Ceiling mounted hoists are used to help solve the problems related to moving and handling patients. In the UK this seems to be seen as the only function of a hoist and attitudes towards fitting hoists in hospitals vary from Trust to Trust. In the new Southmead Hospital in Bristol ceiling mounted hoists have been fitted in every single bedroom, in the new Royal Liverpool PFI hospital only a small percentage of the bedrooms will have hoists fitted, and some Trusts do not use ceiling mounted hoists at all. However, can a ceiling mounted hoist provide further benefits than just aiding with lifting and moving a patient?
In March 2014 as part of a field trip to Denmark to see the existing Aarhus Univeristy hospital, the site of the new Aarhus Univeristy Hospital and the regional hospital in the city of Horsen, a team from MJ Medical were intrigued to see how hoists are utilised in Danish healthcare settings. Meeting with hoist manufacturers hoist manufacturers, they were shown the latest innovations in hoist technology and how they can be used in new and innovative ways other than for simply lifting and moving.
The hoist – more than just getting from A to B
The function of a ceiling hoist is generally perceived as an aid for lifting and moving a patient from a bed to a chair or into an En-suite. However, in Denmark a research team of two fully qualified physiotherapists have realised that a ceiling hoist has much more potential.
The most innovative way of using a ceiling mounted hoist is as a rehabilitation aid. The team were shown how, with the use of new attachments for the hoist, rehabilitation can begin almost straight away at the bedside, even with the most critically ill patients. Using the hoist the physiotherapist or nurse can begin to get the patient making simple movements, such as lifting their heads or raising an arm or leg, whilst still in their beds. This can then build up to doing more complex exercises, getting the patient sitting up, standing and eventually, using the hoist as a walking aid, taking their first few steps. The presence of the hoist in the patient bedroom allows the rehabilitation process to begin almost immediately rather than having to wait until the patient is able to be taken to a gym. Being able to begin rehabilitation at an early stage in a patient’s recovery also has the added benefit that the patient’s length of stay can be reduced. This is particularly useful in an ICU setting where patients are too sick to get out of bed but where they greatly benefit from rehabilitation at an early stage.
The team were able to see this in practice in the ICU at Aarhus University Hospital where all the ICU bays and single rooms were fitted with a ceiling mounted hoist. They used an H frame track which allowed the hoist to provide full coverage of the space around the bed, going back as far as the pendant which was situated at the head of the bed. The nurses working in the ICU told us that they used the hoists on a daily basis not just for moving the patients but also to weigh them, using the inbuilt scales, and for doing rehabilitation exercises. The hoists were not perceived as an infection control problem or an obstacle that got in the way of other equipment. Conversely the staff saw the hoists as a useful tool which benefitted their working environment and the patient’s recovery.
Another use of the hoist in Denmark was for the positioning of patients both in the patient bedroom and in the operating theatre for surgical procedures.
In the patient bedroom the hoist can be used for positioning the patient on the bed to allow the nursing staff to carry out procedures such as washing a patient or changing a dressing in a safer and more efficient way. Using the hoist allows some activities, which would traditionally require at least two members of staff, to be done by just one person therefore freeing up valuable time and resources. It also allows the nurse to have greater contact with the patient while they are carrying out these activities. While the hoist is holding the patient the nurse is free to be by the patient’s side to talk to and reassure them if they are feeling apprehensive about what is happening. This improves the experience for the patient and improves the working environment for the staff.
The hoist is also used in the operating theatre not just to transfer the patient on to the operating table but also to turn the patient or to hold them in a particular position. For example, if a procedure involves a leg being elevated the hoist can hold the leg in place rather than a Doctor or nurse having to hold it. The hoist provides efficiency in the operating room allowing patients to be moved and positioned easily and, at the same time, reducing the number of people needed to carry out this process.
Hoists in Danish Hospitals
Within the hospitals we visited the use of ceiling mounted hoists in patient bedrooms was very commonplace. The Danish appeared to be very keen to minimise injuries resulting from manual handling, therefore have incorporated the use of ceiling mounted hoists in their hospitals as a standard part of the way they work on a daily basis.
The hospital in the city of Horsens, which was in the middle of a refurbishment programme, hoists were fitted in one of the operating theatres and anaesthetic room, x-ray room and the simulation suite.
Hoists had fitted out all of the patient bedrooms and En-suites in the refurbished wards with a ceiling mounted hoist. The simple square shaped rooms on the wards meant that using the full room coverage solution, an H frame with traverse rail, the hoist can reach all corners of the room allowing the patient to be moved to, or be picked up following a fall, from any part of the room. Apart from the simple shape of the room, another design feature of the patient bedrooms that complimented the use of the hoist was the use of privacy screens between the bed spaces rather than curtains. Without curtains there were no issues of clashes with curtain tracks to contend with, a common problem encountered when designing a hoist solution in the UK, and the movement of the hoist was not compromised at all.
A similar solution is also being planned for the new Aarhus University Hospital, a giant hospital complex which is the largest hospital construction project in the history of Denmark. The new hospital will be all single bedrooms with a hoist fitted in all the bedrooms leading into the en-suite. Again the bedrooms are going to be a simple square shape and this design has been chosen to allow full flexibility and to maximise the use of the hoist.
What can the UK learn?
The example of how Denmark is utilising hoist technology demonstrates how they offer much more in a healthcare setting than one might think. Hoists can provide more functionality than just assisting with lifting and moving a patient; used for patient mobility general it can reduce injury to staff and improving the working environment and it can help patient’s recovery and even reducing the length of patient stays through its use in rehabilitation. All of these additional uses save time, reduce resource requirements and potentially generate cost savings.