3. manual handling - cornwall council · 3. manual handling ... manual handling operations...

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3. Manual Handling

Equipment in this section:

3.1 Slide Sheets

3.2 One Way Glide Sheets

3.3 ‘Satin Type’ Sheet Systems

3.4 Bed management Systems

3.5 Transfer board

3.6 Handling belt

3.7 Patient turner

3.8 Stand Aid

3.19 Hoist powered

3.10 Slings

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General considerations:

All prescribers for manual handling equipment must have completed mandatory manual handling training to an appropriate level and attended mandatory updates. Regulation of mandatory updates vary slightly across agencies, prescribers need to comply with their employing agency and professional body.

All prescribers of manual handling equipment must complete tissue viability training to an appropriate level.

All prescribers must refer to manufactures guidance and advice regarding the use and maintenance of the equipment.

Additional advice on manual handling can be obtained from manual handling advisors in your respective agencies.

Risk assessment and prescriptions forms must be completed as part of your assessment for all manual handling equipment.

Prescribers should refer to the Tissue Viability pathway and seek further advice from the Tissue Viability services when in doubt

Weight limits of equipment apply

Consider user environments- space and hazards to person and carers

Prescribers must work within legal and organisational frameworks

Single use due to risk of cross contamination

Maintenance- prescribers/delivers of equipment need to reinforce with users/carers the need for equipment to be regularly checked- particularly aids that are at risk of deterioration. If user is unable to take on this responsibility an alternative arrangement needs to be identified.

Consider social and dignity issues for users.

Consider training and support needs of carers

Consider consent and compliance issues for users and carers.

Additional or second slings should only be prescribed as a result of an identified need and not automatically.

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Related policies and guidance documents:

.

Manual Handling Operations Regulations 1992 (as amended): Guidance on Regulations. L23. HSE Books. ISBN 0 7176 2823 X[4]

Getting to grips with manual handling: A short guide. INDG143 [368KB]

The Manual Handling Operations Regulations 1992

Management of Health and Safety at Work Regulations 1999

Manual Handling Operations Regulations 1992 (MHOR) as amended 2002

Handling home care HSG 225[1]

achieving safe, efficient and positive outcomes for care workers and clients.

Health and safety in care homes HSG 220[2]

this book is targeted at owners and managers of care homes, as well as employees and safety representatives.

Manual handling in the health services ISBN 0 7176 1248 1[3]

provides guidance, which is intended to help everybody who plays a part ensuring that risks from manual handling are minimised.

Getting to grips with handling problems ISBN 0 7176 0622 8[4]

provides practical advice and guidance on manual handling in the Health Services.

Cornwall Council’s Manual Handling Policy

PCH’s Manual Handling Policy

Charterest Society of Physiotherapy (2014) Manual Handling Guidance

College of Occupational Therapists (2006) Manual Handling Guidance

http://books.hse.gov.uk/hse/public/saleproduct.jsf?catalogueCode=9780717628230

http://www.hse.gov.uk/pubns/books/hsg225.htm

http://www.hse.gov.uk/pubns/books/hsg220.htm

http://books.hse.gov.uk/hse/public/saleproduct.jsf?catalogueCode=9780717612482

http://books.hse.gov.uk/hse/public/saleproduct.jsf?catalogueCode=INDG143REV2

http://www.cornwall.gov.uk/Default.aspx?page=19301

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3.1 Equipment: Slide Sheets

Description: slide sheets are made from very low friction material that slides against its self. They are multidirectional, with or without handles. There are tubular and flat designs which can be used for many different purposes eg repositioning on bed or chair, or to assist with fitting of garments or slings. The sheet MUST NOT be left in situ. Risk assessment is essential regarding how many carers are required to move the person with the slide sheet.

Dimension: various

Related policies/Guidance; See documents listed at beginning of this section

Example Brand names:

Indicators

The person needs additional support to complete a sliding transfer or to reposition them.

Carers need additional support to reposition or transfer the person

Ladder Approach Contraindications Safety & function Prescriber/assessor Actions

All alternatives have been explored:

Different technique

Referral to other services e.g. Rehab OT

Shearing risks – consider the size of the person and whether all of body to be moved/just a body part when deciding which size to supply

Poor balance

Person gets confused

Carer ability

Uneven or poor transfer surfaces

User environment

Access to both sides of the bed

Balance

Progression of condition

Must not be used if there are any signs of equipment wear & tear

Weight limits

Sliding sheet must be

Risk assess

Manual handling training

Product familiarisation completed

Assessment of carer’s needs

Risk assessment

Refer to MHRA, HSE guidance & local MH policy

Prescription goals identified.

Teach user appropriate techniques

Demo/delivery planned

Review date

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Consider in risk assessment - Where patient using it alone may slide off bed

removed immediately following its use.

Safety Checking of Community Loan Equipment

DESCRIPTION

STANDARD EQUIPMENT ITEMS

FI Bar Coded

Manufacturer’s Instructions Supplied to User/Carer

Single use Items

Legislation Comments/ technical

instruction N R LOLER PUWER

Easi slide

M

N/A

N Y Y

Key: FI - Final Inspection, N – New, R – Recycled, M – Manufacturer, C - Community Equipment Loan Store

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3.2 Equipment: One Way Glide Sheets

Description: A cushion/sheet which allows sliding easily in one direction whilst resisting sliding in another direction.

Dimensions: various


Example Brand names: Immedia (Etac) OneWayGlide, Prism One Way Glide Sheet,

Indicators

Used to help prevent a person sliding forward in wheelchair, day chair or bed.

The person needs additional support with positioning in a chair, wheelchair or bed

Facilitates independent or assisted positioning back in the chair



Different technique (eg prompting the person to sit back in the chair)

Referral to other services e.g. Rehab OT

Assess suitability of seating – is that causing the person to slump forwards?

Shearing risks

Poor balance

Person gets confused

Carer ability

Uneven or poor transfer surfaces / compatibility with pressure relieving products (discuss with TV)

Incontinence

User environment

Must not be used if there are any signs of equipment wear & tear

Risk assess



Carers assessment

Risk assessment





Review date

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DESCRIPTION


FI Bar Coded


Single use Items



Easi slide

M

N/A

N Y Y


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3.3 Equipment: ‘Satin Type’ Sheet Systems

Description: Suitable for independent or semi-dependent people. Reduces friction between user and bed in order to reduce shear forces on person and reduce work load of care givers. 2 direction base sheet, 2 way or 4 way draw sheet. Remains in bed.

Dimension: mini, midi, maxi or double

(Images Copyright PRISM Medical)

The following dimensions relate to the PRISM Medical products.

Mini – under trunk/hip section

Midi – under trunk/hip and shoulder

Maxi – whole bed

The midi and maxi have a choice of 60 cm and 70 cm widths.

2 Direction Satin sheet

Maxi flat: 240x200cm or 200x200 cm (Used same as standard flat sheet tucked in)

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Maxi corner: 90x200 cm has elastic straps at the corner in order to fix the sheet ontop of the mattress.

Maxi fit: 90x200 cm fitted sheet with locking strings and a lower satin area which covers the entire width of the mattress.

Maxi Double: 280x200 cm flat sheet for double bed with satin on one side.

Draw sheet (if combined with a satic 2 direction base can be used to assist with turning).

Mini: 200x100 cm.

Midi: 200x140 cm.

4 Direction Satin sheet

Satin sheet 4 direction midi: 200x140 cm (drawsheet with satin on underside).

Satin sheet 4 direction maxi: 200x200 cm (as above).


Example Brand names: Immedia (by Etac and Prism) Satin Sheet System, Wendylett (by Romedic)

Indicators

Helps independent user turn in bed

Carers need additional support to reposition or transfer the person in bed



Different technique

Referral to other

Shearing risks

Uneven or poor transfer surfaces / compatability with

Ensure sheet can be tucked out of the way when person is transferring from bed

Risk assess – inparticular with relation to person’s weight (NB PRISM satin sheet has no safe working weight limit)

Risk assessment


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services e.g. Rehab OT

Rope ladder

Bed lever

pressure relieving products

Incontinence

If to be used in conjunction with profiling bed, person must be able to lift up their shoulders from side to side (to reduce friction)

Assess provision of bed rails to use alongside satin type sheets

Stripes indicate glide direction

Incontinence pad with satin also available



Carer’s assessment




Review date


DESCRIPTION


FI Bar Coded


Single use Items



Easi slide

M

N/A

N Y Y


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3.4 Equipment: Bed Management Systems

Description: In-bed systems for severely immobile patients. Ideal for use with immobile patients who are in pain, and those with pressure ulcers.

Dimension: standard or Maxi for large and heavy users.

Three different models of Nylon Sheet:

Lock on the sheet and Non-slip along the bedside. Lock on the sheet. 3 lock on the sheet and Non-slip along the bedside.

Images Copyright ETAC

The following dimensions relate to ETAC products

4 Way glide LPL

4 Way Glide Mattress: 140x200 cm.

4 Way Sheet LPL NS-lock NS sides: 85x200 cm.

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4 Way Sheet LPL NS-lock: 85x200 cm.

4 Way Sheet LPL with 3 x NS-lock NS sides: 85x200 cm.

Safe working weight limit maxium 200 kg

4 Way glide Maxi

4 Way glide LPL maxi mattress: 180x210 cm.

Nylon Sheet LPL Maxi with NS Lock NS sides: 110x200 cm.

Safe working weight limit maxium 300 kg


Example Brand names: Prism, Etac, Immedia 4 Way glide system, Ross Turnsheet.

Indicators

The person is fully dependent for transfers and repositioning

The person needs support on the bed to enable the carer to carry out personal care tasks

Can be used with support of a hoist



Consider satin type sheet systems

Risk assessment required if pressure relieving system in situ

Consider continence – incontinent versions

Assess re whether bed rails should be supplied in combination with the bed management system

Risk assess



Carer’s assessment

Risk assessment



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available

Consider provision of second ‘top sheet’

Consider number of carers available to undertake transfer

Ensure person fits entirely on bed management system/no body parts are dragged



Review date


DESCRIPTION


FI Bar Coded


Single use Items



Easi slide

M

N/A

N Y Y


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3.5 Equipment: Transfer board

Description: Transfer boards have a smooth wooden surface, tapered at either end.

Dimension: maximum user weight 30stone (190kg).

Related policies/Guidance

Example Brand names: Boomerang by Smitcare. Some other designs remain in circulation within CELS

Indicators

The person needs additional support to transfer between two even surfaces.

A carer needs assistance to transfer the person between two even surfaces.



Alternative technique

Referral to other agencies

Risk assessment Care assessment Increased care package

Shearing & pressure care

Stability & balance

Uneven &/or unsteady surfaces

User confusion

Weight limits

Carer ability

Ability of user to lift own body weight

User environment


Impact upon care package

Balance

Dexterity

Risk assess


TV training


Risk assessment





Review date

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DESCRIPTION


FI Bar Coded


Single use Items



Transfer board

M C

Y Y


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3.6 Equipment: Handling belt

Description: Handling belts are made of contoured fleece fabric, (deluxe model has an anti slip section) and quick release buckle, with padded handles at each end. They have a selection of horizontal and vertical handles along the outside surface.

Dimension: Mini- 510-1140mm (20-45”). Maxi- 610-1140mm (24-45”). Maxi plus 915-1520mm (36-60”). “


Example Brand names: Smitcare

Indicators

The person needs additional support to transfer or reposition.

A carer needs assistance to transfer or reposition the person.

To provide support whilst mobilising




Sliding board

Bed lever

Referral to other agencies


Stability & balance

Uneven &/or unsteady surfaces

User confusion

Weight limits

Carer ability

User environment


Balance

Dexterity

Ensure correct size is used

Not to be used as a lifting belt

Please consider the condition of the service user’s skin when assessing

Risk assess


TV training


Risk assessment





Review date

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whether to use non slip version.


DESCRIPTION


FI Bar Coded


Single use Items



Handling belt

M C

N Y


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3.7 Equipment: Patient turner

Description: circular metal disc for patient to stand on with two handled angle stem with integral knee blocks.

Dimension: for Etac handle height 890mm to 1260mm. Max user weight 150kg/ 23.5stone.


Example Brand names: Etac Patient turner plus a limited stock of Rotastand solo & Homecraft turner at CELS

Indicators

Person needs assistance to complete a swivel/pivot transfer.

Carers need assistance to complete swivel/pivot transfers with person.

Reduce the number of carers needed to support a swivel/pivot transfer. (individual risk assessment is required to identify if 1or 2 carers are needed)




Turn table

Bed lever

Referral to other agencies e.g. physio/Rehab OT


Person must always be supervised in its use

Instability if person pulls up on turner

Weight bearing

Standing balance

Carer ability

person has poor cognitive ability

User environment – space & surfaces

Appropriate adjustment of equipment to user height

Not to be used a s a mobility aid.

Risk assess



Risk assessment





Review date

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DESCRIPTION


FI Bar Coded


Single use Items



patient turner

M C

Y Y


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3.8 Equipment: Stand aids

Description: wheeled platform with spreader bar and raise mechanism.

Dimension: Length- 1170-1220mm. Height 1138mm. Turning radius 1250mm. Width 610-1240mm.

Related policies/Guidance:

Example Brand names: Manual & powered versions available. Oxford 140.

Indicators

The person can actively assist with transfers but needs additional support to stand.

Equipment will help to maintain a function.

Equipment will enable user to maintain weight bearing.

As part of a rehab program.

1 or 2 carer use determined by risk assessment.



Technique

Small transfer aids e.g. handling belts, turn tables, sliding boards, patient turners.

Change of routine

Change to living space e.g. moving furniture

Transfers over long distances or room to room

Weight bearing

Reliability of stand

User environment

Carer ability

Manoeuvrability of stand aid in environment

Pain

Shearing & TV

Extreme behaviour of

Storage

Weight limit


Confused patients

Risk assess

TV training



Risk assessment



Prescription form



Review date

Add to maintenance & service contract

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Risk assessment Carers assessment Increased care package costs

person

Ability of carer

Mental capacity


DESCRIPTION


FI Bar Coded


Single use Items



stand aids

M C

Y Y

Y


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3.9 Equipment: Mobile hoist powered

Description: A metal base or chassis with legs - wheeled, usually two with brakes with a mast - the vertical support. This

incorporates the lifting mechanism which uses a battered powered pump operated by switches on a flexible cable. Wheeled legs

can be widened to accommodate floor transfers and some equipment. The boom extends from the mast to provide the reach

across and has the spreader bar attached. The spreader bar provides the width to span the user’s shoulders and the attachment

points for the slings. The battery can be removed for recharging

Dimension: Midi- weight limit 25stone/ 170kg

Major- weight limit 47 stone /190kg

Related policies/Guidance: Choosing a mobile hoist fact sheet from DLF

Example Brand names: Oxford Mid & Major. Other designs remain in circulation within CELS e.g. TX, Molift, stowaways

Indicators

The person is unable to safely transfer from one position/place to another.

Person not able to tolerate jerky movements of manual hoist.

The person can operate hoist lift/lower themselves.

1 or 2 carer use determined by risk assessment.

The carers are not able to safely support the person to transfer from one place/ position to another.

Carers are not able to operate a manual hoist.

Powered hoist enables single carer to safely complete transfers.

Temporary solution during DFG

To prevent hospital admission

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Technique

Small transfer aids e.g. handling belts, turn tables, sliding boards, patient turners.

Change of routine

Change to living space e.g. moving furniture

Manual mobile hoist Risk assessment Carers assessment Increased care package costs

Transfers over long distances or room to room

User environment

Carer ability

Manoeuvrability of hoist in environment

Pain

Shearing & TV

Extreme behaviour of person

Mental capacity

Storage

Weight limit


Manual mobile hoists are not a long term option

Consider implications of long term use on carers.

Confused patients

Risk assess

TV training



Risk assessment



Prescription form



Demonstrate to user battery charging & maintenance needs

Review date

Add to PAT list



DESCRIPTION


FI Bar Coded


Single use Items



mobile hoist powered

M

C

Y Y

Y

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3.10 Equipment: Slings

Description: Slings are available in a range of fabrics and sizes. Most companies have a range of standard or universal slings as well as specials designed

for specific purposes e.g. to be sat on all day, bathing, toileting, paediatrics. Sizes, styles, and weight limits vary. They may be provided in fabric such as

polyester, fleece-lined, mesh and low friction fabrics such as parasilk. Options include head support, extended leg and shoulder sections and chest

straps. There are a number of companies who produce made to measure slings. These can take a long time to be provided, as well as being very

expensive and there is no guarantee that they will be a solution, so should be a last resort. Assessment of slings should consider users needs, carer’s

needs, environment and transfers to be completed.

Dimension: seek manufactures guidance


Example Brand names: stock slings

Access sling- small, medium & large

Quickfit deluxe- small, medium & large

Quickfit – small, medium & large

Standaid sling- standing & transport

Indicators

The person needs to be transferred/repositioned using a hoist/stand aid.

Standard or universal slings should be explored and excluded before progressing to more specialist slings.

Second slings maybe required due to continence, bathing, transfer surfaces/locations.


Risk assessment Carers assessment Increased care package

Compatibility of sling & hoist

Types of transfers to be undertaken- is more

Risk assess

TV training

Risk assessment

Refer to MHRA, HSE

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costs Muscle tone

Strength

Tissue viability

Pain

Temperature control

Level of understanding & participation of person

Level of understanding & participation of carers

than 1 sling needed

Continence- frequency of washing

Loops are for correct positioning of person not to alter sling size

Slings maybe requested for use in settings with multiply users- slings should only be assessed & provided for individual user

If slings are to be used in none home settings prescriber needs to confirm who is responsible for maintenance of hoist that it will be used with & check compatibility.



guidance & local MH policy


Prescription form


Review date


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DESCRIPTION


FI Bar Coded


Single use Items



slings

M C

N Y

Y


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