7 Ergonomic Tools for Safe Patient Handling

Health care organizations should provide the number of team members and assistive devices needed to safely move, position, or prep patients based on the algorithms in seven ergonomic tools recommended in AORN’s new Guideline for Safe Patient Handling and Movement.

The guideline was released electronically earlier this year and will be published in print in the 2019 edition of Guidelines for Perioperative Practice.

As health care organizations begin implementing recommendations from this new guidance, the guideline’s lead author Mary Ogg, MSN, RN, CNOR, says staff nurses should be familiar with seven ergonomic tools for safe patient handling and movement that are spelled out in the guideline and updated from previous mention in AORN’s guidance statement on safe patient handling.

Getting Into the Habit

Each of the ergonomic tools in the guideline addresses a common scenario perioperative nurses experience in the practice setting, including how they move or position patients, but also how they lift and push heavy equipment and even how they stand on the job.

Ogg shares a quick look at why these seven ergonomic tools are a must for everyday perioperative practice and what nurses need to ask and understand before a move takes place:

1. AORN Ergonomic Tool #1: Lateral Transfer of a Patient from a Stretcher to an OR Bed—When this movement is not done safely, it is one of the most common reasons for nurses to sustain life-long musculoskeletal injury.

   Do you know you need two people for this patient move if the patient weighs more than 57.9 lbs.; three people if the patient is heavier than 104.9 lbs.; and four people along with assistive devices such as an air-assisted transfer system if the patient weighs more than 157 lbs.?



2. AORN Ergonomic Tool #2: Positioning and Repositioning the Supine Patient on the OR Bed—These movements can injure nurses’ lower back and shoulders as they push, pull or lift the patient or even portions of the patient’s body.

   Do you realize that 68% of a patient’s body weight is from the waist and up? That’s why two perioperative team members and an anesthesia professional maintaining the patient’s airway should position the patient in the semi-Fowler position using patient positioning equipment ( eg, beach chair) if the patient weighs 68 lbs. or more.



3. AORN Ergonomic Tool #3: Lifting and Holding the Patient’s Legs, Arms, and Head While Prepping—Often the perioperative nurse prepping the patient will take on the role of lifting a patient extremity and completing tasks such as preoperative skin antisepsis.

   Do you ask for team support with lifting and holding a patient’s extremity for skin prep? You need to if your patient weighs more than 40 lbs.



4. AORN Ergonomic Tool #4: Solutions for Prolonged Standing— Standing in one position for extended periods of time can cause lower back pain and even lead to swelling, venous disorders and cardiovascular problems. This prolonged standing is also part of daily work for many perioperative nurses.

   Do you incorporate safety measures to protect yourself from prolonged standing on the job? Using anti-fatigue mats, stand-sit stools, supportive footwear, propping your foot on a footstool and even adjusting the height of the patient bed are all ways to reduce prolonged standing injuries.



5. AORN Ergonomic Tool #5: Tissue Retraction in the Perioperative Setting—Perioperative nurses who are first-assistants may be asked to retract patient tissue at an angle and height that sets them up for musculoskeletal injury.

   Does your team employ a self-retaining retractor whenever feasible? When manual retraction is required, do you know how to hold the retractor in the safest way for reduced injury, such as holding the retractor with the palm facing down when retracting toward your body and with the palm facing up and the arm flexed at the elbow when retracting laterally?



6. AORN Ergonomic Tool #6: Lifting and Carrying Supplies and Equipment in the Perioperative Setting—Lifting and carrying supplies is part of everyday practice for most perioperative nurses and many musculoskeletal injuries begin with these activities.

   Do you know this ergonomic tool and tables in the guideline provide examples of equipment used in the OR and the risk of lifting these objects, such as hand tables and stirrups? The tool and tables are based on the Revised NIOSH Lifting Equation (RNLE) developed for nurses to assess manual lifting of objects. It starts with a recommended weight that is considered safe for an “ideal” lift and then factors in variables such lifting task frequency and duration.



7. AORN Ergonomic Tool #7: Pushing, Pulling and Moving Equipment on Wheels—Even when movement doesn’t require lifting, perioperative nurses can be at risk for injury when they push or pull heavy OR equipment.

   Do you know that when pushing an OR bed, whether occupied or not, a minimum of two perioperative team members should participate in the transport task or one team member should use a powered transport device?

Still don’t have these ergonomic rules on your radar? Ogg suggests perioperative nurses download a pocket reference guide for these seven tools found in AORN’s Safe Patient Handling Tool Kit that can be laminated and tucked in a warm-up jacket pocket for easy reference.

FREE RESOURCES FOR MEMBERS

Guideline Essentials: Ensure you and your team are practicing safe patient handling and movement with access to implementation tools for the new Guideline.

• Quick View: Quick, instructional video shorts and simple implementation steps
• Gap Analysis Tools: Tools to assess areas in which your facility may not be compliant with the guidelines.
• Policy & Procedure Templates: Ready-to-use customizable templates for developing your facility’s policies and procedures.
• Competency Verification Tools: Ready-to-use customizable templates for verifying competency to meet facility requirements.