Musculoskeletal injuries (MSI) are a major source of work-related disability among nurses and other health care workers. Research studies have found nurses with frequent and direct physical contact with patients have a higher incidence of back injuries than those who infrequently work with patients. Most nurses who have been injured commonly report types of manual patient handling, including lifting and transferring patients from one surface to another (such as from a stretcher to a bed), and repositioning patients in bed as a major cause of injury.
Biomechanical analysis of spinal compressive and shear forces involved in moving patients and nurses’ perceptions of the amount of effort required suggest manually lifting and transferring tasks are high risk activities. The combination of high MSI incidence and the corresponding high estimates of biomechanical stress during manual handling procedures have spurred extensive efforts to develop safer methods for moving patients.
Mechanical ceiling lifts
One such method is the introduction of mechanical ceiling lifts to lift and transfer patients and reposition them in their beds.
A ceiling lift consists of a ceiling-mounted track, electric motor and patient sling. Weight capacity for ceiling lifts range from 400 to 1,000 pounds to support different patient populations, including bariatric patients. However, the general weight capacity for ceiling lifts is between 500 and 600 pounds.
Ceiling lift tracks can be configured in numerous arrangements to accommodate many patient beds within a single room or even in multiple rooms. The two most common track configurations are straight track and X-Y gantry. With a straight track, a patient has to be in a specific spot to be lifted and transferred. The X-Y gantry has the benefit of being able to move a patient in multiple directions in a room.
Studies examining the effectiveness of implementing ceiling lifts have found decreases in injury rates, decreases in workers’ compensation claims, perceived decreases in the risk of injury and improved morale with a decrease in absenteeism.
Factors to consider
For hospitals and health care facilities planning to install ceiling lifts, there are several factors that must be considered.
It’s important to understand the needs of the patient population and the amount of patient-handling activities occurring in the area. With frail elderly patients, individuals suffering from dementia or other cognitive impairments and bariatric patients, there may be other factors affecting their ability to move. Areas within hospitals or other health care facilities that typically have high patient-handling activity rates include residential care facilities, in-patient medical/surgical wards, rehabilitation departments, operating rooms, intensive care units, radiology, physical therapy clinics and morgues.
Next, it’s important to understand the architectural capabilities of the rooms and departments where ceiling lifts may be installed. Depending on the patient population to be lifted, the structural ceiling must be able to handle a load of 400 to 1,000 pounds, and there must be a minimum of nine feet from the floor to the top of the ceiling lift track to allow enough space to lift a patient off a bed in the sling. Other considerations include the location of light fixtures, vents, sprinkler heads, televisions, X-ray equipment, overhead medical lights, booms/headwalls, outlets/power sources, windows and columns. Any of these may impact the location and configuration of the ceiling lift track.
Getting the right input
Throughout the design process, it is important to have input from staff who will be operating the ceiling lift as well as from maintenance staff. By working with these individuals, the design team can further understand the patient handling tasks and procedures completed, types of patients moved and requirements for cleaning and ongoing maintenance. This communication is key to ensure the design of the ceiling lift and track configuration will meet the caregivers’ needs and contribute to the creation of an environment that is healing for the patient and ergonomically supportive for staff.
Aaron Miller is an ergonomic consultant based in Kelowna, B.C. He can be reached at aaronmiller@shaw.ca.
