Moving & handling - equipment

The use of moving and handling equipment is common in health care and the amount and kind of equipment available will vary in each organisation. This is because specific care needs of the individuals must be considered and will differ depending on the setting.

However, there are certain pieces of equipment that will be commonly used in most care organisations and here we will discuss frequently used moving and handling equipment and its value in the workplace.

Manual handling is defined as:

Moving and handling practices are crucial to the everyday work of those employed in health care (Royal College of Nursing (RCN), 2022). These include the movement of objects or people. The HSE (2020) stipulate that there is no such object considered as a safe load, therefore it is imperative that the risk of musculoskeletal disorders to practitioners caused or made worse by frequent or heavy lifting is managed and kept to a minimum.

Moving and handling is a concern for all employers, who have a responsibility to keep all employees and individuals in their care safe from harm.

Although, there is no definite law which prohibits moving and handling lifts, there are certain lifts that are considered controversial. This is due to the significant risks posed to both user and individuals engaged in the practice. Moving and handling equipment enables manoeuvres to be carried out without the need for attempting such tasks (Hignett et al, 2003).

Examples of lifts considered controversial:

• orthodox lift
• drag lift
• bear hug
• through arm lift

Equipment should only be selected once appropriate risk assessment has been completed and moving and handling is deemed unavoidable.

It is known that unsatisfactory moving and handling practices can cause acute or chronic back pain, affect joints and limbs, contribute to accidental injury and in some cases can render individuals unable to work. Equipment not applied or used correctly, may put users and employees at considerable risk and result in harm (HSE, 2020).

In the first instance a moving and handling risk assessment must take place. There are a clear hierarchy of measures for dealing with risks from manual handling. This includes:

• avoid where reasonably practicable
• assess where it cannot be avoided – perform dynamic risk assessment for the task, individual capabilities, the load, environmental aspects, and other factors (T.I.L.E.O.) (Table 1)
• reduce the risk of injury

Thereafter, review risk assessments regularly (HSE, 1992).

Hoists and slings

Hoists are classified as lifting equipment and are subject to regulation (Lifting Operations and Lifting Equipment Regulations (LOLER), 1998: Provision and Use of Work Equipment Regulations (PUWER), 1998). Slings enable workers in the care sectors to move patients safely from one surface to another, while significantly reducing the risk of injury to themselves and the individual being moved.

Individuals carrying out moving and handling activity involving use of a hoist must:

• plan the activity
• ensure those involved are sufficiently competent
• be supervised appropriately
• ensure activity is carried out in a safe manner

Universal slings 

These are preferred when moving patients in an upright or seated position.

1. Establish the weight and size of the patient, this will be needed to select the appropriate sling for the user.
2. Check the sling integrity. No fraying, adaptation, or defects should be visible. If this the case the sling must not be used.
3. Check the weight capacity of the hoist and ensure it is compatible with the sling.
4. Measure the sling against the patient to ensure the correct size.
5. For a sling with head support, place the patient in a side lying position and using the sling measure from the top of the head to the coccyx.
6. For a sling that does not require head support measure from the top of the shoulders to the coccyx.
7. Ensure manufacturers care label attached to the rear of the sling is visible, intact and displays essential information relating to size,

Once you have attended appropriate moving and handling training and are familiar with moving and handling equipment, you will be ready to engage in and practice safe patient handling techniques.

References

Fray M, Hignett S. Using patient handling equipment to manage mobility in and around a bed. Br J Nurs. 2015; 24(6). 10-14.

Health and Safety Executive. Getting to grips with hoisting. 2011. https://www.hse.gov.uk/pubns/hsis3.pdf (accessed 15 December 2022)

Health and Safety Executive. Manual handling at work. A brief guide. 2020. https://www.hse.gov.uk/pubns/indg143.PDF (accessed 15 December 2022)

Health and Safety Executive. Manual handling operations regulations, fourth edition. 1992. https://www.hse.gov.uk/pubns/priced/l23.pdf (accessed 15 December 2022)

Hignett S, Crumpton E, Ruszala S et al. Evidence-based patient handling. London: Routledge; 2003. 

Lifting Operations and Lifting Equipment Regulations. 1998. No. 2307. https://www.legislation.gov.uk/uksi/1998/2307/contents/made (accessed 15 December 2022)

NHS Clinical Evaluation Team. Clinical review: slide sheets. 2018. https://wwwmedia.supplychain.nhs.uk/media/Clinical_Review_Report_Slide_Sheets.pdf (accessed 15 December 2022)

Provision and Use of Work Equipment Regulations. 1998. https://www.legislation.gov.uk/uksi/1998/2306/contents/made (accessed 15 December 2022)

Royal College of Nursing. Moving and handling. 2022. https://www.rcn.org.uk/get-help/rcn-advice/moving-and-handling (accessed 15 December 2022)