Chignecto-Central Regional School Board
“Mechanical Lift & Safe Lifting Guidelines”
Health & Safety Division of Operational Services
Student Services Division of Education Services
November 2013
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Introduction
In June 2012, the Nova Scotia Department of Labour and Advanced Education (Occupational Health and
Safety Division) issued a HAZARD ALERT for Patient and Residential Lifts. This alert indicated a HIGH risk of
injury and the typical cause was noted as malfunction or misuse of patient lifts.
Hospitals, Long Term Care Facilities, Schools and even private homes use mechanical lifting systems to
transfer of reposition their clients/students who have mobility issues. Since the need to lift
clients/students poses an injury risk to the attendant/Educational Assistant, and the task cannot be
eliminated, engineering solutions are used in the form of mechanical lifts. Mechanical lifts are also known
as hoists. There are many types of lifts. Some of the more common ones are:
Wheeled Hoist/Portable Floor Lift
Stationary Hoist/Fixed Lift
Ceiling Track – complete with motor
Sit/Stand Lifting Aid
Bath Lift
Using mechanical lifting systems are a documented source of injuries to both clients/students and
attendants/Educational Assistants. The Hazard Alert which was issued focuses on the hazards to attendees
(workers) and outlines a range of preventive measures, which under the Nova Scotia Occupational Safety
General Regulations, which are legal requirements. Preventive measures outlined in this alert include:
Requirements for safe sling use include appropriate matching of sling/hoist, appropriate
size selection of slings, appropriate use of slings and appropriate laundering of slings.
Attention to load limits of the lift and the patient’s weight.
Periodic inspections and Pre-use inspections.
As a result of the issuance of this HAZARD ALERT, and whereas the Chignecto-Central Regional School
Board, places high priority on a safe work environment for all staff and students, the Operational Services
Department and the Student Services Division of the Education Services Department have collaboratively
developed a document entitled “Mechanical Lifts and Safe Lifting Guidelines.” This document contains the
following sections:
Manual Portable Student Lift Checklist
Procedure for Cleaning and Inspecting Sling and Lift
Student Assessment
Tips when Dealing with an Uncooperative Student
Preparation for Lifting Checklist
Determining Risk Factors
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Part A: Manual Portable Student Lift Checklist
Monthly Date September October November December January February March April May June 1. Wash sling 2. Wash down lift 3. Visually check parts:
a. Sling for fraying or excessive wear b. Spreader bars for signs of stress (bending,
etc.) c. All parts, including casters, for signs of
cracking, deformation, deterioration or stress
d. Missing parts e. Locks are working properly f. Battery staying charged and not leaking g. Pump to ensure cycles and operates
appropriately
Annual July/August 1. Lubricate parts (refer to page 43
Maintenance Manual)
2. Inspect for excessive wear, bends or loose parts; a. Caster and base b. Spreader bars c. Shifter handle d. Mast e. Boom f. Swivel bar g. Pump assembly h. Control valve i. Sling hardware
Enter Work Order Number: Signature:
Individuals completing the student lift checklist shall initial each section once the inspection is completed.
Each month shall be dated with the actual date of the inspection.
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Part B: Procedure for Cleaning and Inspecting Sling and Lift
Prior to using the student manual lift, all users must conduct a visual inspection of the lift. If any parts or systems
while operating the lift appear to not be working properly, the lift shall be taken out of service, by marking it with a
sign, dating and signing it. Report it immediately to your supervisor for further action and document in the note
section of the log book section of the lift.
Sling: The sling should be regularly washed in water temperature not to exceed 180F (82°C) and an approved board
supplied anti-biological solution used for cleaning. Property Services will supply the appropriate product.
Lift: A soft cloth dampened with water and a small amount of mild detergent is all that is needed to clean the
student lift. The lift can be cleaned with non-abrasive cleaners.
Inspections: Check: visual inspections of any parts that maybe under stress due to use. This would include but not limited to; slings, spreader bar, brakes, batteries or any signs of cracking, fraying, deformation or deterioration.
Prior to anyone using the lift the person assigned must review the user manual and the CCRSB lift manual.
Part C: Student Assessment
When possible two people should assist with the use of the portable student lift, however, based on the individual
student assessment one person may be adequate.
The definitions below are for Student Care Teams to be used to describe the student’s ability with regards to student
handling and movement. Further details to be found in the relevant risk assessment charts attached.
Independent:
Student requires no assistance.
Supervised (Standby):
Requires assistance with equipment, environment and or footwear, set-up or verbal reminders.
Cooperates and follows directions.
Walks with or without equipment (cane or walker) unassisted.
May need verbal cuing or coaching.
Minimal Assistance:
May need minor physical assistance. This is defined as no more than 35 lbs or 16kg of force exerted by the
Educational Assistant.
May need to use walking aid such as a cane, etc or have to transport accessory equipment.
May need verbal cuing or coaching.
Minimal Assistance with Transfer Belt:
For use on students only (EA’s shall not wear the transfer belt when working with students). The EA shall
ensure the belt is adjusted and fitted appropriately (snug), so it is does not move. Each student shall wear
the appropriate sized transfer belt, as determined in the manufacturers’ information.
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When using a transfer belt, patient must be fully weight bearing once standing and require only slight
physical exertion from the Educational Assistant when rising to stand, or lowering to sit.
Transfer belts should be laundered similar to the process for the student mechanical lift sling (wash
frequency to be determined by use, at a minimum, once per term).
Moderate Assistance/Partially Dependent
When the student is partially dependent some physical support for trunk or legs is required during transfer or
ambulation. Further assessment will be required to determine the appropriate equipment.
Maximum Assistance/Totally Dependent
The student may be dependent for turning, repositioning, standing walking or transferring. The student may
have difficulty with key factors in providing assistance such as inability to follow directions, inability to weight
bear, demonstrating uncooperative behavior, unpredictable behavior or inability to provide the needed level
of exertion or strength required to safely perform the task.
Part D: Tips when Dealing with an Uncooperative Student
Stop and Wait: Do not rush into or continue with the transfer unless a threatening medical emergency is
occurring. Ensure or assist the student to feel calm. When calm, the student is more likely to feel safe and
cooperative.
Speak to the student in a confident tone and determine if touch would be soothing for the student.
Do not touch the student if it stimulates or accelerates the behavior
Be aware of the verbal and physical cues you are sending to the patient. If the EA’s are nervous, this can
increase the fear and aggression in the student.
Be careful not to crowd an anxious student, as this may increase the negative behavior.
Be aware that confusion and fear often accompany sensory loss and disorientation.
Ensure the student is oriented and is aware of their responsibilities during the transfer.
Use clear and concise directions.
Be aware that floor slopes and floor patterns can create an illusion to the student and make the pathway
seem unsafe. Give as much control over movements as possible when the student is in pain or frightened.
Do not respond to the student’s aggression or agitation with a confrontational tone as this approach may
elicit further resistance from confused or scared students.
Understand that when scared or hurt the student’s reflex response is to move in opposite direction that they
are being directed.
Remember that students will resist if in pain.
Avoid gripping a confused or agitated student’s hand. Instead guide with the palm of your hand.
Positioning yourself very close can offer security but also may trigger aggression.
All movement and procedures should be carefully considered and planned prior to the lift.
Part E: Preparation for Lifting Checklist
Wear clothing and footwear appropriate for physical tasks (non-restrictive clothing).
Assess the situation (weight and size).
Visually plan the move.
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Communicate with the student and/or partner about the move.
Prepare the area (i.e. clear away any obstacles).
Prepare the wheelchair: remove or push aside foot rests, remove side arms when possible, loosen seat belt,
position as close as possible to the student or area student being moved to, make sure brakes are on.
Prepare the student (i.e. clothing and footwear)
Position yourself close to the student.
Choose leader if the lift requires two person.
Leader commands, 1,2,3 …LIFT.
DO:
Look after yourself, exercise regularly, maintain good posture.
Tighten your abdomen muscles.
Use your legs for lifting, not your back.
Expect the unexpected.
Ensure path is clear.
Wear proper footwear.
DO NOT:
Grab the student under the armpits or by holding onto their arms and legs.
Have student grab you around the neck.
Rotate or twist your spine while lifting (keep your nose between your toes).
PART F: Determining Risk Factors
Considerations for Using this Guide:
The following are meant as a guideline when determining risk factors and appropriate control measures to protect
staff from injury. Each student shall be assessed on an individual basis and plans shall be implemented as
appropriate. When determining appropriate controls for each student/situation it is important that equipment that
is appropriate for the situation is identified and used (i.e. lift belts, commode chairs, student lifts, etc.)
EA’s shall be prepared for their assignment with appropriate dress based on the known risks with their individual
student assignments. This may include appropriate dress, footwear, and accessories. Some situations may warrant
staff keeping their hair tied back and reducing/eliminating wearing jewelry.
Staff that have medical conditions that may limit their lifting capacity must make these known during the planning
process. Considerations for these conditions must be made when determining appropriate control measures.
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Definitions:
Physical Ability: Refers to the student’s ability to weight bear, trunk and limb control.
Cognitive Ability: Refers to the student’s ability to understand and follow directions. Consideration should be
given to age and ability of student to comprehend requests or directions. Further consideration should be given
to the student’s impulse control and any behavioral challenges.
Communication Ability: Refers to students’ ability to verbalize needs or wants to care giver.
Risk Assessment Tool:
The following risk assessment tools are for specific activities that may pose risk to staff related to muskeletal injuries
(sprains and strains to muscles).
Considerations when using the Risk Assessment Tools
Unless there are contributing factors that are identified by the planning team, students under 40 lbs. shall be
considered in the minimal category of risk.
If there are safety concerns related to any lifting procedure or specific student, the school in collaboration with
Student Services shall discuss the need for an Occupational Therapist /Physiotherapist (OT/PT) referral.
Students will require re-assessment each school year as well as, following any of the following: significant change
in weight or height, student surgery or equipment changes.
Definitions related to the Risk Assessment Tool:
Low – exhibit signs requiring physical tasks related to student support once daily.
Moderate – exhibit signs requiring physical tasks related to student support several times daily. (i.e. Time Out Room)
High – exhibit signs requiring physical tasks related to student frequently throughout the day.
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Risk Factor Activity Risk Rating for Student Control Measures
Moving and Handling Students
Transferring student between equipment:
Chair to Wheelchair
Wheelchair to Standing Frame
Chair to Changing Table or Toilet
Swing in Sensory Room
Chair to Mat/Cot in Sensory Room
Carrying Students
Lifting Student onto Change Table
Weight
40-50 lbs 1
Score: 5 Minimal Controls
Brakes on all equipment as appropriate.
Bars in washroom to help student assist with movement.
Transfer belt maybe required.
Verbal cueing to student of transfer/move.
Safe lifting techniques to be used by staff.
Ensure adjustable equipment is adjusted to appropriate height prior to each move/lift.
6-10 Moderate Controls
Minimal Controls
Two staff may be required for specific moving or handling activities.
May involve the use of transfer belt or other lifting aids.
11-15 Maximum Controls
Minimum and Moderate Controls
Two staff recommended for physical transfer and assisting with mechanical lifts use.
Mechanical (i.e. hand pump or electric) student lift may be used for lifting and transferring student.
Consider consult/referral with OT/PT.
51 to 80 lbs 2
81 lbs + 3
Height
40 inches or less 1
41-48 inches 2
49 inches + 3
Physical Ability
Full 1
Partial 2
Limited/None 3
Cognitive Ability
Full 1
Partial 2
Limited/None 3
Communicative Ability
Full 1
Partial 2
Limited/None 3
Score
8
Risk Factor Activity Risk Rating For Student Control Measures
Posture of Employees
Leaning/Stooping Over/Twisting
Desks/Tables
Wheelchairs/Walkers
Change Tables (ones unable to adjust)
Toilet
Sensory Room Supporting Student during Treatment
Toileting
Change Table
Supporting student during dress (coats, boots, etc.) during busy hallway activities
Minor Controls (7 and under)
Adjust equipment to appropriate height.
Use proper lifting techniques.
Ensure proper equipment is identified and used.
Ensure proper posture and position changes.
Moderate Controls (8-13)
All minor controls
Two EA’s may be necessary, but very dependent of student need/ability.
Maximum Controls (14-18)
All minor and moderate controls.
Alternating staffing assignment as able/necessary.
Ensure proper posture and position changes.
Size of Desks Used (if appropriate)
Small Desk 3
Medium Desk 2
Adult Desk 1
Student Requirement for Personal Care
No Care 1
Intermediate Care 2
Full Care 3
Weight of Student
40-50 lbs or less 1
51 lbs – 80 lbs 2
81 lbs + 3
Amount of Use of Time Out Room
Several Times/Week 1
Daily 2
More than once daily 3
Ability to Adjust Equipment to Fit Employee
Adjustable Equipment 1
Non Adjustable Equipment 3
Physical Size of Room and Location of Equipment
Space to work on both sides of equipment 1
Space to work on one side of equipment 2
Space not large enough for equipment 3
Total Score
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Risk Factor Activity Risk Rating For Student Control Measures
Potential for Unpredictable Behavior
Moving and handling of students who may move suddenly or struggle while transferring or during personal care.
Using NVCI holds in various situations.
Holding Time Out Door.
Students that have potential to run away.
Weight of Student
Height of Student
Strength of Student
Student control over body movements
Verbal/Cognitive ability of student
Student Diagnosis
Physical Ability of Student
Behavior Plan
Ability of student to accept change (Substitute EA/Teacher)
Location of Time Out Room
Understanding and following plan for diagnosis of student.
Training to help anticipate unpredictable behavior.
Non-verbal communication skills.
Ensuring adjustable equipment is at appropriate height during treatment.
For specific treatment two staff may be necessary, and will depend on ability of student.
Training of staff in NVCI and other related training (autism, etc.).
Following behavior plan in place for student.
Communicating with appropriate staff on the planning team for the student.
Attempting to make best use of space to ensure a safe environment for student and staff.
Alternating staffing assignment as able/necessary.
Using PPE as required with specific students.
Following specific safety practices for specific students.
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Risk Factor Activity Risk Rating For Student Control Measures
Moving and Handling Objects
Moving:
Equipment
Furniture
Lifts
Adjusting Change Tables
Carrying Student Back Packs or Personal Care Items
Medical Equipment
Multi-floor schools potentially increase risk.
Need to share equipment increase risk.
Equipment that is not adjustable may increase risk.
Proper Storage is available.
Items to be moved are on wheels, makes movement easier.
Fire doors that do not have hold open devices.
Use of student lift for moving student in wheelchair or requires mobility assistance from floor to floor (platform or enclosed platform lifts SHALL NOT be used for moving equipment from floor to floor).
Request assistance from Property Services for large heavy items, (relocating items in the building).
Many items are on wheels.
Proper Body Posture.
Proper Lifting Techniques.
Request assistance for holding doors open when moving between areas.
Ensure adjustable equipment is adjusted to appropriate height prior to each move/lift.
Risk Factor Activity Risk Rating For Student Control Measures
Pushing and Pulling
Wheelchairs
Commode Chair
Other Mobility Aids
Weight of Wheelchair
Weight of Student
Physical Ability of Student
Verbal/Cognitive Ability of Student
Behavioral Issues with Student
Training on Equipment from Qualified Individuals
Proper Posture
Appropriate Dress, Including Footwear
Regular Position Changes
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Risk Factor Activity Risk Rating For Student Control Measures
Environmental Issues, Space Constraints and Floor Surfaces
Space Constraints in
Change Area
Elevator/Lifts
Classroom when using Electrical Wheelchair or Other Equipment
Location of Time Out Room
Stairs/Ramp
Class Trips/Off Site
Classroom Space
Washroom Size and Equipment Required
Multi-Floor School
School Design
Infrastructure of Destination/Trip and Facilities Available
Evaluate best use of area designated for student.
Ensure no trip hazards for staff or student.
Arrange equipment in a manner best suited for staff use and area.
Designate an area appropriate for charging batteries, etc.
Staff shall use designated equipment as per manufacturer’s specifications.
Staff shall be provided with appropriate training from qualified individuals on equipment use.
If location of equipment/resources requires two-person assistance with transporting student this shall be implemented.
Prior to school trips facilities shall be determined to be available as necessary for the student, staff and equipment.
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Risk Factor Activity Risk Rating For Student Control Measures
Physio / Student Exercise/ Sensory Programs
Student Transfer to:
Floor
Bench
Chair
Swing
Bed
Mats
Wheelchair Use of Equipment
Trampolines
Mats
Elastic Bands
Weights
Treadmills
Sensory Equipment
Transfer Belts (as part of exercise)
Walker
Stander Also, consideration should be given to leaning/stooping over any of the above items.
Weight of Student
Height of Student
Physical Ability of Student
Verbal/Cognitive Ability of Student
Physical Ability of Staff
Physical Layout of the School
Storage Capacity
Frequency of Participation in Activity
Training to staff on equipment and tools provided by qualified individuals.
Provide appropriate support equipment for staff when doing the physio exercises.
Staff shall use appropriate posture.
Staff shall use appropriate lifting techniques.
Two staff may be required for specific situations or students.
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Risk Factor Activity Risk Rating For Student Control Measures
Students in Emergency
Lifting student in an emergency.
Preparing students for evacuation (if student receiving personal care when alarm sounds).
Evacuating students (main floor vs. second floor).
Moving chair through fire doors or down a small step.
Power Chairs vs. Manual Chairs
Code Blue/Lockdown
Height of Student
Weight of Student
Number of floors/levels in school
Number of available staff during emergency
Location of student during emergency
Ability to use elevator during emergency
Available area of refuge
ON HOLD: being discussed Provincially
NOTE: The Program Planning Team will be responsible for completing the risk assessment for each applicable student. Educational Assistants will
have an opportunity to provide consultation and all relevant information pertaining to the student and staff safety shall be shared.
