Mobilization of the Obese Patient and Prevention of Injury

OBJECTIVES AND BACKGROUND:Obese patients are difficult to transport between emergency departments, imaging facilities, operating rooms, intensive care units, acute care units, and rehabilitation facilities. Each move, along with turning, bathing, and access to bathrooms, poses risks of injury to patients and personnel. Similarly, inadequate mobilization raises the risk of pressure ulcers. The costs can be prohibitive. METHODS:On 6 pilot units, mobilization of patients was delegated to trained lift team technicians who covered the units in pairs, 24 hours per day, 7 days per week, to assist with moving and lifting of patients weighing 200 pounds or more, with a Braden Scale score of 18 or less and/or the presence of pressure ulcers. RESULTS:In fiscal year 2012, hospital-acquired pressure ulcers on pilot units decreased by 43% (from 61 to 35). Patient handling-related employee injuries on pilot units decreased by 38.5% (from 13 to 8). Employee satisfaction related to organizational commitment to employee safety and impact on job satisfaction was positively impacted by implementation of the lift team. With the reduction in employee injuries and the fall in the prevalence of pressure ulcers, the adoption of the lift team program decreased costs by $493,293.00. CONCLUSIONS:Implementation of lift teams on pilot nursing units decreased patient handling-related employee injuries, resulting in sharp improvements in quality patient care and reduced costs.