Audit

Inserting Slide sheets (Dependent Patient) PUSH/PULL Method

Assessment Commenced

Minimum 2 x slide sheets collected

Bed at safe working height

Brakes applied to bed

Side rails lowered

Pillow moved to block patient view of floor

Patients arms crossed over chest

Patient knee bent using pressure point under knee whilst simultaneously applying pressure to ball of patients foot

Staff member on side with bent knee positions hands on patient hip and shoulder with fingers pointing up

Staff member on opposite side takes patient knee and elbow

On agreed cue, staff push pull patient onto side

Staff member at patients back inserts 2 x slide sheets long ways beneath patient. Staff member pushes sheets into the mattress and ensure half is pushed through to other side

Patient returned to back and opposite staff member pulls slide sheets through

Staff member demonstrates safe practice at time of assessment?

Inserting Slide Sheets (Dependent Patient) Concertina Method

Assessment Commenced?

Bed at safe working height

Bed brakes engaged

Side rails lowered

2 x staff to undertake process

2 x slide sheets collected

Staff fold slide sheets together in concertina fashion

Folded slide sheets placed beneath patients feet with folds facing patient and a tail facing away from patient on top layer

*Tail refers to the ends of the slide sheet which must be on top layer and facing away from the patient*

Staff adopt running stance with outside leg as front leg, outside hand anchoring slide sheet tail, inside arm gathers slide sheets from under pile with palm facing up

On agreed cue, both staff shift weight from front foot to back foot and pull/slide gathered sheets until arm is at right angle

Previous step repeated in stages until slide sheet is unraveled the length of the patient

Staff Member Demonstrates Safe Practice at time of assessment

If Staff Member is Unsafe - please detail plans to assist in ensuring staff and patient safety

Inserting Slide Sheet - patient able to assist

Assessment commenced

Bed brakes applied

Bed at safe working height

One side rail lowered

Patient encouraged to bend knees and reach across body to grasp opposite side rail

Patient encouraged to pull self over to side

Staff member places 2 x slide sheets long ways beneath patient - pushing them into the mattress

Patient asked to roll onto back. Side rail raised

Staff member walks to opposite side of bed and lowers side rail

Staff member pulls slide sheets through

Staff Member Demonstrates Safe Practice at time of Assessment?

If Staff Member is Unsafe - please detail plans to assist in ensuring staff and patient safety

Removing slide sheets (Dependent Patient) PUSH/PULL Method

Assessment Commenced?

Bed at safe working height

Bed brakes engaged

Side rails lowered

Slide sheets pushed beneath patient as much as possible on one side

Patient rolled away from slide sheets not pushed under patient using push/pull method as with inserting slide sheets push pull method

Top slide sheet placed over patient

Staff member at patients back pulls bottom slide sheet at an angle starting from feet and working towards head

Staff member at back of patient takes corner of slide sheet furthest from them at foot end and begins pulling slide sheet on itself at an angle until slide sheet removed

Patient returned to supine position

Staff member demonstrates safe practice at time of assessment

Removing Slide Sheets (Dependent Patient) Twist and Pull method

Assessment Commenced

Bed at safe working height

Bed brakes engaged

Side rails lowered

Patient skin not moist

Staff stand on opposite side of bed at foot end of bed and roll bottom slide sheet to small of patients back

Staff turn and face head of patient and roll bottom slide sheet from head to small of patients back

Staff member with most slide sheet OR the most room trusts and pulls gathered slide until removed from beneath patient

Staff stand on opposite side of bed at foot end of bed and roll remaining slide sheet to small of patients back

Staff turn and face head of back and roll remaining slide sheet from head to small of patients back

Staff member with most slide sheet OR the most room trusts and pulls gathered slide until removed from beneath patient

Safe Practice Demonstrated at time of assessment

Moving a Dependent Patient up/down bed/trolley/OR table with slide sheets (may also be assessed moving patient along ground) SIDE TRANSFER METHOD

Assessment Commenced?

Bed at safe working height

Bed brakes applied

Side rails lowered

Min 2 x slide sheets inserted beneath patient

Bed/trolley/OR table electronically tilted in direction patient being moved

Staff take position directly opposite each other in line with patients torso

Staff grasp top slide sheet as close to patient as possible.

Staff hands are shoulder width apart (and in line with patient hip and shoulder), palms down, knuckles up

Staff feet are shoulder width apart with knees slightly bent (body close to bed/trolley)

On agreed cue, staff transfer weight from front foot (foot end of bed) to back foot (head end of bed) and slide top slide sheet along bottom slide sheet in small increments until desired location reached.
No twisting of staff backs

Bed returned to neutral position

Slide sheets removed using appropriate safe technique

Side rails raised

Staff member demonstrates Safe Practice at time of Assessment

If Staff Member is Unsafe - please detail plans to assist in ensuring staff and patient safety

Moving a dependent patient up/down a bed/trolley (fish parcel technique)

Has Assessment Commenced?

Bed at safe working height

Bed brakes engaged

Side rails lowered

Min 2 x slide sheets inserted beneath patient using appropriate safe technique

Patient arms across their chest or tucked into their side

Patient bed tilted in direction of move

Staff positioned side by side at end of bed facing patients head/feet

(If patient on ground, side by side at end to slide patient)

Staff grasp top slide sheet as close to patient as possible (bed end removed if required)

Staff positioned with outside leg as front legs running stance - weight on front foot

(If patient on ground, staff should not be on slide sheet and should be on knees)

On agreed cue, staff move weight from front foot to back foot, sliding top slide sheet along bottom slide sheet

Bed returned to neutral position

Slide sheets removed using appropriate safe practice

Safe practice demonstrated at time of assessment

Moving a patient up the bed (patient able to assist)

Assessment Commenced

Bed at safe working height

Bed brakes engaged

Min 2 x slide sheets inserted beneath patient using appropriate safe technique

Side rails up

Bed electronically tilted to facilitate movement

Patient encourage to bend knees so feet flat on bed (feet not on slide sheet)

Patient encouraged to use monkey bar if appropriate or to cross arms across chest

Staff member stands at side of bed and grasps patient ankles

Patient encourage to push through heels to move self up bed

Bed returned to neutral position

Slide sheets removed using appropriate safe technique

Staff member demonstrates safe practice at time of assessment

Sitting a patient up in bed (patient unable to assist)

Has the assessment commenced

Bed at safe working height

Bed brakes engaged

Back rest raised as much as possible (electronically if enabled)

Staff positioned on either side of bed facing head of bed with outside leg as front leg

Both staff grasp BOTTOM bed sheet and bring in lie with patients shoulders

On agreed cue, staff move weight from front foot to back foot, using a rowing motion to move sheet forward

Staff maintain taking weight until patient ready to be returned to start position

On agreed cue, staff move weight from back foot to front foot and lower sheet to mattress

Safe practice demonstrated at time of assessment

Guiding patient from supine to edge of bed to chair

Has assessment commenced?

Side rails lowered

Bed at lowest height

Bed in neutral position

Bed brakes engaged

Patient encouraged to move towards edge of bed (approx 1 hand width from edge of bed)

Head of bed electronically raised to suitable height unless contraindicated (ie some hip and neuro patients)

Patient encouraged to bend both knees so feet flat on bed and to roll towards side of bed they intend to exit

Patient encouraged to place upper arm across body so hand is in flat contact with mattress

Patient encouraged to position legs so lower part of legs is in line with edge of mattress (patient will look like they are sitting on a chair)

Patient encouraged to simultaneously dig elbow into mattress, push up with upper arm, drop legs over side of bed

Patient encouraged to wiggle forward to edge of bed so feet flat on floor

Patient sitting on edge of bed with hands on mattress on either side of body, feet flat on floor

Bed electronically raised to move patient to standing position

Patient encouraged to mobilise to chair (with appropriate mobility aid as required ie walking frame)

Safe practice demonstrated at time of assessment

Lateral Side turn with slide sheets - patient unable to assist (THEATRE ONLY)

Assessment commenced

OR table/trolley at safe working height

Min 2 x slide sheets inserted using appropriate safe technique

Patient knee bent using applying pressure beneath knee and to ball of foot on side patient to face away from

Patient arms across their chest

Staff have feet shoulder width apart

Staff member on side patient to face takes bent knee and upper elbow of patient

Staff member on side patient to face away from grips top slide sheet

3rd staff member positioned at feet of patient

On agreed cue, staff member holding slide sheet pulls directly up - staff member holding elbow and knee pulls down

Slide sheets removed using appropriate safe technique

Safe practice demonstrated at time of assessment

Lifting Patient with hoist (ceiling or mobile)

Assessment commenced

Bed at safe working height

Bed brakes engaged

Appropriate sling type and size selected for task and hoist

Sling inserted using appropriate safe technique

Brakes applied to hoist prior to attaching sling

Head of sling attached to hoist prior to attaching leg straps

Brakes disengaged prior to lifting patient

Hoist moved using straight lines (no twisting of staff body)

Patient lowered to receiving surface - if being placed in a chair, gentle pressure applied to top of knees to encourage patient into optimal seated position - no pulling on sling to achieve this)

Brakes applied to hoist prior to detaching sling

Sling detached from hoist and left insitu

Safe practice demonstrated at time of assessment

Transfer of patient with Arjo Sara Stedy

Has assessment commenced

Patient clinically and physically appropriate for Sara Stedy transfer

*patients equal to or greater than 100kg are not to use the Sara Stedy*

Patient encouraged to move to edge of bed or chair

Stedy moved to in front of patient and patient encouraged to place feet on foot plate with knees inline with knee pad

Brakes engaged on Stedy

Patient instructed to place hands on cross bar and to stand tall

*staff not to provide physical assistance to stand

Seat flaps lowered and patient instructed to sit

Brakes disengaged and patient instructed to remain holding cross bar at all times

Staff member moves Stedy in straight lines

Stedy placed in front of receiving surface as close as possible and brakes engaged

Patient instructed to stand (staff do not assist)

Seat flaps raised and patient instructed to sit on receiving surface

Brakes disengaged and Stedy removed

Safe practice demonstrated at time of assessment

Lateral transfer of patient - slide sheets and Pat Slide

Assessment commenced

Correct number of staff engaged?

*min 4 staff required excluding a staff member maintaining airway if required

Min 2 x slide sheets collected + Pat Slide

Bed/trolley/table brakes engaged

Bed/table/trolley at safe working height

Patient rolled away from direction to be transferred using appropriate safe technique

Pat slide placed beneath patient with 2 slide sheets long ways on top of pat slide

Patient returned to supine position

Receiving surface aligned with existing surface but at a slightly lower or equal height

Verbal check that brakes on all surfaces engaged

Staff positioned with two on sending side and two on receiving side. One staff member maintaining air way if rwquired

On agreed cue, staff push patient legs whilst receiving staff pull on top slide sheet. Legs are followed by head/upper body.

Patient is placed in optimal position on receiving surface using slide sheets

Slide sheets are removed using appropriate safe technique

Side rails raised on bed

Safe practice demonstrated at time of assessment

Lateral Transfer of patient with Hovermatt and Pat Slide

Assessment Commenced?

Brakes on sending surface engaged

Correct number of staff obtained (min 4 + 1 for airway if required)

Patient clinically appropriate for hover equipment

If patient not already on hovermatt, patient rolled using push/pull method to insert hovermatt

Hovermatt correctly placed - correct way up and feet at correct end

Safety straps connected

Hovermatt inflated and then pat slide inserted (wiggled) beneath Hovermatt acting as a bridge

Receiving surface brought next to sending surface and positioned at same or slightly lower height

Verbal and physical check that brakes are engaged on all surfaces

On agreed cue and only when Hovermatt is fully inflated, staff on sending side push foot end of Hovermatt whilst receiving side waits for it. Process repeated for head end.

When patient in correct position, Hovermatt deflated and hose removed

If Hovermatt to be removed, done so in appropriate safe technique.

If transferred to a bed or trolley - side rails raised

Safe practice demonstrated at time of assessment

Hoverjack

Assessment commenced?

Patient clinically suitable to use hover equipment

Patient rolled using push pull method to insert Hovermatt correct way down and feet at correct end. If unable to roll, patient placed on slide sheets and moved in appropriate safe manner onto hovermatt

Hovermatt safety straps secured

Hover jack placed inline with Hovermatt (either laterally or long wise) with valves at foot end and heavy canvas face down

Hovermatt inflated and patient push/pulled onto hoverjack with a min 4 staff

Hovermatt deflated

Hover jack safety straps secured

Hoverjack inflated one chamber at a time starting with Chamber 1 (bottom chamber). Each chamber completely filled prior to advancing to next chamber

When fully inflated, Hovermatt inflated and pat slide inserted beneath Hovermatt to,act as bridge

Receiving surface brought along side hoverjack (if no room, hoverjack taken to receiving surface)

Verbal and physical check brakes are engaged on receiving surface

Hovermatt fully inflated and lateral transfer in two stages (feet first, head second) using a min of 4 staff

When patient in correct position on receiving surface, Hovermatt deflated and removed using appropriate safe technoqie

Side rails of receiving surface raised

Safe practice demonstrated at time of assessment

Supine to Prove Transfer with Hovermatt (THEATRE ONLY)

Assessment commenced

Patient clinically suitable for Hover equipment

Patient placed on Hovermatt prior to being anaesthetised. Hovermatt correct way up and feet end in correct position

Patient positioned on the edge of the Hovermatt closest to the side they will be rolled

Once patient anaesthetised and clinically stable, sending surface brought next to receiving surface and at appropriate height to allow for s,path tramsfer

Correct number of staff in position (1 at head, 2 on receiving side, 2 on sending side, 1 at feet)

Verbal and physical check that brakes on both sending amd receiving surfaces are engaged

On agreed cue, Hovermatt inflation commenced

As Hovermatt inflates, staff on sending side Hovermatt up and over to start patient rolling onto receiving surface. Staff on receiving side take patients upper hip and shoulder and guide to prone position

Hovermatt deflated and removed. Sending surface removed

Safe practice demonstrated at time of assessment

Recovering a collapsed patient from a chair

Assessment commenced

If patient clinically stable - sling inserted beneath patient and transferred with hoist

Patient clinically unstable - medical emergency. 1 staff member kneels in front of patient with one foot flat on floor positioned between patients feet and holding beneath patients knees

If additional staff present - 1 staff member supporting patients head from side of chair.

Staff member at front of patient places own weight on front leg maintaining straight back

Staff. Member at front of patient transfers weight from front leg to back leg, pulling on patients legs. If required, staff member shuffles back and repeats process until patient in on the floor

Once patient stable for transfer from floor, hoverjack and Hovermatt used to lift patient if clinically suitable

Staff member demonstrates safe practice at time of assessment?

Transferring a patient from Prone to Supine from theatre table to bed/trolley (THEATRE ONLY)

Assessment commenced

Receiving surface aligned with sending surface but at a slightly lower height and with enough gap to allow for theatre table to be rotated without catching on receiving surface

Patient arms secured to avoid injury and avoid damaging any lines insitu. Blankets used to pad gap between surfaces to minimise risk of injury to patient

Min 2 x slide sheets on receiving surface longways

Min 6 x staff positioned with 1 at head maintaining airway, 2 on receiving side, 2 on sending side, 1 at feet

On agreed cue, theatre table rotated in direction on receiving surface

When theatre table at maximum rotation, staff on sending side gently push patient whilst staff on receiving side gently guide patient to receiving surface

Once patient is supine on receiving surface, staff use slide sheets to position patient in optimal position on receiving surface

Staff demonstrate safe practice at time of assessment

Rolling a patient with a Repositioning Sheet

Assessment commenced

Repositioning sheet must already be placed beneath patient (under bed sheet)

Loops on side patient to roll away from placed on hoist sling bar with even distribution of loops (ie 4 on either side of sling bar). Correct hoist must be used - can be either ceiling or floor hoist providing sling bar is compatible)

Hoist raised until patient rolled to desired positioning

Patient propped up and sling lowered

Safe practice demonstrated at time of assessment

Assisting Patient legs on bed (no hands mum technique)

Assessment commenced

Staff member clinically appropriate for this technique

Patient sat on edge of bed with bed at lowest height

2 x staff with 1 positioned behind patient, 1 in front of patient. Slide sheet pushed beneath patients buttocks from behind patient

Patient encouraged to wiggle back in bed until back of knees in contact with edge of mattress. Staff member at front of patient anchors slide sheet to ensure it remains in optimal position

Bed raised to appropriate height

Leg lifter placed over patients feet and handle given to patient OR second slide sheet looped around arch of patients feet and tail given to patient to hold

Patient instructed to lean all the way back with straight arms and extend legs aiming to hit imaginary high target

Staff member behind patient providing light touch to reassure patient

Staff member at front walks into patients legs from head of bed to foot of bed until majority of patient legs are on the bed. Legs should be inline with staff members pelvis when walking into legs

Slide sheet removed from around patients feet and patient encouraged to reposition self on bed

All slide sheets removed and bed returned to safe height for patient

Safe practice demonstrated at time of assessment

Assisting Patient legs onto bed - alternate method

Assessment commenced

2 x staff and 2 x slide sheets

Patient encouraged to sit as far back on bed as possible

Slide sheet folded and placed across foot end of bed

Slide sheet placed around patients legs being careful to capture as much body surface as possible

Staff member at rear of patient positioned at foot end of bed, staff member at front of patient positioned at foot of bed holding the slide sheet tail in hand closest to foot end of bed whilst other hand rests on patient feet

On agreed cue, patient instructed to lay on side with "ear to pillow" whilst staff member at front passes slide sheet tail to opposing staff member

Staff member at rear of patient pulls on slide sheet in a sliding motion whilst staff member at front of patient pushes the feet across the bed. Both staff refrain from bending or hunching

Slide sheets removed

Safe practice demonstrated at time of assessment

Sit to Stand Machine

Assessment commenced

Patient clinically suitable for device

Correct sling for device selected

Machine brought before seated patient and brakes applied

Sling placed on patient and attached to machine correctly

Patient encouraged to stand as machine raises

Machine mast raised lifting patient

Once patient in standing position, brakes disengaged

Staff member moves machine in straight lines whilst second staff member monitors patient

Patient positioned over receiving surface and brakes applied to machine

Patient lowered to receiving surface

Sling detached from machine and patient

Machine brakes disengaged and machine removed from area

Staff demonstrate safe practice at time of assessment

TED Applicator

Assessment commenced

Correct applicator size selected for the TED

Applicator placed on a slightly lower surface that is stable

Heel of TED facing back of device

TED fed over applicator until heel (identifiable by colour difference in stocking) is visible in applicator window

Staff member encourages patient to stand into applicator if clinically suitable. Once foot in TED, staff member pushes applicator as far as possible OR if patient unable to stand into stocking, staff member pushes applicator over heel of foot and up ,eg

Safe practice demonstrated at time of assessment

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.