Manual handling
Our process for hoist provision and follow up
Assess the need for a hoist
• Complete ward-based transfers assessments to identify need for hoist ;
• Information gather , consider checking Connecting Care , Medequip , ward-based manual handling plan , collateral history for further details ;
• Identify need for hoist at board round with multidisciplinary team and clarify plan of patient aiming home with hoist ;
• Identify sling size required as part of assessment .
Discuss the need for a hoist at home
• Discuss with patient and family the need for a hoist at home ;
• Discuss with family if they wish to be involved with hoisting ;
• Note that some care agencies will not accept family as second person to hoist .
Access visit
• Arrange access visit with family and / or carer – senior occupational therapist to support with this ;
• During access visit complete checklist and then summarise findings within medical notes .
Sling selection for community use
• Order slings from Medequip to be delivered to ward ;
• Order two sizes to trial to ensure best fit due to differences between hospital and community slings .
Trial slings on ward
• Trial Medequip slings and identify correct sling size ;
• Complete manual handling plan for carers / family ;
• Include recommendation for hoist sling loops and positioning .
Clarify who will be completing hoisting tasks at home
• Confirm who will be hoisting the patient – formal carers or family ;
• If family / carer to hoist , see family / carer hoisting flow chart ;
• If formal carers to hoist , give manual handling document to social worker / self-funding co-ordinator / hospital discharge team . and regular updates with the manual handling team have been arranged .
Outcomes
A number of benefits were observed for patients , families and staff . The new processes have notably improved patient experience and allow for safer discharges , with issues being addressed prior to discharge rather than at point of follow up .
It allowed all patients to have a consistent approach and better education for those providing the hoisting , with clear recommendations for a patient ’ s manual handling within their home environment .
With the hoist process in place there is potential for patients to have a reduced length of stay in hospital , as ward occupational therapists know what is expected for the discharge .
For UHBW occupational therapists it allows for a clear and consistent approach with a quality assessment and documentation of the recommendations being made . It supports occupational therapists with further developing clinical reasoning , with increased confidence in complex discharge planning . It also allows for the service to work more efficiently with less demand on clinical time .
The hoist Safe Operating Procedure has also been shared across the trust , including with Weston General Hospital and the Bristol children ’ s hospital .
Order appropriate equipment
• Order hoist and associated equipment for delivery to discharge address ;
• Order second sling to be delivered with main equipment order ;
• Arrange collection of sling not required from ward / occupational therapy department ;
• Ensure correct sling goes home with patient on day of discharge .
Follow up procedure
• Complete a follow up phone call within 24 hours of discharge ;
• If family or informal carers are carrying out hoisting , complete a follow up visit within 24 hours ;
• See follow up protocol for further follow up considerations ;
• Request ward clerk to keep notes on ward ;
• Complete SWIFT referral for social services occupational therapist to follow up patient if long term point of care / family support required .
Words KATHLEEN JAMES and FAY COLVIN , team leads at University Hospitals Bristol and Weston NHS Foundation Trust
January 2022 OTnews 49