Risk reduction in lateral patient transfers


23 / 01 / 2009

  • SHA region
  • The organisation
  • What we did and why
  • How we did it
  • The results and next steps
  • Contact details and further information
  • SHA region

    NHS South East Coast

    The organisation

    Isle of Wight Healthcare NHS Trust, Winners of NHS Employers Back In Work Awards 2006.

    What we did and why

    Back problems and musculoskeletal disorders remain the major cause of sickness absence in the NHS. NHS Employers' Back in Work campaign is part of an endeavour to encourage employers to take a pro- active approach in managing this problem. Launched four years ago in partnership with the Health and Safety Executive, the annual Back in Work Awards showcase innovative work by a wide range of NHS organisations.

    In 2006 Isle of Wight Healthcare NHS Trust, one of two overall winners received the award in the 'Joined-up Working Practices', 'Evidence of Problem Solving' and 'Innovative Programmes and Ideas' categories.

    The Back Care Advisory Team at the Trust, based at St. Mary's Hospital, identified a dangerous manual handling procedure that was taking place in Trust operating theatres, resulting in excess musculoskeletal strain and injury.

    This was due to the high level of manual handling undertaken by the theatre staff. One of the highest risk activities involved the lifting of patients from trolley beds onto operating tables. The method used required a significant amount of manual handling of patients and was perceived to increase risk of causing, or aggravating musculo-skeletal injuries of the back and shoulders.

    How we did it

    The Back Care Advisory Team liaised with the Theatres manager to discuss the high levels of staff injury and identify high-risk activities. After discussion and trial of several prototypes, a preferred model was agreed.

    The new system consisted of a patient transfer canvas with hand loops along its length, to be placed on top of the bed sheet and underneath the patient. Inserted by either rolling the patient, or by using a pair of slide sheets from the head or foot of the patient, this technique was generally carried out within the surgical wards and involved the surgical ward staff who were preparing the patients for surgery. They were already familiar with the procedure, so no additional training was required. The ward staff and the theatre porters worked together to ensure the canvas was in place, prior to the patient leaving the ward. The patient was then laterally transferred in the theatre, using a patient transfer board as a bridge for sliding across.

    Once the canvasses had arrived, the back care team agreed a training programme with the theatre managers and arranged for implementation of the new procedure. All lateral transfer training took place within the operating theatre department, in many cases within the theatres. Theatre staff in attendance included surgeons, anaesthetists, nursing staff, operating department practitioners, assistants and theatre porters.

    A member of the theatres staff undertook an audit to identify the attitude of the staff to the new procedure and intervention. This produced positive feedback.

    The results and next steps

    A safer procedure was identified and introduced to trust operating theatres at relatively low cost. The new system adopted resulted in a marked reduction in sickness absence levels and work injuries normally associated with patient lifting within the theatres staff.

    The Trust collected data relating to sickness and absence that detailed lower back pain or injury as a cause. The data covered a time period from one year before and almost three years after intervention. In addition, mean staff replacement costs were recorded in the form of overtime and agency staff that may have been brought in to cover the sickness absence.

    Initial analysis demonstrates that although there was a 33 per cent increase in theatre staff from 2001 to 2005, there was a significant decrease of 63.68 per cent in the occurrence of sickness absence reported as result of neck and back injuries.

    The direct cost benefits of the reduction of sickness absence greatly outweigh the initial costs of the intervention. The cost of the intervention is calculated as the cost of the material purchases and the staff replacement costs due to training, (which has taken place outside of normal on-going staff training). The total for this comes to £8220.25.

    It would appear that the cumulative saving to date due to significantly decreased sickness absence is approximately £98,000. After costs have been deducted, this returns an overall saving of approximately £90,000.

    These costs are related to the direct employment costs and do not take into consideration the indirect costs, such as managers' time, loss of expertise and experience, occupational health involvement, accident investigation, clerical effort and low team morale.

    Throughout the Trust there has been an overall reduction in all reported incidents of staff harm involving manual handling since the system was fully operational. A detailed analysis of all the reports over the years 2003/04 and 2004/05 identifies that there were no incidents recorded where staff were injured during lateral transfer manoeuvres.

    Subsequently, the same equipment and procedure has been rolled out throughout the Trust, thus impacting on many staff groups and greatly reducing the risk of injury from lateral patient transfers within the Trust.

    Contact details and further information

    Contact Judy Green, Isle of White Healthcare NHS Trust judy.green@iow.nhs.uk (telephone 01983 534 213) 

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