TABLE OF CONTENTS Safe Transfers North East School Division... 2 Manual Lift Introduction... 3 Basic Lifting Techniques... 3 Lie to Sit Transfer... 4 Cradle Transfer... 4 Two Person Side to Side Transfer... 5 Two Person Top and Tail Transfer... 5 One Person Pivot Transfer... 6 Sliding Board Transfer... 7 Mechanical Lift Safety Protocol... 8 Safe Use of a Mechanical Lift... 8 Sling Safety... 9 Positioning the Sling: From a Seated Position...10 Positioning the Sling: From a Laying Position.....12 Transfer Procedure: Wheelchair to Change Table...14 Transfer Procedure: Change Table to Chair...15 References...16 1 P a g e
Safe Transfers North East School Division Audience School staff who are involved in the transfer of students with physical disabilities. Purpose To provide guidance following hands on training of effective lift and transfer techniques To ensure the safety and dignity of students and staff when completing lifts and transfers Important Notes 1. This manual provides general instructions for positioning slings when a student is in a seated or supine position. It also provides general instructions for operating a mechanical lift and completing safe transfers using a mechanical life. However, students may require special consideration in addition to these general guidelines. 2. This booklet is not meant to replace the training provided by an Occupational Therapist. All staff members involved in transfers using the mechanical lift must receive training by an Occupational Therapist. 3. A single manual lift can be used when the student weighs less than 30 lbs. A two person manual lift can be used when the student weighs up to 50 lbs. A mechanical lift should be used if the student cannot weight bear, has unpredictable spasms and/or weighs over 50 lbs. 4. All staff working with students using a transfer or lift should attend an annual informational session on lifts and transfers facilitated by the Occupational Therapist. Contributors: Registered Occupational Therapists: Nicole Playter, Evelyn So, Kirsten Dinsdale, Kerry Nugent, Jessi-Beth McCannell 2 P a g e
Manual Lift Introduction Safe lifting is performed best when planned. Before every lift, an assessment of the environment, the student, and the lifter is required as every lift is different. Proper technique is important for the safety of both the person who is lifting and the student. A single manual lift can be used when the student weighs less than 30 lbs. A two person manual lift can be used when the student weighs up to 50 lbs. A mechanical lift should be used if the student cannot weight bear, has unpredictable spasms and/or is over 50 lbs. The techniques in this manual are designed for transferring the student between two surfaces, not for carrying the student over long distances. Basic Lifting Techniques Set up the environment prior to lifting to decrease the amount of lifting required Place feet shoulder width apart Bend knees, squat rather than leaning out of base of support Keep student close to the body of the lifter Keep back straight Push rather than pull Use transfer belts when able 3 P a g e
Lie to Sit Transfer 1. Position body in half kneeling stance perpendicular to the student 2. Keep back straight 3. Place one arm under the back below the shoulder blades 4. Place other arm under the upper thighs 5. Lift with your hips Cradle Transfer 1. Bring the student close to the transfer surface (within two steps) 2. Bend knees and keep back straight 3. Place one arm on the back just below shoulder blade 4. Place the other arm under the student s upper thigh 5. Keep the student close to body 6. Lift with your legs 4 P a g e
Two Person Side to Side Transfer 1. Bring the student close to the transfer surface (within two steps) 2. Stand one person on each side of the student, perpendicular to the student 3. Place the transfer belt waist height on the student 4. Bend knees and keep back straight 5. Place one arm on the back of student where the transfer belt is situated 6. Place the other arm underneath the student s thighs 7. Count to three and lift together 8. Lift with your legs Two Person Top and Tail Transfer 1. Bring the student close to the transfer surface (within two steps) 2. Stand one person in the front facing the student and the other person behind 3. Person in front: hold on to the thighs of the student 4. Person in back: wrap arms around under the armpits and use forearms to stabilize the core of the student 5. Bend your knees and keep your back straight 6. Count to three and lift together 7. Lift with your legs 5 P a g e
One Person Pivot Transfer 1. Bring student close to the transfer surface, perpendicular to the transfer surface 2. Place the transfer belt at waist height on the student 3. Face the student 4. Bend knees and keep back straight 5. Hold on to the transfer belt on the sides of the student s waist 6. Count to three 7. Stand together and pivot bum towards transfer surface 8. Assist student to sit down softly, bending knees rather than using back 6 P a g e
Sliding Board Transfer 1. Bring the student close to the transfer surface, perpendicular to the transfer surface 2. Place the transfer belt at waist height on the student 3. Have the student weight shift away from the transfer surface. Place transfer board under the students lifted thigh (same side as transfer surface) 4. Remove the wheelchair arm (if applicable) 5. Have student scoot up the transfer board to the new transfer surface, weight shifting with their arms and bum 6. Bend knees, hold on to the sides of the transfer belt at students waist and guide the scooting transfer 7. Once on transfer surface, weight shift to remove the transfer board 7 P a g e
Mechanical Lift Safety Protocol A mechanical lift is used when an individual is no longer bearing weight and/or is inconsistent in weight bearing ability. A mechanical lift should be used if the student cannot weight bear, has unpredictable spasms and/or weighs over 50 lbs. Prior to using equipment, all instructions pertaining to the operation of the specific lifting system should be read. Safe Use of a Mechanical Lift 1. Mechanical lifts require a minimum of TWO STAFF MEMBERS to ensure the safety of the student and staff members at all times. One staff member is responsible for operating the lift and the equipment. The second staff member is responsible for the attachments and the safety and comfort of the student to ensure safety during the transfer. 2. DO NOT use the lift to transport a student. 3. NEVER leave a student unattended in a lift. 4. When using a floor lift, ensure that the base is kept wide open to maintain stability. 5. Ensure that the battery is charged to decrease disruptions to the student during transfers. 6. Ensure you know how to use the emergency stop button and lowering feature on the lift. 8 P a g e
Sling Safety 1. Slings should only be used by staff that have been trained to doing so. 2. Visually inspect the sling before each use. Check for signs of fraying or loose stitching at seams. Check entire sling for rips or holes. Check for signs of weak fabrics (e.g. brittle, stiff). 3. Check that all loops are securely attached to the carry bar and the student is fully supported. 4. If there is any damage to the sling, ensure that it is not used to transfer the student. 5. When transferring, ensure that the sling is not cutting into the student s skin which can cause discomfort. If the sling must be adjusted, place the student back down before adjusting the sling. 9 P a g e
Positioning the Sling: From a Seated Position 1. Grasp sling by its bottom opening, with smooth side against individual s body. 2. Slide sling down individual s back until the curved bottom of the sling tucks under edge of buttocks. 3. Grasp inside leg loops of sling and gently pull them forward until sling s bottom is beneath the thighs. 10 P a g e
4. Secure legs by placing leg straps through inside leg loops in the desired configuration. 5. Attach appropriate leg and back straps to carry bar for desired inclination. 6. Raise carry bar by pressing the UP arrow on the hand control. Check to ensure that all straps are securely attached to the carry bar. 11 P a g e
Positioning the Sling: From a Laying Position: 1. Roll individual towards you. Lay sling lengthwise behind individual; gather half of sling s material against back and thighs. 2. Roll individual back onto sling and pull sling flat. Pull inside leg loops up and between the thighs. 3. Fit sling s leg straps through inside leg loops in desired leg-band configurations. Gently lift the leg straps by hand, to test that the leg-band configurations are secure and do no pinch the thighs or groin area. 12 P a g e
4. Attach sling s leg and back straps to carry bar for desired sling inclination. Contact your Occupational Therapist for specific inclination instructions. 5. Raise carry bar by pressing the UP arrow on the hand control. Check to ensure that all straps are securely attached to the carry bar. 6. When lifting, ensure that leg straps lie flat under thighs. Move the individual to the desired area. 13 P a g e
Transfer Procedure: Wheelchair to Change Table Preparation and Planning Must designate a leader and an assistant. Ensure that the lift is in good working condition (e.g. battery level). Ensure the sling is in good working condition. Make a visual inspection for signs of wear and tear. Look for fraying, cuts, or tears in the material of the sling s body and its straps. Position wheelchair to allow enough room for transfer; ideally 3 inch clearance from obstacles. For manual wheelchairs, put wheelchair brakes on. Adjust change table to your safe working height (hip of shorter caregiver). Explain procedure to student. Place sling under individual (see Instructions: From a Seated Position Positioning the Sling) Performance of the Lift Ensure the correct positioning of the sling (e.g. head is supported, student in the center of the sling). Lower carry bar to safe working height. Where straps can be placed on carry bar comfortably and without strain on the staff member. Ensure the sling and loops are appropriately attached on the carry bar. Raise the student off the wheelchair in a smooth movement. When the student is just above the wheelchair, do another visual check to ensure straps are on and ensure student comfort. Ensure that the assistant helps guide the student in the sling throughout the transfer. Widen base of the lift when moving it to ensure stability. Position student appropriately on the change table and gently lower onto the change table. Remove straps from carry bar. Move lift away from change table area to clear your working area. Above all, ensure individual comfort and safety. 14 P a g e
Transfer Procedure: Change Table to Chair Preparation and Planning Must designate a leader and assistant. Ensure that the lift is in good working condition (e.g. battery level). Ensure the sling is in good working condition. Make a visual inspection for signs of wear and tear. Look for fraying, cuts, or tears in the material of the sling s body and its straps. Position wheelchair to allow enough room for transfer; ideally 3 inch clearance from obstacles. For manual wheelchairs, put wheelchair brakes on. Adjust change table to your safe working height (hip of shorter caregiver). Explain procedure to student. Place sling under individual (see instructions: From a Laying Position Positioning the Sling) Performance of the Lift Lower carry bar to the point above the individual where straps can be placed on carry bar comfortably and without strain to staff member. Raise the student off the change table in a smooth movement. When the student is just above the change table, do another visual check to ensure straps are on and ensure individual comfort. Glide the lift along with hands on student or straps of sling. Bring individual above the wheelchair and gently lower into the chair. Ensure individual is positioned properly. Remove straps from carry bar. Remove sling from under the student. Above all, ensure individual comfort and safety. 15 P a g e
References Appendix C: SOCP Lifting and Positioning Training (2010, May). Retrieved from https://www.dhs.state.or.us/spd/tools/dd/socp/docs/8c_lift.positioning.pdf Interior Health MSIP: A Practical Guide to Resident Handling (2004, October). Retrieved from http://www.washingtonsafepatienthandling.org/images/fullguideformsipapracticalguidetoresidenthandling.pdf Mayer, Jennifer. (2012, August). Motion Specialties: Ceiling Lift General Direction. Novita Children s Services: Manual Handling Guide- Cradle Transfer (2008, December). Retrieved from http://www.novita.org.au/library/factsheet-man_handling-cradle_transfer.pdf Novita Children s Services: Manual Handling Guide Lie to Sit Transfer (2008, December). Retrieved from http://www.novita.org.au/library/factsheet-man_handling-lie_to_sit_transfer.pdf Novita Children s Services: Manual Handling Guide Side to Side Transfer (2008, December). http://www.novita.org.au/library/factsheet-man_handling-side_to_side_transfer.pdf Retrieved from Novita Children s Services: Manual Handling Guide- Top and Tail Transfer (2008, December). http://www.novita.org.au/library/factsheet-man_handling-top_and_tail_transfer.pdf Retrieved from Sling Instruction Sheet: Waverly Glen Universal Sling Winnipeg Regional Health Authority: Safe Patient Handling and Movement Program (2008, May). Retrieved from http://www.wrha.mb.ca/professionals/safety/files/manual.pdf 16 P a g e