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Need a lift? Why one sling doesn't fit all
Choose based on medical needs
A patient who is recovering from abdominal surgery needs to be lifted from the bed to a chair. Another patient with a pressure ulcer needs to be repositioned. Putting a sling under these patients to use lift equipment seems out of the question.
Yet an array of sling choices are available, enabling nurses and nursing assistants to use lift equipment even with patients with delicate medical conditions. In fact, lift equipment has evolved to provide solutions for patient handling dilemmas of acute care, says Andrea S. Baptiste, MA (O.T), CIE, an ergonomist/biomechanist with the Patient Safety Center at the James A. Haley VA Medical Center in Tampa, FL. Baptiste was the chair of a task force that created a Patient Care Sling Selection and Usage Toolkit ( http://www1.va.gov/visn8/patientsafetycenter/safePtHandling/toolkitSlings.asp.)
Many employee health professionals are not aware of the choices beyond the "universal sling," she says. But just as health care workers should assess patient handling needs, they should consider the most appropriate sling, Baptiste adds.
"The decision about what sling you're going to use is dependent on the transfer you're trying to accomplish, the patient's medical condition or medical status, and their functional ability," she says. "Do they have head control? If they don't have head control, then you need a high back to support their transfer.
"The seated sling is most commonly used to transfer the patient in a seated position. If you have someone who needs to stay supine, you just need a supine sling," she says.
Because different units handle patients with different acuity levels, sling selection will vary. Frontline health care workers need to be involved in the choice, just as they are in evaluating and selecting safe needle devices, Baptiste notes.
"The biggest mistake people make is they find one solution for one [type of lift] and then they say, 'OK, let's put these all the units.' The needs in other units may be totally different," she says.
Here are some things you should know about slings:
Slings are categorized by function. There are five categories of slings, based on the function you need to perform. A standing sling provides assistance to patients who are weight-bearing and need help standing upright. It may be used in a sit-to-stand lift. A seated sling often is considered the universal sling. The patient remains seated during the lift. The sling may come with head support, padding, positioning handles, or special fabrics. Supine slings are also available for patients who need to remain flat.
Patients wear an ambulation sling when they need fall protection while they're walking. It is often used in a rehabilitation unit when patients are just beginning to walk again. The limb support sling holds a patient's limb in place while the nurse performs wound care, bathing, or other procedures. "Holding a limb in an outstretched position for five minutes can put a lot of stress on the shoulder [of nurses]," says Baptiste. (For more information on selecting slings for different medical conditions, see chart.)