SUPPLEMENT: Integrating Mobility and Safe Patient Handling: Practical Considerations for Interdisciplinary Care
Professionals from a variety of backgrounds have contributed to the ever-growing understanding of the importance of safe practices for assisting healthcare recipients with care tasks. Industrial hygienists, ergonomists, nurses, therapists, occupational health professionals, and engineers have all worked together to publish several white papers and position statements, culminating in the publication of the national interdisciplinary safe patient handling and mobility (SPHM) standards in 2013.1
Despite extensive evidence that SPHM programs reduce employee injuries by an average of 72%2-8 and reduce costs associated with employee injuries,9-15 injuries among caregivers continue to rank in the top 5 of all industries.16 Many facilities continue to struggle to achieve the comprehensive system changes required to fully embrace a culture of caregiver safety mirroring that of a patient safety culture.
In recent years, a subtle but important paradigm shift has occurred within the SPHM world. Risk for functional decline, especially for hospitalized older adults, is well documented,17-19 and a growing body of evidence has brought to light the detrimental influence of immobility for healthcare recipients across the continuum of care,17-26 (Table 1) along with the improved patient outcomes associated with increased levels of mobility at all phases of recovery27-40 (Table 2). In addition to patient outcomes, early and progressive mobility programs have shown a positive influence on healthcare facilities through shorter length of stay and fewer of the complications associated with immobility such as pressure ulcers, falls, and hospital–acquired infections,41,42 all of which can dramatically affect the cost of care.43,44
There are, however, barriers to providing optimal patient mobility, including the labor intensiveness and physical difficulty of assisting weak, dependent, and, often, heavy patients out of bed. These barriers have close parallels and similarities with barriers to safe patient handling programs. Morris27 and Winkelman31 have identified that it can take a team of 4 or 5 people to perform mobility interventions.
Arnold M, Wilson C, Mcilvaine J, Labreche M, Stevens LM
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