KEYNOTE PRESENTATION
From Patient Handling to Patient Safety
Keynote Speaker:
Professor Mike Fray, PhD, BSc (Hons), BHSc, FHEA.
Professor of Ergonomics and Assisted Performance
For many years in supporting the use of ergonomics and human factors tools and methods to improve the safety and effectiveness of patient handling methods there was always the challenge of how we can gain traction with the patient safety sector. This presentation will explore a career in patient handling and how recent developments have shown that there are opportunities to make improvements by engaging in the wide range of skills developed in systems thinking, human factors and safety science. The timeline history will cover the volume of evidence that supports assistive devices for patient transfers and assisted mobility and explore with some interactive sessions how systems thinking can inform patient handling how the person by the bedside completing the transfer is rarely the reason for why things go wrong in heath and community care.
The session will describe the development and the delivery of the world leading national project for Patient Safety Specialists in the area for NHS England. The information will cover the breadth of the skill sets provided in the learning syllabus and explain how these might be applicable to the field of patient handling safety. These safety-based approaches can assist with reactive and proactive risk management scenarios.
During the session we will engage with the SEIPS models (Carayon et al 2016) and look at an acci-map enquiry, for a well-known patient handling error. The aim of the session will be to raise the awareness of systems solutions for patient handling problems.
PLENARY SESSIONS
Taking a different look at assistive technology.
Professor Mike Fray, PhD, BSc (Hons), BHSc, FHEA.
For the duration of UK legislation controlling manual handling activities in all workspaces the development of assistive devices has been firmly held in the hands of the manufacturers. This stifles the development of innovative solutions due to the financial restrictions of disruption in the marketplace and of course their balance sheet.
This session sets out an ergonomics-based approach to the design of assistive technology based on the replacement of functional deficit rather than technical adaptation. The session will go on to summarize a number of studies recently completed within Loughborough University and the EHF team.
Low beds have become much more prevalent over recent years. Worldwide there is a focus on the reduction in the number of falls from beds and in early mobility. The supply of ‘ultra-low’ beds is a response. This study explores two studies that create better understandings for how people fall and why the environment is so critical. Finally, it explores the preferred height for getting out of bed with minimal effort.
We have seen powered options for raising the full weight of people for the purpose of transfers. There has been almost no research in the provision of powered devices to move a loaded hoist form one location to another, toilet to bed, bed to chair or bathroom. This study reported the benefits of both powered drive and powered positioning in the requirements to reduce the musculoskeletal load on care staff.
One area that internationally has not moved into powered solutions is sit to stand assistance. Many of the products that are in circulation are described as active standers. This study compared a range of sit to stand devices by collection joint position, pressure on the knee, ground reaction force, and e.m.g. to measure muscle activity across the full range of sitting to standing
Creating Accessible Healthcare Environments: A Systems Approach to Bariatric Care
Associate Professor Caz Hales PhD, BNurs (Hons), RN.
Healthcare settings must evolve to provide equitable, dignified care for patients of all body sizes. This requires shifting from individual-focused approaches to examining how healthcare systems can remove barriers to care. Creating accessible environments demands a comprehensive strategy that addresses physical infrastructure, provider competency, and institutional policies.
This interactive presentation will:
1.Review emerging clinical obesity definitions and diagnostic criteria shaping bariatric service delivery
2.Analyse current service models and care practices through an accessibility lens
3.Present innovative system-level solutions for delivering equitable, effective care for diverse patient populations
By examining these key areas together during the session, we can work toward healthcare spaces that truly serve all 3.patients with dignity and respect.
WORKSHOPS
Practical Workshop: Rolling patients – is it that easy?
A 90-minute workshop with 3 work stations looking at techniques to roll patients in bed AND optimise patient/carer comfort, dignity and safety.
Billie Lai – a Moving & Handling Educator at Waitemata Health since 2008.
Julie Slatter – a Moving and Handling Educator at Waitemata Health since 2015
Jeanette Henderson – a Moving and Handling Educator at Waitemata since 2008.
Frequent turning and positioning is essential for dependent patients to reduce the risks of immobility and de-conditioning. It is often challenging for caregivers to manage these tasks and requires significant caregiver numbers, time and physical effort. Turning or rolling patients may be seen as a routine activity.
However further thought into the setup, equipment and other factors that impact the activity (including considering the surface they are on) will improve the patient experience and satisfaction and likely reduce the risk for the caregivers.
Better planning around turning and repositioning can optimise the effectiveness of these activities and may reduce the caregiver numbers required to perform the activity safely. Consideration of the surface the patient is on and the environment they are in is an essential part of that planning.
This interactive workshop will demonstrate three different ways of rolling patients using technique and technology to really ensure maximum comfort and optimal outcomes. Each workstation will have a brief patient moving and handling scenario and a solution for it. You will have the opportunity to try that solution out as time, and numbers, allow. Any questions that can’t be answered on the day will be recorded and we will try to answer afterwards. Using real life patient stories and outcomes reinforces the belief that moving and handling risk assessment must be individualised and holistic. Every situation is different and the broader your knowledge of possible solutions, the more likely you are to find the best one for your patient (and team).
Practical Workshop: Making the most of your Maxi-transfer sheet
Nick Harmon & Shajeeda Tinielu
This interactive workshop will give participants the opportunity to experience and experiment with Maxi-transfer sheets.
This interactive workshop will give participants the opportunity to experience and experiment with Maxi-transfer sheets.
Caring for dependent patients regardless of their body habitus can be a challenge when there are the additional attachments or patients with multiple and complex needs such as those in ICU and high dependency wards.
Nick will share the many ways the Maxi transfer sheet can be used for repositioning, transfers and supporting patients for chest xrays. Nick brings his experiences with this type of sling in ICU to share with participants. He will demonstrate how the maxi transfer sheet can be combined with air assist mats to facilitate turning patients of larger size.
Nick and Shajeeda will support participants to try out these techniques for themselves.
Practical Workshop: Experience walking slings and amputee slings
Eleanor Barrett
This interactive workshop aims to support participants to experience walking slings as an aid to early supported mobility. Walking slings can help reduce the perception of fear of falling in adults of larger size when starting their rehabilitation journey. Having the opportunity to feel the level of support and changes to a persons mobility in these slings can enable staff to consider how these can be utilised in their work areas. Amputee slings can pose a challenge in terms of how to fit these to patients and while we may not necessarily have any amputees in the audience, participants can observe then practice using these. Attendees will have the opportunity to try fitting these slings and being hoisted in different types of slings to feel the differences. Eleanor will share what the Wellington based team has learnt when using these types of slings.
A Pilot for a Weekly Moving and Handling Ward Round in a Healthcare Facility
Anne McMahon and Mary Gill
Following the successful creation and implementation of a weekly ward round, Anne and Mary are keen to share the Waitematā M&H team journey to achieve this.
The presentation will cover why they thought it was a good idea!
The method used, the results and finishing with possible implications for future practise. There will be time for questions at the end of the presentation.
The documents created for the Ward round can be made available, upon individual request, following the seminar day.
A Paediatric Lens on a Moving and Handling Programme Component
Sarah Utting
Following the successful creation and implementation of a paediatric version of the moving and handling update module at Waitematā District.
Sarah will share the journey that has led to its creation. This will include the literature around paediatric moving and handling, what has been taught and how the module is now being run at Waitematā District.
A practical session will then be given to show how to transfer a child off the floor and clinical discussion around transferring in and out of car seats/standing frames. There will be time for questions at the end of the session.
Air Assisted Falls Retrieval at Te Toka Tumai
Following a patient fall where the patient is unable to assist themselves, the safe retrieval from the floor back to bed, is essential for both the patient and their carers.
This workshop will demonstrate the safe retrieval of a fallen patient from the floor and then back to bed using air assisted equipment.
Craig will discuss the importance of access for this equipment and his journey in achieving the supply of falls retrieval bundles.
Working in Isolation
Appropriate & comprehensive risk assessment is the single biggest influencing factor in safe moving & handling activities. But what if we are working in an area where there are no other people we can call on immediately? Or maybe we are working in someone’s home, or another community setting where additional support is not readily available, and our environment is less than ideal?
The objective of this session is to discuss how we can comprehensively risk assess to protect ourselves and our patients/clients and look at options for safe moving & handling activities in areas where we are working in isolation.
Mobilizing the Bariatric Patient
Nathan Carney and Fletcher Suckling
Explore safe and effective ways to help caregivers help patients of size get back to their feet and care for them on a day to day basis. By combining world leading equipment with Active Healthcare’s 25 years’ experience we bring you practical solutions that really work.
USL Medical Workshop – The Compella Bariatric Bed
Ernest Nel
Understanding the differences a bed can make to Bariatric Nursing and Patient Care. Understanding the options with:
• Mobility
• Patient turning without the requirement of nursing staff to manually do this,
• Pressure care
• Transport
Therapeutic Seating to Reduce Moving & Handling and Falls
Jacinta Maurin
Enhanced Clinical seating plays an important role across a wide range of settings: the acute ward, rehab, aged care, and even the family home.
This presentation outlines the 24-hour postural care approach to care. In this session we will explore a number of service provision opportunities to improve quality of life for residents in health and aged care sectors, while reducing the overall cost of care and potential for carer and patient injury.
Falls prevention and retrieval:the tools to enable best practice
Garry Stanners, Arne Moxham, Ashley Currie, Rick Clare
Join us for an interactive session as we delve into the topic of falls prevention and explore the latest technology designed to reduce the number of falls and create a safer environment for those in your care.
Together we’ll take a trip down memory lane and see how the approach to designing equipment has evolved from harm mitigation focus, which has some unintended consequences versus a more holistic prevention approach.
Through practical demonstrations of each piece of equipment,you will gain a better understanding of each approach and why the latest cutting-edge technology is considered best practice.
We will also display a new range of products designed to safely lift people who have fallen, including an app that helps guide decision making on whether it is safe to lift the fallen person.
You’ll get the opportunity to try the solutions for yourself and ask any questions during a live Q&A session.
Testing VR for bariatric patient care training
Caz Hales
Have you wondered what it might be like to be in the patients position with others talking round you?
Have you thought about how to fit all the necessary equipment for a person of larger size into a bed space?
We would like to introduce you to the first ever VR bariatric patient care training experience. We have reached the point that our VR prototype is ready for testing by people working in health services and seek your feedback to help further shape this new programme.
Background
Victoria University of Wellington in partnership with CCHV DHB, Wellington Free Ambulance, and Whitireia Polytechnic successfully applied for a research grant. The aim of this collaboration is to explore using Virtual Reality (VR) technology to create an educational and training platform that addresses patient size, equipment choice, spatial considerations, weight-bias, cultural values, and empathy.One of the goals of this collaboration is to design and develop a conceptual prototype of bariatric specific education VR environments.
Caring for patients with extreme obesity poses many healthcare and service provision challenges for health professionals and providers in Aotearoa New Zealand. Care facilities and equipment are often unsuitable or limited, and staff experience injuries when moving and handling patients of larger size who have identified ‘weight’ as a contributing factor to preventable harm. These physical care challenges, in conjunction with health professionals’ weight-bias towards larger bodies, adversely impact healthcare interactions and quality of care. Extreme obesity is a serious health issue, and Māori, and Pacific Peoples are disproportionately affected in a healthcare system that is often inherently discriminating and structurally marginalising.
Virtual reality (VR) simulated environments have been successfully deployed in health and safety training in industrial settings and, more recently, in healthcare as part of the COVID-19 response e.g. swab testing and handling. VR training environments can simulate existing settings and equipment and inform requirements and opportunities for future designs. In this respect, VR provides a cost-effective test bed where multiple variables and scenarios can be developed and customised for the bariatric training of healthcare practitioners. Further, the use of VR in healthcare is becoming more established with several successful applications both globally, and within Aotearoa New Zealand.