Post on 14-Apr-2020
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OUTLINE SPH NEW HIRE TRAINING
INTRODUCTION OF SPH TEAM
CURRENT INJURY GRAPHS
BACKGROUND OF SAFE PATIENT HANDLING AB1136
AREAS OF BODY EXPOSURE
LIFTING POLICY
REFUSAL TO PERFORM PATIENT MOBILITY
TRAINING REQUIREMENTS
ANNUAL ON-LINE TRAINING MODULE
NEW HIRE HANDS-ON TRAINING
ANNUAL DEPT/UNIT SPECIFIC REFRESHER TRAINING
UNIT LEVEL RESPONSIBILITIES
ROLE OF SPH COORDINATORS
UD, RN, LIFT CHAMPIONS
ROLE OF LIFT TEAM
REHAB. SERVICES
SAFE PATIENT HANDLING
EQUIPMENT AVAILABLE
LOCATION
CLEANING
DOCUMENTATION
BMAT ROOM DOCUMENTATION
RN INSTRUCTION
-VERBAL, SUMMARY PAGE, ROOM DOCUMENTATION
GENERAL BODY MECHANICS
FUNCTIONAL TASKS APPLICATION USING EQUIPMENT
TRAINING REQUIREMENTS
Initial Training Requirements
• On-line training module (mednet home page) • New Grad Orientation (hands-on) • Experienced staff New hire training scheduled by unit (hands-on)
Annual Requirements
• On-line training module • Dept. specific refresher training ( hands-on)
HR TRACKING
• Safe Patient Handling Training on HR tracking • Print certificate of completion for file
UNIT LEVEL SPH RESPONSIBILITIES (WHO IS IN CHARGE? WHO DOES WHAT?)
UNIT DIRECTORS
-Annually complete a Clinical Area Patient Handling Hazard Evaluation and Plan to identify the area’s
unique hazards.
-UD should collaborate with safe patient handling coordinator to develop corrective actions to control
patient mobility & handling hazards identified through injury/accident investigations, unit hazard
evaluations, refusal to lift events, and staff reported hazards. Ensure all unit staff complete training in
accordance with the training requirements outlined in this policy.
-Ensure sufficient trained staff are available to perform mobility & handling activities at all times in your
clinical area in accordance with the performance of Mobility & Handling Activities.
-Provide necessary resources to support SPHM operations in your clinical area, including the supply and
replacement of equipment, slings, and attachments used by staff in your area.
-Designate equipment, sling, and attachment storage locations, which allow equipment to be readily
available & accessible for use by staff, and ensure that equipment is stored correctly.
-Encourage employee feedback and participation in the completion of the Clinical Area Patient
Handling Hazard Evaluation and Plan. Encourage staff reporting of hazards and adhere to the
Employee Right to Refuse Statement & Guidelines.
RN-COORDINATOR OF CARE
-Assess the mobility of all patients upon admission or transfer to your unit and as patient condition Changes thereafter.
-Outline SPHM instructions for all anticipated mobility & handling activities after completing each patient’s mobility assessment.
-Communicate your SPHM instructions to other involved staff, the patient &/or their representatives.
-Direct all movements of your assigned patients through your SPHM instructions, including movements through a transfer of care to another clinical area or unit.
-Provide assistance or designate a responsible person to assist in complex patient handling tasks Mentoring existing staff in proper use of equipment located on unit.
SPH UNIT CHAMPIONS
Annual refresher training on equipment located on unit
Maintaining competency records in SPH for unit staff
Providing feedback to unit at staff meetings on injuries related to patient handling
Encouraging staff to embrace safe patient handling practices, and ensure that equipment and supplies are available and in working order.
Proper Body Mechanics
Allow the patient to safely assist with his/her own movement, whenever
possible.
If pushing or lifting over 35lbs. of force, use assistive device, get additional
assistance and lift team.
Maintain a straight back with a wide stable base and avoid trunk rotation.
Keep your shoulders, spine and hips in line. Keep elbows tucked in and wrists
facing down.
Adjust beds, gurneys or other surfaces to waist height and as close to you as
possible.
When providing care or repositioning patients in bed/gurney, put the bed at
hip or waist level of the shortest assisting person. Taller staff remember to
separate legs, bend knees and maintain a neutral spine to appropriate surface
level.
When boosting, move the patient shifting your weight from one foot to the
other. If not contraindicated, place bed in Trendelenburg to assist with
transition.
When pushing, keep load close to your body. Use an upright neutral posture,
push with your whole body and keep elbows tucked in.
When rolling patient, if not contraindicated, bend both legs or far leg of
patient and rotate in direction of roll. Roll trunk by extending arms and use
body wt. leaning back instead of shoulders and arms. Second person assisting
by pushing trunk from opposite side.
When lowering or lifting, use legs while maintaining hip and spine alignment.
With any manual group lift in an emergency, first designate a team member to
lead the turn/lift. Second, ensure team members know their roles. Lastly,
ensure the objective is clearly communicated to all team members and the
patient. Manual group lifting requires a minimum of 4 people or more.
Depending on the patient’s weight, a 2 layer sheet under patient works best
when mechanical lift is not appropriate. Avoid lifting with just upper
extremities.
CLEANING AND STORAGE
PROCEDURE FOR LIFT
EQUIPMENT
-Before and after use
-Clorox wipes for C-diff or Spore precautions
(Contact time 3min. wet)
-Peroxide wipes for all other cleaning
(Contact time 5min. wet)
-EVS wipe down weekly to prevent dust
collection
REMEMBER TO CLEAN ENTIRE MACHINE
STORAGE OF LIFT EQUPMENT
In use- use within 30 minutes
Not in use- stored in designated areas
BMAT- Pediatrics
Recommended patient population: Patients age > 4 years of age with ability to follow directions
Ensure activity order in place and safety screening clearance before assessing with BMAT
ASSESSMENT LEVEL 1 SIT AND SHAKE
From a semi-reclined position, ask your patient to sit upright and rotate to a seated position at the side of the bed. Ask patient to reach across midline to shake your hand
MOBILITY LEVEL 1 DEPENDENT
ASSESSMENT LEVEL 2 STRETCH AND POINT
Ask patient to extend leg forward until it is straight at the knee. Ask the patient to point and flex foot/toes. Repeat with other leg if appropriate.
MOBILITY LEVEL 2 MODERATE ASSIST
ASSESSMENT LEVEL 3 STAND
Ask your patient to elevate off the bed or chair using an assistive device if needed. Patient should be able to raise buttocks off bed and hold for a count of five.
MOBILITY LEVEL 3 MINIMAL ASSIST
ASSESSMENT LEVEL 4 WALK
Ask your patient to march in place at bedside. Then ask patient to advance step and return each foot.
MOBILITY LEVEL 4 MODIFIED INDEPENDENCE
SAFE PATIENT HANDLING TIPS
MaxiMove
-REMEMBER MAXIMOVE SLINGS ARE DISPOSABLE AND SINGLE PT. USE
-DO NOT LOCK BRAKES ON MAXIMOVE WHEN LIFTING A PATIENT
FROM BED OR FLOOR
-USE SLING ONE SIZE LARGER WHEN DOING A FALL RECOVERY LIFT
-REMEMBER SMALL AND XXL SLINGS ARE AVAILABLE IN MATERIALS
MANAGEMENT
-REMEMBER TO TURN OFF LIFT AFTER EVERY USE
-CHECK BATTERIES ONCE A SHIFT (8 HRS. TO CHARGE EMPTY BATTERY)
SAFE PATIENT HANDLING TIPS
TENOR BARIATRIC LIFT
PURPLE SLING WITH BLACK EDGES
REMEMBER SLINGS ARE LAUNDRY ONLY
704 LBS WT LIMIT
LEGS OF SLING MUST BE CROSSED WITHIN LOOPS
DO NOT LOCK BRAKES ON TENOR WHEN LIFTING A PATIENT
FROM BED OR FLOOR
USE ONE SIZE LARGER WHEN DOING FALL RECOVERY LIFT
SLINGS ARE AVAILABLE IN XL & XXL IN LIFT TEAM DEPT
NOTIFY LIFT TEAM WHEN NEEDED
REMEMBER TO TURN OFF LIFTS AFTER EVERY USE
CHECK BATTERIES ONCE A SHIFT (8HRS. TO CHARGE EMPTY
BATTERY)
SAFE PATIENT HANDLING TIPS
LIKO GOLVO
GREEN SLINGS WITH COLORED EDGES NEAR SHOULDERS
SLINGS ARE LAUNDRY ONLY OR SINGLE PATIENT USE
440 LBS WT LIMIT
LEGS OF SLING MUST BE CROSSED WITHIN LOOPS
BRAKES REMAIN UNLOCKED WHEN LIFTING A PATIENT FROM BED
OR FLOOR
USE ONE SIZE LARGER WHEN DOING FALL RECOVERY LIFT
CAN BE USED FOR CAR EXTRACTIONS
SLINGS ARE AVAILABLE IN L, XL & XXL
KEEP LIFT PLUGGED IN AFTER EVERY USE
CHECK BATTERY ONCE A SHIFT (MAXIMUM CHARGE REACHED
AFTER 6HRS)
ALWAYS PERFORM WITH 2 STAFF FOR SAFETY
SAFE PATIENT HANDLING TIPS
TOLLOS BARIATRIC STEDY AID (SIT TO STAND)
REMEMBER TO LOCK BRAKES TO LIFT PATIENT AND UNLOCK BRAKES TO SIT PATIENT
ALWAYS HAVE SOMEONE HOLDING LIFT TO CONTROL MOVEMENT DURING DESCENT
750 LBS WT LIMIT
BRIGHT BLUE SLING W/COLORED LOOPS
REMEMBER SLING IS WIPE DOWN/REUSABLE
ALSO AVAILABLE IN WHITE DISPOSABLE SLINGS W/COLORED EDGES
NOTIFY LIFT TEAM WHEN NEEDED
SLINGS ARE AVAILABLE IN XL & XXL IN LIFT TEAM DEPT
REMEMBER TO TURN OFF LIFT AFTER EVERY USE
CHECK BATTERIES ONCE A SHIFT (8HRS. TO CHARGE EMPTY BATTERY)
SAFE PATIENT HANDLING TIPS
SARA STEDY
-REMEMBER THE SARA STEDY IS NOT A WALKING DEVICE
-PATIENT MUST HAVE SITTING BALANCE
-PATIENT MUST BE ABLE TO FOLLOW COMMANDS
-PATIENT MUST BE ABLE TO PERFORM SIT TO STAND WITH MINIAML
ASSISTANCE
-PATIENT MUST BE AT LEAST WT BEARING AS TOLERATED OR FULL WT.
BEARING WITH BOTH LE’S AND AT LEAST ONE UE
SAFE PATIENT HANDLING TIPS
RoWalker
REMEMBER TO ENTER ROOM WITH ROWALKER AT THE LOWEST
HT. REMEMBER TO TAKE OFF SAFETY LOCKS WHEN ADJUSTING
REMEMBER TO TAKE OFF SAFETY LOCKS BEFORE ADJUSTING HT.
AND SECURE LOCKS BEFORE USAGE
REMIND PATIENT THE HT. ADJUSTING GRIP IS NOT A BREAK
ROWALKER ABLE TO ACCOMMODATE PATIENTS FROM 5’1” AND
ABOVE.
WT. REQUIREMENT <400 LBS
SAFE PATIENT HANDLING TIPS
QUICKMOVE WALKER
SIT TO STAND TRANSFER AND WALKING DEVICE
REMEMBER TO ENTER ROOM WITH QUICKMOVE WALKER AT LOWEST HT.
PATIENT MUST BE ABLE TO PULL SELF UP TO STAND
REMEMBER TO LOCK DEVICE PRIOR TO MOBILIZING PATIENT
QUICKMOVE WALKER CAN ACCOMMODATE PATIENTS FROM 5’1’’ AND
ABOVE
WT. REQUIREMENT < 375 LBS
FOOT PLATE IS USED FOR SIT TO STAND TRANSFER
FOOT PLATE IS REMOVEABLE FOR AMBULATION
CLEAN ENTIRE LIFT BEFORE AND AFTER USE
SAFE PATIENT HANDLING TIPS
SEATED POSITIONING SYSTEM
REMEMBER TO KEEP HIPS IN LINE WITH CHAIR
USE BODY WT. AND SHIFT WT. BACKWARDS WHEN
REPOSITIONING PATIENT
ALWAYS PERFORM WITH 2 STAFF FOR SAFETY
SEATED POSITIONING SYSTEM SHOULD BE IN DIRECT CONTACT
WITH CHAIR (DO NOT PLACE CHUX OR SHEET BETWEEN CHAIR
AND SEATED POSITIONING SYSTEM)
SAFE PATIENT HANDLING TIPS
SAGE TAPS 2.0
REMEMBER EACH COMPONENT OF THE SYSTEM CAN BE
REPLACED SEPERATELY AND IS LOCATED ON SUPPLY CART
TOP SHEET PLACED AT PATIENTS SHOULDER
WEDGES ARE TO BE USED BLACK SURFACE UP AND ANCHOR
WEDGE BENEATH THE PATIENTS THIGHS
REMEMBER TO MONITOR SKIN AT ALL AREAS OF CONTACT WITH
WEDGES AND ANCHOR
TAPS CAN BE USED FOR LATERAL TRANSFERS IF ACCOMPANIED BY
A SLIDE BOARD OR ROLL BOARD
REMEMBER TO ADJUST BED TO HIP LEVEL OF SHORTER PERSON,
TIGHTEN ABDOMINAL AREA, STRONG WRIST (PALMS FACING
DOWN), ELBOWS INTO BODY AND WT. SHIFT DURING
REPOSITIONING OF PATIENT.
Roll board Slide board
SAFE PATIENT HANDLING TIPS SAGE TAPS XL/XXL
ORDER FROM MATERIALS MANAGEMENT
COMES AS AN ENTIRE SYSTEM
REMEMBER TO PLACE MATTRESS COVER PRIOR TO GLIDE SHEET
TOP OF GLIDE SHEET IS PLACED AT PATIENT’S SHOULDER
ATTACH GLIDE SHEET STRAPS TO MATTRESS COVER
REMEMBER TO MONITOR SKIN AT ALL AREAS OF CONTACT WITH WEDGES
AND ANCHOR
XL/XXL TAPS CAN BE USED FOR LATERAL TRANSFERS IF ACCOMPANIED BY A
SLIDE BOARD OR ROLL BOARD AND ADDITIONAL ASSISTANCE
REMEMBER TO ADJUST BED TO HIP LEVEL OF SHORTER PERSON, TIGHTEN
ABDOMINAL AREA, STRONG WRIST (PALMS FACING DOWN), ELBOWS
INTO BODY AND WT. SHIFT DURING REPOSITIONING OF PATIENT
Roll board Slide board
SAFE PATIENT HANDLING TIPS
MAXI AIR & PUMP
REMEMBER TO ORDER FROM MATERIALS MANAGEMENT WHEN
ANTICIPATING A PATIENT APPROPRIATE FOR DEVICE
REMEMBER TO CENTER PATIENT ON MAXI AIR MATTRESS
REMEMBER TO SNAP HOSE IN AND CLOSE VELCRO TAB FOR
EFFICIENT MATTRESS INFLATION
REMEMBER TO LOCK BRAKES ON BOTH SURFACES, RAISE BOTH
RAILS ON BED AND TIGHTEN SAFETY STRAPS LOOSELY PRIOR TO
INFLATION.
TIGHTEN SECURELY PRIOR TO MOBILIZING PATIENT
SAFE PATIENT HANDLING TIPS
MAXISLIDE FLITES
FLITES ARE FOR REPOSITIONING PATIENT UP AND DOWN IN BED,
SLIDING LATERALLY AND CAN ASSIST WITH TURNING
2 FLITES ARE NEEDED TO PERFORM REPOSITIONING
FLITES ARE DISPOSABLE AND SINGLE PATIENT USE
WHEN PERFORMING LATERAL TRANSFER, STAFF WILL PUSH AT
SHOULDER/HIP OF PATIENT FROM DEPARTING SURFACES AND
PULL FROM RECEIVING SIDE USING HANDLES AND APPROPRIATE
BODY MECHANICS
FLITES MUST BE REMOVED AFTER USAGE
SAFE PATIENT HANDLING TIPS
SLIDE BOARD & ROLL BOARD
REMEMBER TO CLEAN THE BOARD BEFORE AND AFTER USE
ENGAGE BRAKES ON BOTH TRANSFER SURFACES
ADJUST DEPARTING SURFACE TO HIP/WAIST LEVEL OF SHORTEST
ASSISTING PERSON.
REMEMBER TO ROLL PATIENT OVER COMPLETELY BEFORE
PLACING SLIDE BOARD/ROLL BOARD
USE A SLIDE SHEET BETWEEN PATIENT AND SLIDE BOARD
PRIOR TO SLIDING PATIENT, ENSURE PATIENT’S HEAD AND FEET
ARE SUPPORTED
USE SLIDE SHEET TO SLIDE PATIENT TO RECEIVING SURFACE
RECEIVING SURFACE SHOULD BE SLIGHTLY LOWER
MINIMAL 2 PERSON ASSIST REQUIRED
TRANSFER BOARDS SHOULD REMAIN HUNG WHEN NOT IN USE
SAFE PATIENT HANDLING TIPS Limb Clip Disposable Sling
Designed for single patient use
Assists the caregiver with lifting, supporting and positioning
the limb for easier access when performing activities such as
dressing, foot care, wound care and venous wrapping
Compatible with the Maxi Move lift
Remember to fold plastic clip down and away from patient’s
skin when sliding under patient’s limb
Can use Maxislide/flite between patient and sling to assist
with sliding
Available in standard size only
Sling’s limb weight capacity 154 lbs
Floors at RR Location of Lift Equipment 8 North Core 8 East Core 8 West Core 7 North Core 7 East Core 7 West Core 6 North Core 6 East Core 6 West Core 5 PEDS Core 5 East Alcove near room 5137 5 L&D Removed 4 North Core 4 East Located in 4 North 3F Mattel Alcove across from room
3531 1 Gonda Alcove across from 1255x
Floors at SM Location of Lift Equipment 3NW (Ortho)
Service Elevators: Sara Stedy, Sara Plus, Maxi Move
Battery Charger(s): RM 3207
4NW (Med Surg) Near RM 4220: Sara Stedy, Sara Plus, Maxi move, Quick Move
Battery Charger(s): RM 4209
5NW Geri
Service Elevators: Sara Stedy, Sara Plus w/slings, Maxi Move
Battery Charger(s): RM 5256
6NW (Peds)
Service Elevators: (2) Sara Stedys, Sara Plus, Maxi Move
Battery Charger: Treatment RM
4CWICU
Near RM 4326 (Maxi Move)
Near RM 4348 (RoWalker)
Battery Charger: Storage RM
Ante Partum RMs (4) Maxi Air Pumps
2MN (ROF) RM 2431A (belongs to L&D): Sara Stedy
IOF POD 5 (belongs to PACU): Sara Stedy
4MN (Med/Surg)
POD 5: Sara Stedy, Sara Plus w/sling, Maxi Move
Battery charger: RM 4467
5MN (Telemetry)
POD 5: Sara Stedy, Sara Plus, Maxi Move
POD 9: Sara Stedy
RM 5452 (Sara Plus slings)
Battery Chargers: RM 5452
4SW (Onc)
Middle of Unit: Sara Stedy, Sara Plus, Maxi Move
RM 4537 (Sara Plus slings)
Battery Chargers: RM 4537
3SW (PACU/PTU) POD 5: Sara Stedy
2SW (NICU) None. If in need, ask post-partum
IOF POD 5 of PACU: Sara Stedy
2MN (L&D/Antepartum) Area 2431A: Sara Stedy
OR No lifts
ED Outside Ambulance Bay: (2) Sara Stedys
GI Lab/MPU No lifts
1223 16th St. (Surgery Ctr) Storage RM 20: Sara Stedy
1245 16th St. (SMOC) Pathology lab: Golvo lift
MOC RM 207: Sara Stedy, Sara Plus, Maxi Move, (1) Maxi Air Pump
Locating Safe Patient Handling Resources: Step 1:
Step 2:
Step 3:
U-Move SPH Equipment Cheat Sheets: Located just a bit lower:
Then find the Cheat Sheet:
Find your answers here!
Safe Patient Handling
Summary of Available Equipment Mechanicals Lifts
Maxi Move: For BMAT 1, full body lifts, fall recovery
Weight limit 500 lbs
Accessories: Single patient use blue lifting slings (M, L, XL, XXL)
Rechargeable batteries
Tenor: For BMAT 1, bariatric full body lifts, fall recovery
Weight limit 704 lbs
Accessories: Laundered purple slings (XL, XXL)
Rechargeable batteries
Maxi Lite: For BMAT 1, full body lift, car extraction
Weight limit 350 lbs
Accessories: Single patient use blue lifting slings (M, L, XL, XXL)
Rechargeable batteries
Sling Size EMPAC# MFR’s Product Full Description
EMPAC Description MFR Catalog #
Medium (yellow) 606183 Clip Medium – Standard Flites Clip Medium – Standard Flites MFA1000M-M
Large (green) 606184 Clip Large – Standard Flites Clip Large – Standard Flites MFA1000M-L
X Large (blue) 606185 Clip XLarge – Standard Flites Clip XLarge – Standard Flites MFA1000M-XL
XX Large (orange) 606186 Clip XXLarge – Standard Flites Clip XXLarge – Standard Flites MFA1000M-XXL
Sling Size EMPAC# MFR’s Product Full Description EMPAC Description MFR Catalog #
Medium (yellow)
606183 Clip Medium – Standard Flites Clip Medium – Standard Flites MFA1000M-M
Large (green) 606184 Clip Large – Standard Flites Clip Large – Standard Flites MFA1000M-L
X Large (blue) 606185 Clip XLarge – Standard Flites Clip XLarge – Standard Flites MFA1000M-XL
XX Large (orange)
606186 Clip XXLarge – Standard Flites Clip XXLarge – Standard Flites MFA1000M-XL
Golvo 7007 ES: BMAT 1, full body lift, car extraction
Weight limit 440 lbs
Accessories: Laundered green sling w/loops (L, XL)
Sara Plus: For BMAT 2 sit to stand, transfer to chair, toilet, commode
Weight limit 420 lbs
Accessories: Green lumbar support (S, M, L, XL)
Rechargeable batteries
Tollos Steady Aid: For BMAT 2 sit to stand, transfer to chair, toilet, commode
Weight limit 750 lbs
Accessories: Wipe down blue full back sling w/loops (M, L, XL, XXL)
Single patient use lumbar support sling available (XL, XXL)
Sling Size EMPAC# MFR’s Product Full Description EMPAC Description MFR Catalog #
Medium (yellow)
-- M-Soft Original HighBack Sling, Polyester, Reinforced Leg and Back Supports
M-Soft Original HighBack Sling, Polyester, Reinforced Leg and Back Supports
3526115
Large (green) -- L-Soft Original HighBack Sling, Polyester, Reinforced Leg and Back Supports
L-Soft Original HighBack Sling, Polyester, Reinforced Leg and Back Supports
3526116
X Large (blue) -- XL-Soft Original HighBack Sling, Polyester, Reinforced Leg and Back Supports
XL-Soft Original HighBack Sling, Polyester, Reinforced Leg and Back Supports
3526117
Sara Stedy: For BMAT 3 sit to stand, transfers to chair, toilet, commode
Weight limit 400 lbs
No accessories
RoWalker: BMAT 3, walking device w/built-in seat
Transfer device from bed to chair
Can hold 02 tank, cardiac monitor
Accessories: wipedown red lumbar walking sling (S, M, L)
Quick Move: BMAT 3 sit to stand transfers
BMAT 3 patient who can walk and needs occasional seated rest breaks
Weight limit 375 lbs
Accommodates patients 5’1” and above
Accessories: none
Lateral Transfer Devices
Prevalon TAPS: BMAT 1 or 2, who need frequent bed repositioning
Lateral transfer with a slide board
Single patient use, stays under the patient
Accessories: 2 wedges, incontinence pad
MaxiSlide: BMAT 1 or 2 boosting, repositioning and lateral transfers without a slide board
Single patient use, do not leave under patient
1 MaxiSlide per package
Use 2 MaxiSlides together with handles facing up
Maxi Air: For bariatric boosting and lateral transfers without a slide board
Single patient use
Accessories: Use w/pump
Size EMPAC# MFR’s Product Full Description EMPAC Description MFR Catalog #
Standard 644093 Prevalon TAP system System Prevalon Turn and Position (For Bed)
5594007200
XL
N/A 605130 Prevalon Micro Tab Body Pads PADS Body Micro Climate (under pads) PK of 5
5594007250
Size EMPAC# MFR’s Product Full Description
EMPAC Description MFR Catalog #
XL 606182 MaxiSlide flite 45” - XL MaxiSlide flite - XL NPAV5260
Size EMPAC# MFR’s Product Full Description EMPAC Description
MFR Catalog #
L (Green handles) 606180 Maxi Air Maxi Air MAS014000-WW
XXL (orange handles) 674101 Maxi Air Maxi Air
-- 606181 Maxi Air Motor Maxi Air Motor
AHAIR
Seated Positioning System
Prevalon Chair Positioning System: Position patient up in the chair
Place on chair prior to transferring patient to the chair
Single patient use
Accessories: Incontinence pad
Limb Sling
Limb Clip: Single patient use
Use w/Maxi Move
Standard size only, weight limit 154 lbs (600 lbs patient)
Size EMPAC# MFR’s Product Full Description EMPAC Description MFR Catalog #
Standard 605133 Seated Positioning System System Prevalon Seated Position (For Chair)
5594007530
Size EMPAC# MFR’s Product Full Description EMPAC Description MFR Catalog #
Standard 680078 ARJH Limb Clip Flite Limb Clip Flite VIG22000-L1
REFUSAL TO PERFORM PATIENT MOBILITY
ASSESSMENT FORM
It is the right of each employee to refuse to move a patient, but there must be a clear and
objective reason for the refusal. If patient mobility assistance is part of an employee’s job
description, and the employee refuses to perform this job function, meet with the employee
each time and document their reasons for the refusal. This form should be signed by both
employee and manager, and placed in the employee’s personnel file.
EMPLOYEE NAME: _________________________UNIT: ____________ DATE: _____________
PATIENT: ________________________________________________ MRN: _______________
Assistance from other personnel was not available. Describe attempts made to locate
other personnel: ________________________________________________________
Lifting equipment was not available; describe: _________________________________
Lifting restrictions; physician documentation verified Yes Not on file
Patient impulsive or combative
Lack of training in proper lifting techniques
Faulty or broken equipment; describe: _______________________________________
Other: _________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Signed: _____________________________________________ Date: ___________________
Employee
Signed: _____________________________________________ Date: ____________________
Manager / Supervisor