Transcript
NHS FORTH VALLEY Bariatric (Plus Size Person) Handling Guidelines
Date of First Issue Approved Current Issue Date Review Date Version EQIA Author / Contact Group / Committee – Final Approval
01 / 04 / 2003 28 / 10 / 2015 01 / 09 / 2015 01 / 09 / 2017 Version 2 03 / 11 / 2015 Christine Wallace, Manual Handling Coordinator NHS Forth Valley Health and Safety Committee
This document can, on request, be made available in alternative formats
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Version 2
Manual Handling Team Health and Safety Department Occupational Heath Service Staff Physiotherapy Service Scottish Ambulance Service Health and Safety Committee General Managers and Service Managers Nursing & Midwifery Policy Forum Tissue Viability Company Reps re specific equipment information Electronically to All Above
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Change Record Date Author September 2015 September 2015 October 2015
Christine Wallace Christine Wallace Christine Wallace
October 2015
Christine Wallace
Version 2
Change
Version
Reviewed and updated contributors
Draft Version 2 Draft Version 2 Draft Version 2
Updated Appendices to reflect current practices Changes made following comments from W&C Unit; Pathology; Company Reps Due to concerns re the document being Draft lengthy, appendices updated to allow Version 2 them to be added to the intranet separately
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Contents 1. Introduction .................................................................................................. 5 2. Scope ...................................................................................................5 3. Getting a Bariatric Patient to Hospital .......................................................... 5 4. Admission to Hospital .................................................................................. 6 5. Bariatric Equipment Access within NHS Forth Valley .................................. 6 6. Transferring a Bariatric patient within the Hospital setting or a long-term care facility: ...................................................................................................6 7. Equipment for Hire ....................................................................................... 7 8. Equipment suitable for Community setting: ................................................. 7 10. Deceased Bariatric Patient Handling Procedure.......................................... 9 10.1 Procedure with Mortuary Involvement at FVRH .................................... 9 10.2 Mortuary Risk Assessment Consideration ...................................... 9 APPENDIX 1 – Getting a Bariatric Patient to Hospital ..................................... 10 APPENDIX 2 – Admission to Hospital ............................................................. 11 2.1 Elective Admission ............................................................................... 11 2.2 Emergency Admission (Emergency Department (ED) / Acute Admission Unit (AAU) .................................................................................................11 2.3 Admission Flow Chart............................................................................ 12 2.4 How to Obtain Patient’s Weight ............................................................. 12 APPENDIX 3 - Huntleigh Contoura 1080 Bed with Weigh Scales ................... 13 APPENDIX 4 - LIKO Weigh Scales attachment for Liko VikingXL ................... 15 APPENDIX 5 - The Safe Working Load of Standard Equipment...................... 16 APPENDIX 6 - Body Shapes ........................................................................... 17 APPENDIX 7 - Bariatric Patient - Risk Assessment and Mobility Chart ........... 18 Risk Assessment ............................................................................................. 18 7.1 - Risk Assessment in Relation to Bariatric Patients – Points to Consider .......................................................................................................27 APPENDIX 8 – Bariatric Equipment Available within NHS Forth Valley .......... 31 APPENDIX 9 – Bariatric Equipment for HIRE & Purchase .............................. 34 Benmor Medical (UK) Ltd ................................................................................. 34 NB - Each Appendix is also available separately on the Staffnet.
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1.
Introduction
The management of caring for bariatric (plus size) patients can present many challenges in terms of provision of and access to equipment, staffing, transport, environmental constraints and communication between agencies. NHS Forth Valley is committed to providing a high quality environment where patients and staff can be confident that best practice is being followed at all times and the safety of staff and patients is of high importance. A ‘bariatric’ person is anyone weighing 159kg (25 stone) or more (ref: Fazel 1997). Consideration also needs to be taken of body morphology – where their size, height, weight, shape and / or width exceeds equipment dimensions e.g. if a patients hip to hip anterior measurement (with the exemption of pregnancy) is 100 cm or greater, they would be defined as bariatric even if their weight is less than 159kg (25 stone). Therefore, a bariatric patient can be defined as anyone, regardless of age, who has limitations in health and social care due to their weight, physical size, shape, width, health, mobility etc. The Bariatric Handling Guidelines have been developed as an adjunct to the Manual Handling Policy and Guidelines on Manual Handling. Their purpose is to have a robust process in place across all areas to support the needs of the emergency and elective bariatric patient from admission to discharge. Factors considered are: • Equipment: Safe Working Load (SWL) of standard equipment, availability of specialist bariatric equipment, time required to access the equipment • Patient Factors: privacy and dignity, tissue viability needs, pain, ability / willingness to cooperate, shape, width, weight distribution and comorbidities • Staff: training, competence, availability of specialist advice • Communication: department to department to support safe transfer from admission to discharge and inter-agency
2.
Scope
These guidelines are to ensure that, when moving and handling bariatric patients, NHS Forth Valley meets all statutory obligations placed upon it to reduce the risk of injury to staff and patients. It applies to all staff involved in the delivery of care and services to patients with bariatric needs.
3.
Getting a Bariatric Patient to Hospital
The Scottish Ambulance Service (SAS) serving the Forth Valley region has equipment to perform this task. Refer to Appendix 1 for further details.
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4.
Admission to Hospital • • • •
Elective admissions Emergency admissions Admission Flow Chart How to obtain bariatric patient’s weight
Refer to Appendix 2 for further details.
5.
Bariatric Equipment Access within NHS Forth Valley
Over Head Tracking Hoists • Mobile Hoists • Bariatric Raiser Recliner Chairs • Heavy Duty Upright Chairs • Heavy Duty Commode / Shower Chairs • Bariatric Walking Frame • TC 300 Transfer Chair • Bariatric Porters Wheelchairs • For Bariatric Bed – please see 3.8 • HoverMatt • HoverJack For equipment type and safe working load (SWL) refer to Appendix 5 for further details.
6.
Transferring a Bariatric patient within the Hospital setting or a long-term care facility:
The following procedure requires to be followed for inter-departmental transfers. Requirement: • Consider if the transfer is absolutely necessary or can the care / treatment be undertaken within the existing ward? Communication • If the transfer is necessary, ensure that as much prior warning as possible is given to the receiving unit. • All relevant information should be passed on regarding the patient and their care needs. • All patient assessment charts (e.g. mobility chart) and risk assessment documentation should be passed onto the receiving unit. Examples of a completed mobility chart Risk Assessment • Prior to the transfer, the receiving unit should carry out their own risk assessment in order to produce an identified plan for the handling of the patient. Please refer to Appendix 7 for details on bariatric patient risk assessment documentation Version 2
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Transport • Ward / department employees should liaise with appropriate services e.g. FVRH - Serco Helpdesk (contact 66888) when organising the transfer and must work together to form and implement plans. Consider the following: • Should the patient be transported on a chair or in their bed? • What is the best route to take when transporting the patient e.g. can carpeted areas or slopes be avoided? • How many employees should be involved in pushing the patient? • Is there an electric bed mover available?
7.
Equipment for Hire (refer to Appendix 9 for further details)
Acute hospital: • To access Huntleigh 1080 bariatric bed, refer to protocol within ‘Huntleigh Folder’ located within each ward at FVRH. Community Hospital: • If the need for a bariatric bed is assessed necessary, contact the Tissue Viability Service on 01324 673747. Additional Equipment: • For additional bariatric equipment available for hire and / or purchase, refer to Appendix 8 and 9. • If information required is not found in Appendix 8 or 9, contact Manual Handling Service for advice on 01786 454718. Hire Procedure: • *Complete a risk assessment in order to justify that the equipment selected meets the needs of the individual patient. • If assessed necessary to hire bariatric equipment, contact line management and Service Administrator to facilitate the process. *It is the responsibility of the clinical area requesting equipment to complete an assessment in order to justify that the equipment selected meets the needs of the individual patient.
8.
Equipment suitable for Community setting:
All bariatric equipment is routinely accessed through the Joint Loan Equipment Service (JLES). Community Bariatric Beds (refer Appendix 9) • Community bariatric beds can be supplied via Joint Loan Equipment Service (JLES). It is essential that an assessment of the patients’ individual needs is completed prior to progression of this equipment. • Responsibility for the assessment will be with ward / department making request. • Adequate lead in time is necessary to plan for this type of equipment. Version 2
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Discharge Home Please refer to Discharge Co-ordinator Service for advice, if indicated, about suitable equipment. All enquiries go through Discharge Co-ordinator Hub 01324 673673 Discharge considerations must commence on the bariatric patient’s admission. Refer to Flow Chart below •
Ensure involvement of all relevant multi-disciplinary team (MDT) members to establish any discharge requirements.
•
Discharge Coordinators to liaise with community services (social work), community Occupational Therapist (OT), Physiotherapist (PT), Community Nurse) to determine if there is any equipment and / or care package already in place.
•
Ascertain if there are any changes necessary within the home environment. Consider: - Equipment needs (e.g. bed, chair, commode, hoisting equipment) - Environmental constraints e.g. access via doors / stairways etc - Access in / out of home - Care package requirements A home visit (with or without the patient) may be required.
•
If provision of new equipment is necessary, determine if this can be obtained from Joint Loan Equipment Service. If a non-stock item is required, funding will need to be identified. Discharge may be delayed if awaiting funding for equipment or awaiting environmental alterations.
•
Establish discharge date as soon as possible.
•
Inform Scottish Ambulance Service (SAS) of pending discharge as soon as possible, giving timescale. The SAS may require to complete their own risk assessment, considering transport home and access to the home.
•
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10. Deceased Bariatric Patient Handling Procedure The following factors should be considered for handling deceased bariatric patients:
10.1 Procedure with Mortuary Involvement at FVRH •
The ward staff should provide the porters and mortuary employees with information on the deceased patient’s size and weight when requesting transport to the mortuary. Additional time may be required to organise the transfer.
•
A bariatric concealment trolley (SWL 250kg / 39 stone) is available in the mortuary
•
If the concealment trolley is not suitable to take their size and weight, the deceased patient should be transported to the mortuary on their bed.
•
It is recommended that at least four staff members be available to transport the deceased bariatric patient to the mortuary or alternatively an electric bed mover could be used.
10.2 Mortuary Risk Assessment Consideration Mortuary employees should consider the Safe Working Load (SWL) and dimensions of the following equipment • Mortuary trolley • Post Mortem Table • Mortuary fridges: o bariatric fridge (fridge spaces 61 – 66) are only suitable for bariatric deceased patients transported on the bariatric concealment trolley above o patients with a wider girth, who are not bariatric, will be transferred on the normal trolley, but placed in a ‘designated fridge’ (fridge spaces 26 – 30). All necessary transfers in the mortuary should be carried out with a sufficient number of staff members, using appropriate handling equipment such as patslide (SWL 200 kg) / HoverMatt (SWL 476 kg) / overhead hoisting system / mobile hoisting system. Mortuary employees must pass on relevant information regarding the deceased patient’s size and weight to: • Funeral Director / Services • Coroner (where applicable) Advice can be sought from the Manual Handling Service as necessary.
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APPENDIX 1 – Getting a Bariatric Patient to Hospital The Scottish Ambulance Service (SAS) serving the Forth Valley region have a limited number of A&E and Patient Transport Services (PTS) ambulances capable of carrying a Megasus trolley cot (SWL 400kg / 63 stone). The SAS has additional equipment; therefore, it is essential they are given prior notification in order to determine which resources are most suitable to be deployed: • Mangar Camel - SWL 318kg (50 stone) (all ambulances carry ELKs) • Stryker Evacuation Sheet -727 kg (100 stone) • Bariatric Zimmer Frame – varying SWL • Quintal Transfer Board (banana style) - SWL 230kg (36 stones) • Extending / telescopic wheelchair tracks for over rough ground & up and down kerbs. • Bariatric Wheelchair - SWL 254kg (40 stones) • Stryker stair chair (descent only) 230 kg (36 stone) • C-Max stairchair (powered) 159kg (25 stone). Risk Assessment Prior to ambulance equipment being deployed, a risk assessment will be carried out at the scene by the ambulance crew. Emergency Admission Under 999 conditions only the ambulance crew might call upon Central Scotland Fire & Rescue Service, for assistance. If the transport to hospital is less urgent, steps will be taken to use appropriate handling equipment in order to reduce the risk to both the patient and the staff. Patient Transport Service (PTS) The PTS have access to the same equipment as Emergency Department (ED) ambulance crews. They will also only transport a patient following completion a risk assessment.
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APPENDIX 2 – Admission to Hospital 2.1 Elective Admission GP practices, community agencies, outpatient clinics / pre-op clerking, Liaison Nurses will initiate elective admissions. The admitting ward / department should liaise with the above community service providers prior to admission; to obtain accurate information on the patient’s weight, handling needs and any associated equipment requirements A referral letter should be sent in advance. The ward managers are responsible for informing other relevant staff such as physiotherapy, occupational therapy, tissue viability, radiographers, discharge planning etc.
2.2 Emergency Admission (Emergency Department (ED) / Acute Admission Unit (AAU) The admitting clinical team need to ensure appropriate assessment is undertaken, specialist advice sought and communicated to ensure transfer areas are adequately prepared to accept the patient and delays and use of inappropriate equipment is avoided. When an individual is identified / perceived as being a ‘bariatric patient’, information on their weight, body shape (anthropometrics) should be obtained immediately on admission or as soon as possible thereafter. Information may be sourced from community services and available medical history documentation. The referral letter arriving with the patient should outline the patient’s weight and any associated mobility / handling needs.
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2.3 Admission Flow Chart Elective Admission
2.4 How to Obtain Patient’s Weight
Emergency Admission
It is imperative to establish the weight, body mass index and weight distribution on admission as this will impact on the choice of equipment and service provision used to support the patient. It may also be appropriate to contact Estates to check the Safe Working Load of the floor in the admitting area.
Prior to admission patient information communicated between community services (GP, District Community Nurse, Out Patient Dept.) and admitting unit.
Ward / Department
Assessment Unit e.g. ED, AAU
Initial Patient Assessment
Ascertain weight, weight distribution, height, BMI. Establish safe working load (SWL) of immediate equipment e.g. trolley, bed, chair, toilet / commode, hoisting / stand aid equipment. (Ref Appendix 5 for guidance) N.B If it is suspected that patient’s weight exceeds SWL, ensure bed / trolley / plinth remains at its lowest position to reduce likelihood of collapse in the short term. Document any concerns. Complete an Individual Patient Handling Risk Assessment Form and Mobility Chart (in care bundle) This MUST be sent with the patient in any interdepartmental transfers (Ref Appendix 7). Any assessments must be reviewed and updated regularly as changes occur. From the risk assessment - equipment (Ref Appendix 8 & 9) & staffing requirements should be identified and sourced. Admission to Labour Ward – the admitting obstetric team should review the woman and refer to the antenatal risk assessment pathway
How to obtain patient’s weight Options:
Huntleigh Contoura 1080 bed scales (Ref Appendix 3) LIKO Viking XL Hoist with weight scales - operator instructions (Ref Appendix 4) Floor Scales (within FVRH wards)
Who needs to be informed?
It may be appropriate to inform or seek further advice from the following: Clinical Nurse Manager Manual Handling Service Refer to Huntleigh Healthcare (HNE) Resource pack Other relevant members of Multi-Disciplinary Team (i.e. Physiotherapist; Radiographers, Occupational Therapist) Portering services Tissue Viability (TV) if any concerns regarding skin integrity
This list is not exhaustive - other internal departments / external agencies may need to be informed based on individual risk assessment. Please refer to the Risk Assessment documentation in Appendix 7
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APPENDIX 3 - Huntleigh Contoura 1080 Bed with Weigh Scales How to use Huntleigh 1080 Weighing Scale • The weighing scale is located at the foot of the bed on a pullout tray. • The scale weighs up to 500kg & weighing can be carried out with the bed in any position. STEP 1: Press FIRST
Press THIRD Press SECOND Operating Instructions Before the patient is put onto the bed, the scale needs to be calibrated • Identify the 3 square blue buttons down the left hand side on the weighing scale box. • The top button should be pressed first (Press FIRST) • Then the ‘0’ button located under the display screens. (Press SECOND) • Wait for the green light to come on • Then press the top left blue button again .(Press THIRD) STEP2:
Press FIRST Press SECOND
Press THIRD • •
Next press the middle blue button on the left hand side. (Press FIRST) Follow the same process as above o press the ‘0’ button under the display screens (Press SECOND) o wait for the green light, and o then press the middle blue button again (Press THIRD)
STEP 3
Patients Weight
•
When the patient is positioned on the bed, the weight of the patient will be displayed on the top display screen.
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Exert from instructions manual – Huntleigh Contoura 1080 Bed with weigh scales
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APPENDIX 4 - LIKO Weigh Scales attachment for Liko VikingXL C
D
A – Once the patient is in the sling, press the ‘On’ function and press to RESET display to zero “0.0” B - To display patient’s weight – press this button once patient is in a stabilized position when suspended in the sling B
C - Zero indicator
A
D - Stable Weight indicator
Please note: It is recommended that you press ON / RESET button before weighing each patient to assure optimal accuracy. Error Signs
Scale has detected >10% of full scale after the on/reset is pressed
Tilt indicates scale is not level
Battery with display indicates battery level is low
Battery without display indicates battery is extremely low
Excessive load on scale
Broken internal connection
Battery replacement: When battery requires replacement a small battery symbol will appear in the left corner of the display. Contact the Estates Department to arrange for a replacement battery.
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For guidance only (This list is not exhaustive) Each patient must be individually assessed for the piece of equipment to be used. If the Safe Working Load (SWL) is not indicated on the equipment, it is the responsibility of the staff member accessing the equipment to liaise with the manufacturers to obtain this information.
APPENDIX 5 - The Safe Working Load of Standard Equipment BEDS / FRAMES SWL Huntleigh Evolution 250kg (39 st) Huntleigh Contoura 1080 used in FVRH 500kg (78 st) Hill-Rom Total care 226 kg (34 st) Below are just a few of the types of beds available in the Community Hospitals, make sure you check your own beds
IMAGING TABLES Angiograph MRI
Burmeier wooden framed beds 175 kg (27 st) Richmond high / low bed 180 kg (28 st) Linak high / low bed 180kg (28 st) Invacare Etude basic (Home setting) 180 kg (28 st) Invacare Etude Medley Ergo (Home) 180 kg (28 st) Low version is available Max user weight 145 kg Sidhil Bradshaw Bariatric bed (Home) 368 kg (58 st) Max user weight 320 kg Invacare SB755 Wide bed (Home) 235 kg (37 st) Max user weight 200 kg MATTRESSES SWL Pentaflex foam (standard) Pentaflex Solo foam (Bariatric) 140kg (22 st) Nimbus 3 dynamic mattress 400kg (62 st) Huntleigh AplphaXcel Overlay 248kg (39 st) (Community Hospital only) Hunleigh AutoExcel Overlay 140kg (22 st) (Community Hospital only) MSS Softform Pressure reducing foam 203kg (32 st) replacement mattress
X-ray Ultrasound tables THEATRE TABLES Maquet Betastar Maquet Orthostar Maquet Shoulder & Traction tabletops Maquet Maternity table (1042322)
Hill-Rom Thermocontour Viscoelastic replacement mattress TROLLEYS Stryker 1007 StretcherTrolley Stryker 0735 HillRom Trolley
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160kg (25 st) SWL 317kg (50 st) 225kg (34 st) 318kg (50 st)
CT
SWL 200kg (31 st) 250 k (39 st) *with 60cm bore 204kg (32 st) *with 68cm bore 210kg (33 st) *150kg (23 st) SWL 244kg (38 st) 225kg (35 st) 225kg (35 st) 225kg (35 st)
*Additional information re Imaging Tables and Ultrasound can be found in Appendix 9.2
SEATING Standard patient chair Standard manual wheelchair Standard electric wheelchair Portering chair Portering chair - Bariatric Portering Chair MRI compatible Standard commode Shower chair Dental chair FULL BODY LIFTING HOISTS Arjo SkyMaxi 600 Arjo SkyMaxi 1000 Liko Golvo Liko Viking M Liko Viking L 28th October 2015 UNCONTROLLED WHEN PRINTED
SWL 160kg (25 st) 114kg (18 st) 102kg (16 st) 190kg (29 st) 380kg (59 st) 220kg (34 st) 100kg (16 st) 150kg (23 st) 135kg (21 st) SWL 268kg (42 st) 458kg (70 st) 200kg (32 st) 200kg (32 st) 250kg (39 st)
FULL BODY LIFTING HOISTS Liko Viking XL Arjo Opera Hoist Liko Viking S (Home setting) Liko Viking XS (Home setting) Liko M230 (Home setting) STAND AIDS Liko Sabina Stand aid Arjo Encore Stand aid Arjo Sara 3000 Stand aid Oxford Journey Stand aid STANDING TURNING DISCS Samhall / Etac turner Romedic Turner STAND & TRANSFER AIDS Arjo Stedy Cricket (Community) MOBILITY AIDS Zimmer or mobilator frame Crutches LATERAL TRANSFER AID Pat slide HoverMatt (HM) LIFTING FROM THE FLOOR HoverJack (used with HM) MORTUARY FVRH Post Mortem Table (Afos) Over-head Gantry Hoist Trolleys (AR Twigg) CONCEALMENT TROLLEYS Concealment Trolley Bariatric Concealment Trolley
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SWL 300kg 200kg 160kg 182kg
(47 st) (32 st) (25 st) (28 st)
SWL 200 kg (32 st) 190kg (30 st) 200kg (32 st) 135kg (21 st) SWL 150kg (24 st) 190kg (30 st) SWL 182kg (28 st) 140kg (22 st) SWL 160kg (25 st) 127kg (20 st) SWL 200 kg (31 st) 476 kg (75 st) SWL 412 kg (65 st) SWL Unsure 220 kg (35 st) 160 kg (25 st) SWL 190kg (30 st) 250kg (39 st)
APPENDIX 6 - Body Shapes Individuals come in different shapes and sizes, according to their height and weight distribution. Bariatric people can be categorised into four different body types (Liko 2004). 1. Anascara - severe generalised oedema. Manual Handling Problems: Limbs may be awkward to position, or may interfere with handling, as they tend not to stay close to the body. 2. Bulbous Gluteal Region - excessive buttock tissue creating a protruding shelf. Manual Handling Problems: Suitable seating can be an issue due to protruding shelf. 3. Apple Pannus - weight carried high, abdomen may be rigid or mobile, hangs to the floor (known as apron), and legs can be normal. Manual Handling Problems: Upright sitting can be an issue as person has difficulty with bending in the middle. This may affect technique for getting in / out bed for example.
4. Pear Abduction - fat stored around hip area, weight carried below waist, significant tissue below knees, and tissue bulk on outer thighs. Manual Handling Problems: Assisting patient into bed due to the weight of lower limbs. Hoist sling positioning due to difficulty in getting leg straps into position.
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APPENDIX 7 - Bariatric Patient - Risk Assessment and Mobility Chart Risk Assessment A comprehensive risk assessment using the Individual Patient Handling Risk Assessment Form (in Care Bundle) must be completed and documented by the receiving unit within 6 hours of admission. Advice on the availability and hiring of specialist equipment can be found in Appendix 8 and 9 or by contacting the Manual Handling Service on 01786 454718. On admission to a designated ward, a full manual handling risk assessment and Bariatric Mobility Chart must be completed (Ref Appendix 7). This requires all the manual handling manoeuvres associated with the bariatric patient and their care, to be taken into account; •
Patient manual handling risk assessment and mobility chart must be completed.
•
The completed manual handling risk assessment / mobility chart must accompany the patient at all times and information regarding handling activities must be communicated to all healthcare employees involved with the patient.
•
The risk assessment / mobility chart requires be reviewed on a daily basis, in the initial stages, and if / when the patient’s condition changes.
•
Steps should be taken to eliminate or reduce identified manual handling risks, by equipment provision, ensuring appropriate numbers of staff are available, planning the patient journey to eliminate access difficulties.
•
Following the assessment of the patient’s manual handling needs, appropriate equipment must be made available, through loan, hire or purchase.
•
Identified numbers of staff must be available for all handling needs; this may require bank staff, agency staff or other means (e.g. borrowing staff from other wards / departments for handling tasks).
•
If manual handling risks cannot be eliminated or reduced (e.g. due to lack of available equipment, lack of staff, environment restrictions etc.) staff should record these risks on the manual handling risk assessment and report any adverse events on Safeguard
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Individual Bariatric Patient Handling Risk Assessment Form This form must be completed for each individual patient, along with a mobility chart, if required. Please photocopy this form and the mobility chart back to back to ensure all patient details are included on documentation
Patients Name
Address
Date of Birth CHI Number
Patient weight ……………………………..Height…………………………………..Body Shape..................................... BMI ………………………………….. Please state the patient’s ability prior to admission:........................................... ………………………………………………………………………. RELEVANT MEDICAL HISTORY e.g. CVA, arthritis etc.
PHYSICAL HANDLING CONSTRAINTS e.g. eye sight, hearing, speech etc.
PSYCHOLOGICAL HANDLING CONSTRAINTS e.g.
TISSUE VIABILITY e.g. Intact / Red / Skin Lesions
confused, aggressive etc.
FALLS HISTORY (Does the patient have any previous history of falling to the ground, past or present? If patient is aged 65 or over, has a history of falls; please complete Clinical Quality indicator (CQI) assessment) ATTACHMENTS e.g. IV infusions, indwelling catheters,
DAY / NIGHT VARIATIONS (Please specify)
oxygen therapy etc.
CULTURE / RELIGIOUS CONSIDERATIONS (Please
ENVIRONMENTAL CONSIDERATIONS (particularly
specify)
useful in the community)
OTHER CONSIDERATIONS e.g. social factors, age, weight of patient etc.
Please complete the following as to how the patient currently transfers / mobilises (Please tick as appropriate) Transfers (including to / from bed; wheelchair; commode; toilet) Independent Supervision Assistance of 1 2 3 More Standaid Hoist Please state number .............. Move up and down the bed Independent Supervision Assistance of 1 2 3 More Glide Sheet Hoist Please state number .............. Sit up over the side of the bed Independent Supervision Assistance of 1 2 3 More Bed Rest Please state number .............. Bathing (including in and out of the bath / shower) (please specify) Independent Supervision Assistance of 1 2 3 More Hoist Other ……………… Please state number .............. ................................ Walking Independent Supervision Assistance of 1 2 3 Walking Aid No Walking Did the patient have a walking stick or frame on admission? YES N0 Is the patient independent?
YES N0
(Please tick as appropriate)
If YES, please sign and date below; If NO, please sign and date below and complete a mobility chart for the patient. Assessor’s Name (Print): Signature: Mobility Chart Completed:
YES N0
Date: Review Date: Date:
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Bariatric Patient Mobility Chart This form must be completed as identified in the ‘Individual Bariatric Patient Handling Risk Assessment Form Patients Name
Address
Date of Birth CHI Number
A risk assessment should be carried out prior to every handling intervention. ‘For extreme / bariatric patient’, it is necessary to complete a new mobility chart as changes with the patients’ mobility occur and this must be documented. Please refer to Manual Handling Guidelines for all manoeuvres. ACTIVITY
DATE
Recommended method of transfer
Recommended Minimum Number of staff needed
Lateral transfers Turning / Rolling Moving up the bed Lying to sitting Toileting Bathing / Showering Sit to stand to sit Bed / Trolley to Chair Chair to Bed / Trolley Walking Falls assessment (Y / N) On / off floor State make and model of hoist / stand aid State sling type and size NAME RISK ASSESSOR Designation
DATE
MOBILITY CODES AST 1 / 2 / 3: Requires assistance of 1 / 2 / 3 or more staff SUP: Supervision only IND: Independent FWB: Full Weight Bearing PWB: Partial Weight Bearing NWB: Non Weight Bearing BR: Bed Rest
NAME
SIGNATURE
HANDLING AIDS / EQUIPMENT CODES H: Full body lifting hoist (specify hoist type + size of sling) STA: Stand aid (specify hoist type + size of sling) BH: Bathing hoist (specify hoist type) SC: Shower chair ST: Shower Trolley
Pt T: Pt turner (specify e.g. Etac, Roturn) W: Wheelchair or pushchair
GS: Glide sheet(s) ES: (Extension Straps) PAT: Pat slide
HB: Hand blocks HS: Handling Sling C: Crutches (specify) S: Stick(s) Z: Zimmer
Please document any additional areas of concern in the next section e.g. lack of appropriate seating / slings / staff available for particular transfers etc. Ensure it is progressed to the next level of management to acquire additional resources if required.
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Name of patient: …………………………………………………Date of birth: …………………………………CHI Number:……………………………. Areas of concern
Risk factors
Risk management
Date
Signature
Physiotherapy Referral Criteria Does the patient have a chest infection, have difficulty independently clearing chest secretions and have a resultant reduced oxygen saturation level? Does the patient have reduced mobility compared to their normal level of mobility?
Yes
Referral for respiratory physiotherapy
No Yes
Patient does not require physiotherapy assessment Referral to Physiotherapy for mobility assessment.
No Are you referring for stair practice? There must be a clear reason for stair Assessment: patient has been acutely ill / bony injury / reduced mobility. Please state reason for referral for stair Assessment. Does the patient have a history of recent falls?
Patient does not require referral to physio. Referral for a quick check on stairs is not an appropriate referral.
Yes
Referral to Physiotherapy for mobility assessment.
Does the patient have longer term rehabilitation needs?
Yes
Referral for physiotherapy assessment.
Has the patient had major surgery including abdominal, neck dissection or mastectomy?
Yes
Referral for physiotherapy assessment.
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EXAMPLE OF COMPLETED Individual Bariatric Patient Handling Risk Assessment Form This form must be completed for each individual patient, along with a mobility chart, if required. Please photocopy this form and the mobility chart back to back to ensure all patient details are included on documentation
Patients Name Jessie Wallis
Address 3 Dyke Street, Bridgetown Polmont
Date of Birth 26/08/49
CHI Number 260849FEM
Patient weight …229kg / 39stone. Height……165 cm / 5’4” ………..Body Shape........Apple Pannus. BMI ……………over 30………….. Please state the patient’s ability prior to admission:..........Patient was able to stand and turn independently with a zimmer frame ………………………………………………………………………. RELEVANT MEDICAL HISTORY e.g. CVA, arthritis etc.
PHYSICAL HANDLING CONSTRAINTS e.g. eye sight,
COPD
hearing, speech etc.
PSYCHOLOGICAL HANDLING CONSTRAINTS e.g.
TISSUE VIABILITY e.g. Intact / Red / Skin Lesions
confused, aggressive etc.
Red
Patient’s weight is too heavy to be moved by manual means
None FALLS HISTORY (Does the patient have any previous history of falling to the ground, past or present? If patient is aged 65 or over, has a history of falls; please complete Clinical Quality indicator (CQI) assessment)
ATTACHMENTS e.g. IV infusions, indwelling catheters,
No history of falls
DAY / NIGHT VARIATIONS (Please specify)
oxygen therapy etc.
Oxygen therapy
None
CULTURE / RELIGIOUS CONSIDERATIONS (Please
ENVIRONMENTAL CONSIDERATIONS (particularly
specify)
useful in the community)
None affecting handling OTHER CONSIDERATIONS e.g. social factors, age, weight of patient etc.
Home Help visits twice a week; requires assessment for more appropriate wheelchair prior to discharge Please complete the following as to how the patient currently transfers / mobilises (Please tick as appropriate) Transfers (including to / from bed; wheelchair; commode; toilet) Independent Supervision Assistance of 1 2 3 More Standaid Hoist Please state number .....4......... Move up and down the bed Independent Supervision Assistance of 1 2 3 More Glide Sheet Hoist Please state number .....4......... Sit up over the side of the bed Independent Supervision Assistance of 1 2 3 More Bed Rest Please state number .............. Bathing (including in and out of the bath / shower) (please specify) Independent Supervision Assistance of 1 2 3 More Hoist Other Bed Bath Please state number ...4........... ................................ Walking Independent Supervision Assistance of 1 2 3 Walking Aid No Walking Did the patient have a walking stick or frame on admission? YES N0 Zimmer Frame Is the patient independent?
YES N0
(Please tick as appropriate)
If YES, please sign and date below; If NO, please sign and date below and complete a mobility chart for the patient. Assessor’s Name (Print): Signature: C. Noakes Mobility Chart Completed:
Catherine Noakes YES N0
Date: 25/08/15 Review Date: 26/08/15 Date: 25/08/15
If patient has been assessed as ‘independent’ on initial assessment; and this status changes, please review and complete another ‘individual bariatric patient assessment form’. 28th October 2015
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EXAMPLE OF COMPLETED Bariatric Patient Mobility Chart This form must be completed as identified in the ‘Individual Bariatric Patient Handling Risk Assessment Form Patients Name Jessie Wallis
Address 3 Dyke Street, Bridgetown Polmont
Date of Birth 26/08/49
CHI Number 260849FEM
A risk assessment should be carried out prior to every handling intervention. ‘For extreme / bariatric patient’, it is necessary to complete a new mobility chart as changes with the patients’ mobility occur and this must be documented. Please refer to Manual Handling Guidelines for all manoeuvres. ACTIVITY
DATE
Recommended method of transfer
25/08/15 Lateral transfers
25/08/15
Turning / Rolling
25/08/15
Moving up the bed
25/08/15
Lying to sitting
25/08/15 25/08/15
Toileting
Bathing / Showering
25/08/15
Sit to stand to sit
25/08/15
Bed / Trolley to Chair
25/08/15
Chair to Bed / Trolley
Recommended Minimum Number of staff needed
Use of HoverMatt – see guidance folder for instructions; clear commands from 1 staff member Use of 2 flat bariatric glide sheets; insert using the ‘unravelling’ method avoiding the need to roll the patient; 3 staff needed to initiate the turn; 2 staff on receiving side; clear commands from 1 staff member Use of 2 flat bariatric glide sheets; insert using the ‘unravelling’ method avoiding the need to roll the patient; position staff 2 at the top of the bed; 2 level with patient’s knees; all facing towards the foot end of the bed; clear commands from 1 staff member Use of electric profiling positioning on bed Use of bariatric commode at bed side; Hoist - MaxiSky 1000 with Bariatric L – Loop De Luxe Padded; position the sling using 2 flat glide sheet, using unravelling method; insert sling between the glide sheets, remove top glide sheet prior to hoisting. Bed bath, using 2 flat glides sheets to assist with hygiene; clothing and changing of bed
4
5
4
1 4
4
NWB BR
N/A
25/08/15
BR
N/A
Walking
25/08/15
NWB
N/A
Falls assessment (Y / N)
25/08/15
N/A
N/A
On / off floor
25/08/15
State make and model of hoist / stand aid
25/08/15 25/08/15
State sling type and size NAME RISK ASSESSOR Designation
S/N Catherine Noakes – Key Worker
DATE
25/08/15
N/A
Use of HoverJack / HoverMatt – see guidance folder for instructions; clear commands from 1 staff member
6
ArjoHuntleigh Maxi-Sky 1000
4
ArjoHuntleigh Bariatric L – Loop De Luxe Padded sling (SWL 210 – 250 kg) Green / Dark Grey
4
NAME
SIGNATURE
Catherine Noakes
C Noakes 28th October 2015
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MOBILITY CODES AST 1 / 2 / 3: Requires assistance of 1 / 2 / 3 or more staff SUP: Supervision only IND: Independent FWB: Full Weight Bearing PWB: Partial Weight Bearing NWB: Non Weight Bearing BR: Bed Rest
HANDLING AIDS / EQUIPMENT CODES H: Full body lifting hoist (specify hoist type + size of sling) STA: Stand aid (specify hoist type + size of sling) BH: Bathing hoist (specify hoist type) SC: Shower chair ST: Shower Trolley
Pt T: Pt turner (specify e.g. Etac, Roturn) W: Wheelchair or pushchair
GS: Glide sheet(s) ES: (Extension Straps) PAT: Pat slide
HB: Hand blocks HS: Handling Sling C: Crutches (specify) S: Stick(s) Z: Zimmer
Please document any additional areas of concern in the next section e.g. lack of appropriate seating / slings / staff available for particular transfers etc. Ensure it is progressed to the next level of management to acquire additional resources if required.
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EXAMPLE OF COMPLETED Additional Assessment Name of patient: ……Jessie Wallis…………… Areas of concern
…………………Date of birth: ……26/08/49……………………………CHI Number:… 260849FEM ….
Risk factors
The patient’s large girth causes over-reaching and results in staff twisting when delivering care.
Musculoskeletal (MSD) injury and pain
The workforce involved may be predominately female of childbearing age.
Personal Injury; increased tiredness, increase risk to unborn baby.
Some staff may have previous or existing musculoskeletal problems or other health issues.
This may exacerbate any underlying MSD
The patient’s weight is in excess of 25 stone (159kg) and is too heavy to be moved by manual means. The patient has a large girth and becomes breathless on exertion. The patient suffers from pain and tissue damage, which inhibits movement. Tubes and piping are attached for catheter and oxygen. The patient is in a side-room, but this limits space. The larger equipment required, takes up more room than is usual. Electrical cables are also attached to most of the equipment. Items of furniture and equipment will require to be moved out of the room or to another position to create space when performing some tasks.
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Pain / breathlessness
Dislodging of catheter and any IV lines
MSD to staff Lack of training in the appropriate equipment
Breaking of cables / fire risk
Risk management
Date
Signature
Handling the patient should be eliminated wherever possible. Over-reaching and twisting should be avoided, by correct use of equipment to assist and maintaining correct posture. Self-care and rehabilitation of the patient should be promoted. Individuals who are pregnant or have musculo-skeletal disorders must identify themselves to managers. If any concerns re an individual’s capability the Occupational Health Department should be contacted. Staff involved with the patient may have had previous experience of caring for a bariatric patient and using the equipment. Training needs require to be identified for other staff. Staff rotation, adequate breaks. The bed used to nurse the patient is the Huntleigh Contoura 1080. Robust analgesic regime to control patient’s pain, including prior to any manual handling activities. Use of the profiling bed to assist positioning to avoid breathlessness. Care when moving the patient to avoid any pulling; good communication throughout; clear documentation of any lines in situ.
25/08/15
C Noakes
25/08/15
C Noakes
25/08/15
C Noakes
These beds are heavier than normal, and may require a minimum of 2 people to move it when empty, and 4 to 6 people to move the bed with the patient on it (requires to be assessed). Can access use of Bed Mover. Correct positioning of the bed cable, during moving or transportation. Staff must move the equipment prior to moving the patient. Staff must be trained in all of the equipment identified prior to moving this patient e.g. HoverMatt / HoverJack
25/08/15
C Noakes
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The patient requires to use the Arjo Maxi-Sky 1000. This hoist has a 4-point spreader bar and can only be used for patients of 191kg / 30 stone or over, due to the shape and size of the spreader bar and slings used on this system.
Injury to patient if incorrect sling used
NB - Only ArjoHuntleigh bariatric slings may be used with this hoist; sling identified for this patient is ArjoHuntleigh Bariatric L – Loop De Luxe Padded sling (SWL 210 – 250 kg) Green / Dark Grey
25/08/15
C Noakes
Physiotherapy Referral Criteria Yes
Referral for respiratory physiotherapy
No Yes
Patient does not require physiotherapy assessment Referral to Physiotherapy for mobility assessment.
No NO
Patient does not require referral to physio. Referral for a quick check on stairs is not an appropriate referral.
Yes
Referral to Physiotherapy for mobility assessment.
Does the patient have longer term rehabilitation needs?
Yes
Referral for physiotherapy assessment.
Has the patient had major surgery including abdominal, neck dissection or mastectomy?
Yes
Referral for physiotherapy assessment.
Does the patient have a chest infection, have difficulty independently clearing chest secretions and have a resultant reduced oxygen saturation level? Does the patient have reduced mobility compared to their normal level of mobility? Are you referring for stair practice? There must be a clear reason for stair Assessment: patient has been acutely ill / bony injury / reduced mobility. Please state reason for referral for stair Assessment. Does the patient have a history of recent falls?
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7.1 - Risk Assessment in Relation to Bariatric Patients – Points to Consider
Generic Factors 1. Environment Considerations Space • Is there enough space for the patient, equipment and any handlers required to move patient safely? • In a shared room, are 2 bed spaces required? • Can unnecessary clutter be removed from the area? Access • Are door widths and mechanisms acceptable? • Do corridor widths accommodate heavy patient beds / trolleys? • Can narrow corridors be avoided?
Safe Working Load limits (SWL) • Check the maximum safe working load for all relevant equipment e.g. beds, trolleys, plinths, tables, chairs, commodes / toilets, hoisting equipment. • Also consider the SWL of floors. Contact Estates / FVRH - Serco or Risk Management Dept. for guidance.
Flooring • Uneven floors, slopes, high friction carpet • Consider routes taken when transporting patients – can areas with uneven floors, slopes or carpet be avoided? • Is there an electric moving device available to push beds / trolleys over uneven flooring, up slopes or over carpets?
2. Patient Factors Weight • Is there an accurate weight available? If not, it will be necessary to obtain one to assist handlers devise safe working practices. Refer to Appendix 3 and 4 Size / Shape • Consider the patient’s weight distribution, as this will have an impact on the handling tasks and equipment selected. Refer to Appendix 6 Mobility/Capability • Is the patient able to move themselves? • Can the introduction of small handling aids enable them to be more independent?
3.
Equipment & Furniture Considerations
Requirement • First establish what equipment is required e.g. bariatric bed, trolley, chair, commode, hoist etc. Availability • Is there any equipment available within the ward? Can equipment be borrowed from another ward / department? • Is it necessary to hire equipment - Refer to Appendix 9 for information on equipment for hire.
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4. Staffing & Organisational Factors Staff Availability • Based on risk assessment, are there enough staff members available to safely handle the patient? Consider different times of the day e.g. night shift. It may be necessary to request an increase in staffing levels. All staff shortages should be reported & documented. • Consider staff availability in other areas – this will require good communication i.e. if the patient is going for an x-ray, ensure sufficient staff members available to handle the patient. • Is it possible to rotate staff?
5. Communication Considerations Handling Needs of the Patient • Has the patient’s handling needs been documented and the information been made available to all staff? • Are special instructions required e.g. specific set-up of equipment / furniture etc? Between Departments / Agencies • Consider elective admissions – can information be gathered and plans made prior to the patient being admitted? • Transfers between wards – ensure all relevant information is passed on to the relevant areas
Specific Considerations Ward • • •
Hygiene needs – is it necessary to consider specialist bathing / showering equipment i.e. shower chair, bariatric bathing slings? Consider hiring equipment if indicated Tissue Viability / Infection Control – seek advice from these departments as indicated Frequency of admissions – if bariatric admissions to a particular ward are common, it should be assessed if it is necessary for the ward to be provided their own equipment?
Physiotherapy / Occupational Therapy • • • •
SWL / width of treatment plinths – are there any alternatives available i.e. a bariatric bed / chair? Treatment / therapeutic handling – do the staff adopt compromised postures when treating bariatric patients (over-stretching), weight of limbs etc. Chest physiotherapy – consider positioning, can equipment be used effectively? (glide-sheets / hoists / electric profiling bed) Equipment – is there appropriate equipment available for rehabilitation purposes i.e. hoists with walking jackets / pants, lifting cushions, walking aids? Can these pieces of equipment be borrowed from another dept, hired or purchased?
Theatres • • • •
SW L / width of theatre table in different positions – are there alternatives available i.e. use of a bed? Positioning for surgery – is more specialist equipment / assistance required? Contact the Manual Handling Service for guidance. Sterile field width – is this compromising staff members’ posture? Consider if any specialist equipment might be required to assist i.e. limb holders. Airway management – is airway management risks limiting movement options? Version 2
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Home • • • •
Access – ramp / steps? Door widths – are these adequate to allow the patient & any equipment to pass through safely? Do the doors require to be altered? Furniture – bed / chair / toilet / shower chair – does the patient have suitable equipment? Range of service providers – good communication between all parties is essential.
Diagnostics •
• •
Travel distance / route – consider pushing / pulling forces for transporting patient on bed / trolley. Can a route be chosen that minimises distance & environmental obstructions i.e. slopes? Can an electric bed mover be used to reduce effort from handlers? How many handlers are required? X-ray / scanning tables – consider SWL / width of the tables. Will the patient fit in the scanner? The diameter of the bore can often be the restricting factor even if the patient is not at the upper weight limit. Ultrasound - there are no real weight restrictions as the patient can be scanned on a bariatric trolley or bed. The patients BMI does impact on the diagnostic quality of the images and often no clear diagnosis can be made.
Maternity • • •
Suitable birthing bed – consider SWL Patient choice – consider risks to both the patient & the staff. Patient positioning – is more specialist equipment required? Is more staff required?
The details from the ‘Points to Consider’ above, have been put into a table below and could be copied and filed with patients risk assessment / mobility chart, for future reference and updates.
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7.2 Risk Assessment in relation to Bariatric Patients – Points to Consider Generic Factors Environment Considerations
Ward
Space • Is there enough space for the patient / any equipment and enough space for the handlers to move safely? • In a shared room, are 2 bed spaces required? liaise with Bed Management Service • Can unnecessary clutter be removed from the area? Access • Are door widths and mechanisms acceptable? • Do corridor widths accommodate heavy patient beds / trolleys? Can narrow corridors be avoided?
Safe Working Load limits (SWL) • Check the maximum safe working load for all relevant equipment e.g. beds, trolleys, plinths, tables, chairs, commodes / toilets, hoisting equipment. • Also consider the SWL of floors. Contact Estates / FVRH - Serco or Risk Management for guidance. Flooring • Uneven floors, slopes, high friction carpet • Consider routes taken when transporting patients – can areas with uneven floors, slopes or carpet be avoided? • Is there an electric moving device available to push beds / trolleys over uneven flooring, up slopes or over carpets?
Patient Factors
Staffing & Organisational Factors
Weight • Is there an accurate weight available? If not, need to obtain one, to assist handlers on safe practices. See Appendix ? Size / Shape • Consider the patient’s weight distribution, as this will have an impact on handling tasks and equipment selection. See Appendix ?? Mobility/Capability • Is the patient able to move themselves? • Can the introduction of small handling aids enable them to be more independent?
Staff Availability • Based on risk assessment, are there enough staff members available to handle the patient? Consider different times of the day e.g. night shift. It may be necessary to request an increase in staffing levels. All staff shortages should be reported & documented. • Consider staff availability in other areas – this will require good communication i.e. if the patient is going for an x-ray, ensure sufficient staff available to handle the patient. • Is it possible to rotate staff?
Equipment & Furniture Requirement • First establish what equipment is required e.g. bariatric bed, trolley, chair, commode, hoist etc. Availability • Is there any equipment available within the ward? Can equipment be borrowed from another ward / department? • Is it necessary to hire equipment - Refer to Appendix 4 for information on equipment for hire, and the process for this.
Version 2.0
Communication Considerations Handling Needs of the Patient • Has the patient’s handling needs been documented and information been made available to all staff? • Is special instructions required e.g. specific set-up of equipment / furniture etc? Between Departments / Agencies • Consider elective admissions – can information be gathered and plans made prior to the patient being admitted? • Transfers between wards – ensure all relevant information is passed on.
Specific Considerations Diagnostics
• Hygiene needs – is it necessary to consider specialist bathing / showering equipment i.e. shower chair, bariatric bathing slings? Consider hiring equipment • Tissue Viability / Infection Control – consider seeking advice from these Departments. • Frequency of admissions – if bariatric admissions to the ward are common, is it necessary for the ward to buy their own equipment?
Physiotherapy / Occupational Therapy • SWL / width of treatment plinths – are there any alternatives available i.e. a bariatric bed / chair? • Treatment / therapeutic handling – do the staff have compromised postures when treating bariatric patients (over-stretching), weight of limbs etc. • Chest physiotherapy – consider positioning, can equipment be used effectively? (glidesheets / hoists / electric profiling bed) • Equipment – is there appropriate equipment available for rehabilitation purposes i.e. hoists with walking jackets / pants, lifting cushions, walking aids? Can these pieces of equipment be borrowed from another dept, hired in or purchased?
Theatres • SW L / width of table in different positions – alternative use of a bed? • Positioning for surgery – is more specialist equipment / assistance required? Contact the Manual Handling Service for guidance. • Sterile field width – is this compromising handlers’ posture? Consider if any specialist equipment might be required to assist i.e. limb holders. • Airway management – are airway management risks limiting movement options
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• Travel distance / route – consider pushing / pulling forces for transporting patient on bed / trolley. Can a route be chosen that minimises distance & environmental obstructions i.e. slopes? Can an electric bed mover be used to reduce effort from handlers? How many handlers are required? • X-ray / scanning tables – consider SWL / width of these tables. Will the patient fit in the scanner? The diameter of the bore can often be the restricting factor even if the patient is not at the upper weight limit. • Ultrasound - there are no real weight restrictions as the patient can be scanned on a bariatric trolley or bed. The patients BMI does impact on the diagnostic quality of the images and often no clear diagnosis can be made
Maternity • Suitable birthing bed – consider SWL • Patient choice – consider risks to both the patient & the staff. • Patient positioning – is more specialist equipment required? Are more staff required?
Home • Access – ramp / steps? • Door widths – are these adequate to allow the patient & any aids to pass through safely? Do they need to be altered? • Furniture – bed / chair / toilet / shower chair – does the patient have suitable equipment? • Range of service providers – good communication between all parties is essential.
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APPENDIX 8 – Bariatric Equipment Available within NHS Forth Valley ARJO Huntleigh Maxi-Sky 600 Arjo Maxi-Sky 600 is a ceiling hoist located in selected side rooms in each ward in FVRH. *CCHC have a different version of the Arjo Maxi-Sky 600 –see below for slings compatible with the hoist in CCHC (SWL 272 kg / 42 stone) *ArjoHuntleigh Maxi-Sky 600 (CCHC Information) Arjo Maxi-Sky 600 in CCHC is a ceiling hoist located in Ward 1. The spreader bar is a 2point spreader bar as picture above, but has attachments for slings with clip attachments
ARJO Slings suitable for use with Maxi-Sky 600 (SWL 272kg / 42 Stone)
ARJO Standard Sling with ‘loops’ available in sizes up to XXL
NB - You can only use ARJO bariatric slings on this hoistVersion 2.0
‘looped’ Flites
(SWL 190kg / 30Stone)
(patient specific slings) Codes: MFA2000-M; MFA2000-L; MFA2000-XL
ARJO Walking jacket for rehabilitation KKA5130M-L; KKA5130M-XL *ARJO Slings suitable for use with Maxi-Sky 600 in CCHC (SWL 272kg / 42 Stone)
ARJO ‘clip’ Flites (patient specific slings) MFA1000-L; MFA1000-XL; MFA1000-XXL
ARJO Huntleigh Maxi-Sky 1000 Arjo Maxi-Sky 1000 – is a ceiling hoist, with a 4-point spreader bar, located in each of the bariatric side rooms within wards in FVRH. This particular hoist can only be used for patients of 191kg / 30 stone or over, due to the shape and size of the spreader bar and slings used on this system. (SWL 450 kg / 70 stone)
‘ARJO
Extended Leg Mesh+100mm MAA4160-L; MAA4160-LL; MAA4160XL
Extended Leg Padded+100mm MAA4100-L; MAA4100-LL; MAA4100-XL; MAA4100-XXL
ARJO Slings suitable for use with Maxi-Sky 1000 (SWL 454kg / 71 stone)
Loop De Luxe Padded Loop Deluxe Divided Leg Loop Basic Padded Loop Basic Hammock MAA8000 M, L, XL Hammock MAA8020 M, L, MAA8010, M, L MAA8030 M, L, XL XXL XL, XXL XL, XXL XXL Bariatric M Yellow / Dark Grey 160-210kg Bariatric L Green / Dark Grey 210-250kg Bariatric XL Blue / Dark Grey 230-340kg Bariatric XXL Terracotta / Dark Grey 318-455kg 28th October 2015 UNCONTROLLED WHEN PRINTED
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HillRom Liko Viking XL
LIKO Slings suitable for use with Liko Viking XL The Liko Viking XL is a mobile lift ideal for all heavy lifting situations, including lifts from the floor and gait training. It is fitted with a Universal TwinBar with four hooks. The widest bar is intended for the upper strap loops of the sling and the short bar for the strap loops of the leg supports.
Liko Original High Back sling XXL (SWL 500kg)
UltraLift Pants Model 920 Liko Ultra Sling model 06 (SWL 500kg) (SWL 500kg) Solo High Back Sling 3506114 Short; 3506115 (patient specific slings) 35920328 XXL Regular; 3506315 Regular 3525916 Large 200kg (SWL 300 kg / 47 st) 35920329 XXXL 3525917 Extra Large 500 kg Net; 3506116 Long Bariatric Raiser Recliner Chairs Heavy Duty Upright Patient Chairs Bariatric Porter Wheelchairs Available within the Height 510 mm / 20” bariatric side rooms Depth 510 mm / 20” in FVRH –check Width 610 mm / 24” Available within SWL on the chair FVRH / SCH / CCHC – chairs you will be using FCH / CCHC Width 24” = 40 Stone 28” PLEASE NOTE – and 30” = 50 Stone These are no wheels Teal – Whittle Chair Seat to reposition the (SWL 318kg / 50 St) height options to aid (SWL 222kg / 35 st) chair when empty (SWL 380kg / 59 stone) In FVRH posture; 405mm (16”); & 254kg / 40 st) TC 300 Transfer Chair
Heavy Duty Shower / Commode Chair
Bariatric Walking Frame
Location; Bariatric Store / Bed Store, FVRH TC300 Seat width 27” (SWL 300kg / 47 Stone) Version 2
Available from Physiotherapy Dept, FVRH
(SWL 318kg/50 Stone)
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HoverMatt
(SWL 476 kg / 75 Stone)
HoverJack If the patient exceeds the weight of the Pat Slide (SWL 200 kg / 31 st) then the HoverMatt must be used for lateral transfers – bed / trolley to trolley / bed. These are stored in carts along with the HoverJack in FVRH Wards • A22 - 01324 567324 • B23 - 01324 567 584 • CAU - 01324 566032 (Bariatric size – slightly wider)
The HoverJack is required to assist with raising the fallen bariatric patient. It is used in conjunction with the HoverMatt. These are stored in carts along with the HoverMatt in: FVRH Wards • A22 - 01324 567324 • B23 - 01324 567 584 • CAU - 01324 566032 (Bariatric size – slightly wider) CCHC FCH SCH Bo’ness
(SWL 412 kg / 65 Stone)
Bariatric Beds Available for NHS Forth Valley ArjoHuntleigh Contoura 1080
For Community Hospitals When requesting a bariatric bed, consider if it is appropriate to request a bed with weigh scales to make it easier to get an accurate weight for your patient.
(SWL 500kg / 78 stone) Selection of bed can be dependent upon the patient’s weight and body shape (anthropometrics – see Appendix 8), which can influence if it is appropriate for them to be moved within a standard bed, due to their girth. If a patient has a hip to hip width of 100cm or greater, but they are less than 28 stone in weight, the patient would be considered bariatric for equipment selection purposes. Version 2
Bariatric Bed & Weigh Scales
Bariatric Beds in Home Settings
CCHC – ArjoHuntleigh Contoura Joint Loan Equipment Service (JLES) 1080 bed is on site hold a small stock of bariatric beds. •
Other areas - Contact Tissue Viability Service on: 01324 673 747 for advice on the most suitable makes / models of bariatric beds to suit patient needs. They will obtain the appropriate bed from Park House
FVRH – Huntleigh 1080 bariatric bed, refer to protocol within the Huntleigh folder in your ward / department
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•
Sidhil Bradshaw Bariatric bed (SWL368 kg / 58 stone) Max user weight 320 kg Invacare SB755 Wide bed (SWL 235 kg / 37 stone) Max user weight 200 kg
Contact Tissue Viability Service on: 01324 673 747 for advice on the most suitable makes / models of bariatric beds to suit patient needs.
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APPENDIX 9 – Bariatric Equipment for HIRE & Purchase Suitable For Acute & Community Settings. The equipment listed below are examples only. It is the responsibility of the ward / department placing the order to select appropriate equipment that meets the needs of the individual patient. LIKO Viking XL Hoist LIKO Free-Span Overhead Gantry Hoist COMPANY Contact Details Liko (UK) Ltd Call Centre: 01530 411000
(SWL 47 stone / 300kg)
(SWL 78 stone / 500 kg)
Benmor Riser / Recliner Chair Product codes: T100RR SWL 222kg(25 stone) /26” (660mm) wide
Delivery within 24 hours Delivery / Collection charge required – this charge includes training of available staff on equipment provided. When phoning to request the Ultra Twin, have This system can be fitted purchase order number and give patient weight as with ultra twist, which there is a choice of motor sizes (2 x 200 kg or 2 x 250 allows 360° rotation kg dependent on patient requirements.
Benmor Static Bariatric chair With drop-sides Product code: ST600 SWL 320kg (50st)
T400RR SWL 254kg (40 stone) / 28”(711mm) wide T500RR SWL 320kg (50 stone / 34” (864mm) wide Benmor Commode Wheeled commode with swing away arms 28” wide SWL 337kg (53 stone)
Available with 28” or 32” seat width (specify when (SWL 320kg / 50 stone) ordering) Benmor Bariatric Folding Wheelchair Supplied with pressure relieving cushion
COMPANY Contact Details Benmor Medical (UK) Ltd Rental / Sales Manager: Alan Stokoe Mobile: 07780430710 Contact no: 0333800 9000 Email:
[email protected] Email: www.benmormedical.co.uk Standard Delivery & collection charge required Minimum rental period of 7 day Benmor Bariatric Walking Frame Height adjustable from 33” – 36” Width between hand-grips 22”
30” (762mm) wide Product Code: T100C/53
SWL 320kg (50st) SWL 300kg (50 stone)
Version 2
Product code: T100W SWL 380kg (60 stone)
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Product code: T100F
Riser / Recliner Chair
Shower Chair / Commode
COMPANY Contact Details
Product Code: PCR-50 (SWL 318kg / 33” width)
Removable armrests & footrests
Product Code: PCR-35 (SWL 227kg / 26” width)
Product Code: PCCW-55 (SWL 350kg / 31” width) Product Code: PCCW-40 (SWL 254kg / 25” width)
Wide Wheelchair
Folding Wheelchair Non-folding 22” - 32” wide Product Code: PCW-71
SWL 454kg / 71 Stone 1st Call Mobility – Rental Guide Riser / Recliner Chair Shower Chair / Commode
Product Code: B70R (SWL 440kg /31” and 33” seat width)
Next day delivery - delivery & collection charge. Minimum rental period of 1 week Walking Frame SWL 293kg Height adjustable from 30” – 40” Width between handgrips 20.5”
Product Code: PCW-40 (SWL 254kg / 28” wide) Product Code: PCW-47 (SWL 300kg / 28” wide)
Static Commode
Various Styles Available Product Code: WC0M (SWL 381kg / 24” – 36” seat Product Code: SC70 width) (SWL 440 kg / 20” – 36” seat Tilting Shower Chair / Commodes width) are available Version 2
Posh Chair Medical Ltd Rental / Sales Manager: Contact details: 08448 000 899 Office no: Fax 02380 458 200 Email:
[email protected]
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Product Code: PCWF-46
COMPANY Contact Details 1st Call Mobility Ltd Rental / Sales Manager: Tim Clarke Contact details: 07990 034585 Office no: 01279 425648 Fax: 01279 425653 Email:
[email protected] Website: www.1stcallmobility.co.uk . ‘Guaranteed delivery within 4 hours’ - delivery & collection charge. Minimum Rental period of 7 Days; long term rates and discounted packages are available 35 of 37
Wide Wheelchair
Walking Frame
Bariatric Couch
Product Code: WC268 (SWL 318kg / 26”, 28” or 30” seat width)
Rollator Zimmer Frame Product Code: BR70 Product Code: WF47 (up to 70 stone) (up to 50 stone)
Product Code: WC324 (SWL 444kg / 28”, 30” or 32” seat width
Stand Tall frames are available
Heavy Duty Bariatric Tilting Podiatry Chair Couch Product Code: BC002 Product Code: BC003 (SWL 320 kg) (SWL 320 kg) Bariatric Tilt Tables are available.
All of the above equipment is potentially suitable for purchase. The Companies also provide a range of heavy duty walking sticks, forearm crutches etc.
If equipment is to be hired, agreement from the Service Administrator is required before making the arrangements. Check with the Company for hire costs and any additional fees such as delivery and pick up charges. It may be possible to rent several items as a package on a short or longterm basis. This may also include staff training and equipment maintenance. Consider long term costs of hiring, it may be cheaper to purchase. Equipment must be used in accordance with manufacturer’s instructions. Staff using equipment must be competent to do so. If you are unfamiliar with features of the product, always ask the company for training in use and features of the equipment hired.
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Publications in Alternative Formats NHS Forth Valley is happy to consider requests for publications in other language or formats such as large print. To request another language for a patient, please contact 01786 434784. For other formats contact 01324 590886, text 07990 690605, fax 01324 590867 or e-mail -
[email protected]
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