Helpful strategies to ensure no one gets injured
by June McCarthy and John Pas

Providing care for a client—while rewarding in many ways—is also physically demanding on both the caregiver and the client.

While a primary objective is to ensure the safety of the patient, it’s also important that the caregiver take measures to protect themselves to avoid personal injuries. In the case of a family member providing care, the impact can be even greater. If the caregiver is a paid professional who, for example, may work for an agency, assisted living center or hospital, those injuries can lead to missed work, physical therapy sessions or higher expenses in worker’s compensation claims and medical bills.

Transferring a patient properly and safely is one of the most challenging tasks for caregivers across a wide variety of health care industries. These include, but are not limited to, caregivers from hospitals, assisted living facilities, rehabilitation facilities, emergency first responders and homecare agencies. An additional challenge of transfers is that they must also focus on the patient's current condition (including possible injuries or diseases), and limitations on their ability to help in any way.

When initiating a transfer there are some key steps to keep in mind to help reduce the risk of injury.

These key steps include:

  • Size Doesn’t Matter—Even if you are larger in height or weight than the person you are lifting, you still need to practice caution and smart lifting techniques.
  • Think Before You Move—Too often caregivers begin to move or lift a client without first thinking through what they need to accomplish and what position the patient should end up in. Think about how not to become a human pretzel—do not twist and pivot in a way that makes you unstable or puts additional strain on your lower back.
  • Bend So You Don’t Break—Caregivers often keep their legs locked. Maintain stable footing and a slight bend in the knees, and then bend with just the lower-back. Keeping the legs locked puts a high-level of pressure on the body, which may lead to inflammation or worse.
  • Use the Right Tool at the Right Time—There are several products available that can assist caregivers with transfers that will increase the client’s safety and comfort while reducing the risk of injury to the caregiver.

Size Doesn’t Matter

At times we can become over-confident when we need to move a client who is smaller than us, but this can be dangerous since we can easily let our guard down. It is important to practice proper lifting techniques at all times so that they become second nature, regardless of who is being transferred. This may involve participating in classes that demonstrate techniques for transfers and using transfer tools that match the client’s condition.

Think Before You Move

When moving a client or patient, keep your hands flat like a paddle to avoid gripping the patient's arms or legs, which could cause unintentional bruising. Straining to move someone could result in unknowingly tightening one’s grip, and if the client is unable to communicate clearly, you won’t
have feedback to make adjustments for comfort.

The correct gait belt can be critical to aid in lifting or repositioning a client. One key feature to look for in a gait belt is the comfort of the person wearing it. But also consider these other factors: When grabbing the belt, does it tighten around the patient’s middle? Is the strap so thin that it could cause injury, or does it fit securely to allow the caregiver to adjust easily without harm? If the client or patient has sufficient upper-body strength, it may be a good practice for the caregiver to also wear a gait belt so the client has something secure to hang on to as well. Look for a gait belt that has several loop handles that run both vertically and horizontally. These allow sufficient hold from almost any position.

When planning to transfer a client from a bed to a chair or wheelchair, it’s important for a caregiver to think about how they need to safely pivot their body. When twisting in any way, moving to a neutral position will be best for a client or patient who may have an issue with lower-body strength. Caregivers should ensure their own legs are not crossed during the transfer, or they will be over-extended once they start to lower the patient into a wheelchair.

Bend So You Don’t Break

We have all heard the urban myths of the groom who passes out at the altar because he locked his knees—well, there is a lot of truth in those stories! Locking one’s knees will put the maximum force on knee joints, which increases susceptibility to an injury if one’s balance is lost or if weight shifts quickly. It’s imperative for a caregiver to keep their knees slightly bent as they move with their client so they can shift their center of balance.

It’s also important that caregivers bend with their knees and not their back since this can put a great deal of pressure on the lower spine and cause a possible injury.

For caregivers who do a lot of patient transfers, it’s wise to do daily stretching exercises to stay flexible and decrease muscle tightness.

Use the Right Tool at the Right Time

Just like a carpenter who has a set of tools or a teacher who uses a textbook, caregivers have many options when it comes to tools that can lower the risk of injury while increasing the level of safety and comfort for their clients. There are products such as friction-resistant unidirectional slide sheets that can reposition a client in bed or to move their body towards the head of the bed after they have moved downward throughout the day.

A caregiver may have to wait for a second person to assist, which can be too late and costly to patient care, but with the right tools this does not have to be the case. There are also soft fabric swivels that help a client swivel as they get in and out of a car seat, as well as wide, soft-padded leg bands that wrap around the calves and shins to provide a pivot point when working with a patient who has low-weight bearing ability, or simply used to lift the legs into a bed, car or chair.

A newly-designed toolkit with all of these products is now available from ICS Medical Supply and comes in an easy-to carry-backpack. These transfer tools are constructed of high-quality, professionally tested materials that are designed to be functional and practical, and have multiple uses depending on the needs of the caregiver.

Remember that when you are conducting a patient transfer, your own health and safety is just as important as your client’s.