Course 623 - Healthcare: Preventing Ergonomic Injuries

Safety guides and audits to make your job as a safety professional easier

Patient Handling Controls



Hospital health care workers, especially nursing assistants who do a majority of the lifting in many facilities, may develop musculoskeletal disorder (MSD) injuries such as:

  • muscle and ligament strain and tears;
  • joint and tendon inflammation;
  • pinched nerves; and
  • herniated discs.

Good work practice includes continually identifying the most hazardous tasks and implementing engineering and work practice controls to help reduce or prevent injuries in those tasks.

Employers must provide employees with proper assist devices and equipment to reduce excessive lifting hazards.

The proper equipment selection depends on the specific needs of the facility, patients, staff, and management.

1. Who is most likely to develop musculoskeletal disorder (MSD) injuries in hospitals?

a. A physician assistant
b. A nurse practitioner
c. A nursing assistant
d. A laboratory worker

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Bathing Assistance

Devices such as shower chairs can fit over the toilet. Using this device can eliminate multiple transfers, which prevents health care workers from having to lift patients several times. A patient can be moved to the shower chair, toileted, showered, and transferred back to the wheelchair. Shower stalls allow for shower chairs to be pushed in and out on level floor surfaces.

adjustable tub
Adjustable Bathtubs: These are used to bath patients who sit directly in the bathtub. They are also used to assist ambulatory patients.
Shower Gurney
Shower Gurney: Use for bathing non-weight bearing patients. The cart can be raised to eliminate bending and reaching to the caregiver.
shower chair
Shower chairs can eliminate multiple transfers, saving health care workers multiple lifts.

2. Use this device for bathing non-weight bearing patients.

a. Shower gurney
b. Shower chair
c. Adjustable bathtub
d. Trapeze lifts

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toilet seat riser
Toilet seat riser.

Toileting Assistance

Toilet seat risers are used on toilets to equalize the height of wheelchair and toilet seat, making it a lateral transfer rather than a lift up and back into wheelchair.

Mechanical Lift Equipment

There are several types of equipment to help lift patients who cannot support their own weight. You should choose a lift that does not require manual pumping to avoid a possible repetitive motion disorders to workers’ arms or shoulders.

In the next few tabs, we will take a look at some popular lift equipment types.

3. When should a caregiver use a toilet seat riser to help patients?

a. To equalize the height of the wheelchair and toilet seat
b. To move non-weight bearing patients
c. To lower the height of the toilet seat
d. To move patients from their bed to wheelchair

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Lift Equipment and Transfer Systems

Overhead track-mounted patient lifters: A track system built into the ceiling that sling lifts attach to. This system provides patient mobility from room to room without manual lifting.

Lateral transfer devices: Devices used to laterally transfer a patient (for example from bed to gurney). They usually involve multiple staff members to help do the lifting. This is often done with the help of a draw sheet, or similar device. Some new lateral transfer systems do not require any lifting by staff, and are totally mechanical. This type of device helps prevent staff back injuries.

shower chair
Lateral transfer devices
Click to Enlarge
patient lifter
Overhead track-mounted lifters
Click to Enlarge

4. What type of lift equipment provides patient mobility from room to room without manually lifting?

a. Lateral transfer devices
b. Wheelchairs
c. Overhead track-mounted patient lifters
d. Walkers

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sliding boards
Slide boards are used to reduce the need to lift patients.
Click to Enlarge

Lift Equipment and Transfer Systems

Slide Boards. A slide board, also called a sliding board, is used to transfer patients who cannot use their legs. The main purpose of the slide board is to help reduce the need for lifting. It is a placed under patients when transferring them from bed to chair, or chair to car. There are several designs for slide boards, some with moving seats that slide, and others that are nothing more than a slick piece of wood or plastic on which the patient slides.

  • Some newer versions of slide boards have devices that allow the resident to slide easily along the board without tissue damage and with no lifting involved.
  • The friction of the movement is borne by the slide board, not the patient’s skin. These devices are very useful for difficult transfers like car to wheelchair.
  • This type of slide board protects against back injuries, brachial plexus injuries and conditions which can cause pressure sores.

5. What is the main purpose of slide boards?

a. Reduce fall injuries
b. Protection against leg injuries
c. Reduce the need for lifting
d. Allow team-lifting of patients

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Lift Equipment and Transfer Systems

Transfer Sheets: Transfer sheets, also called slip or roller sheets, help to reduce friction while laterally transferring or repositioning patients in bed. They also help reduce the force workers need to exert to move the patient.

  • Slip Sheets help to reduce friction while laterally transferring patients or repositioning patients in bed and reduce the force workers need to exert to move the patient.
  • Roller Sheets sheets are constructed of low-friction fabrics that glide over themselves during a patient transfer. They are used to reposition patient in bed and facilitate independent positioning.
roller sheets
Roller sheets
slip sheets
Slip sheets

6. Transfer sheets work by ______.

a. reducing friction while transferring
b. protecting against back injuries
c. increasing lateral forces to move the patient
d. reducing the chance of falling

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Lift Equipment and Transfer Systems

Repositioning Devices: Mechanically pull patients up in bed, which eliminates manual maneuvering by staff.

Height adjustable electric beds: These should have height controls to allow for easy transfers from bed height to wheelchair height. These beds can be kept low to the ground for patient safety and then raised up for interaction with staff. Avoid hand cranked beds, which can lead to wrist/shoulder musculoskeletal disorders such as strain or repetitive motion injuries.

slip sheets
Height adjustable electric beds
roller sheets
Repositioning devices

7. Why should healthcare providers avoid hand cranked adjustable beds?

a. They can injure the worker if they slip
b. The crank can get stuck
c. They increase the amount of force to move the patient
d. They can lead to wrist/shoulder injuries

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Lift Equipment and Transfer Systems

Trapeze lifts: A bar device suspended above the bed which allows patients with upper muscle strength to help reposition themselves. This device is particularly useful with adjustable beds and armless wheelchairs.

Walking belts or gait belts (with handles): A gait belt with handles can be used during ambulation, during a stand pivot transfer, guiding a patient along a transfer board and during seated transfers. They are not designed for lifting patients.

roller sheets
Walking or gait belts
slip sheets
Trapeze lifts

8. Which device is not designed for lifting patients?

a. Trapeze lift
b. Gait belt
c. Electric adjustable bed
d. Repositioning device

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Lift Equipment and Transfer Systems

Sitting-standing wheelchairs: Wheelchairs that provide sitting to standing options for patients. They enable patients to stand easily and can be used independently or with the help of a healthcare worker.

Pivot transfer disk devices: Used for standing pivot transfers and seated pivot transfers for patients who have weight bearing capacity and are cooperative. Although it is mainly used in wheelchair transfers, it can be used in any type of situations involving sitting. To ensure maximum safety while performing swivel transfers, helpers should use gait belts.

pivot transfer
Pivot transfer disk devices
Sitting-Standing Wheelchair.

9. The pivot transfer disk is used primarily for _____.

a. transfer from beds to lift devices
b. wheelchair transfers
c. twisting to a new position
d. toileting activities

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Lift Equipment and Transfer Systems

pivot transfer

Descent Control System - Courtesy ParaMed Systems

Descent Control System (DCS): Emergency evacuation or retrieval from older or disabled structures may require using stairs or negotiating rough terrain when moving patients.

These devices allow ambulance technicians or emergency evacuation personnel to safely move a loaded hospital cot or gurney downstairs or any steep decline.

The Device easily attaches to any ambulance cot currently in the pre-hospital care market. When not in use, the DCS simply folds up and out of the way.

10. When should a provider use a Descent Control System (DCS)?

a. To move a loaded hospital cot down stairs
b. If patient refuses any other method
c. Only if there is no other device available
d. Only if the patient has wrist/shoulder injuries

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Patient Care Plans

A written patient care plan that describes strategies to address specific patient needs, the degree of assistance required, and special treatments, etc., should be developed. Possible strategies include:

  • color coding of patient/residents lift requirements for posting at bedside so that by simply looking at the displayed color-coding system, an employee can know what kind of assistance the patient will need with moving or transfers;
  • segregation of patient based on need, so equipment and trained staff are appropriately assigned; and
  • staggered staffing to provide additional manpower for peak periods.

11. A written patient care plan should describe strategies to address _____.

a. general policies and procedures
a. specific patient needs
c. comply with OSHA mandates
d. after-the-fact reporting

Check your Work

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Healthcare workers who lift and reposition patients have the highest injury rate among the CSEA workforce. This video shows how labor and management can work together to implement a safe patient handling (SPH) program.

A SPH program can help reduce employee injuries, reduce mandatory overtime, increase morale, and lower workers' compensation costs. The video will show you how to implement a SPH program at your facility. This video is a real life example of the successful program at the NYS Veterans' Home at Batavia.