury problems and propose countermeasures.

References:

• Centers for Medicare & Medicaid Services. State Operations Manual, Appendix PP - Guidance to Surveyors for Long Term Care Facilities. [Link to current CMS SOM]
• CMS Requirements of Participation for Long-Term Care Facilities. [Link to current guidelines]