Long-Term Care Survey Alert

Tip: To get your own program off the ground, work around the obstacles until you realize the perks.

Sometimes the best risk management approach is more about what you don't do.

That has certainly proven to be true for Heritage Enterprises' no-lift policy where staff must use either a standing or full lift for residents who require more than a two-person assist, except in rare cases. While the Bloomington, IL-based corporation implemented the policy primarily as an employee safety measure in August 2001, administrators soon learned that the hands-off approach to moving residents reduced both worker injuries and resident falls, reports Paula Williamson, benefits manager for Heritage.

Under the no-lift policy, one staff person can operate the assisted lift but two staff members operate the full lift, Williamson tells Eli. Staff posts the resident's specific lift requirements on a picture board in his/her room, which is especially helpful in giving temp agency staff a "heads up" on the resident's transfer needs.

Training in how to use the lift can overcome staff's initial wariness about the new approach. Heritage Enterprises provides at least two "product champions" who serve as role models and trainers for staff.

Initially, Heritage's rehab department worried that use of the lifts might cause residents to lose muscle strength over time. Yet the opposite occurred.

Case in point: One younger resident -- a large woman with a brain tumor -- initially required use of the full lift, but progressed to the assisted stand lift. She developed weight-bearing status and her mobility improved so much that she was able to take car drives with her husband and then go home for Thanksgiving.

Some family members have noted that their loved ones enjoy greater dignity and privacy during toileting because the slings of the lifting devices provide them some support so they can toilet more independently, Steven Witt, director of the Occupational Safety & Health Administration's Directorate of Standards and Guidance, tells Eli.

Surprise finding: Heritage found the no-lift policy ended up reducing dementia residents' behavioral symptoms during transfers. Heritage field nurse Nancy Annengers believes the lifts may increase the resident's sense of being in a safe environment.

Staff may resist a no-lift policy if they have to wait around for a free lift to move residents, which will slow down their workflow. To get around that problem, Royal Manor HealthCare implemented a scheduling system in one facility where staff identify when residents get up at certain times of day and require the lift, reports Treva Boydelatour, RN, LNC, corporate compliance nurse for the Middlebrook Heights, OH organization. Staff must use either a full or standing lift for any resident who cannot transfer without hands-on assistance, Boydelatour notes.