Research Activities, July 2013
Safe patient handling program does not inhibit recovery of rehabilitation patients or create equipment dependence
Patient Safety and Quality
Patients who go through rehabilitation in a hospital system that has implemented a safe patient handling (SPH) program do as well as patients rehabilitated using traditional approaches, according to a new study. A SPH program is designed, in part, to reduce direct patient handling by staff during patient ambulation and transfers to reduce associated back and other staff injuries. Examples of helpful equipment are ceiling- and floor-based dependent lifts, sit-to-stand assists, ambulation aides, motorized hospital beds, powered shower chairs, and friction-reducing devices. This study may help to alleviate the concern among rehabilitation service providers that patients may become dependent on the patient handling equipment to the point of impeding their recovery.
To examine these concerns, the researchers compared the mobility subscale (locomotion and transfers) of the Functional Independence Measure (FIM) between two groups of patients undergoing rehabilitation at one hospital. Patients in group 1 (No-SPH) underwent rehabilitation 1 year before implementation of an SPH program. Patients in group 2 (SPH) underwent rehabilitation during a 1-year period after implementation. The two groups were comparable in their FIM scores at admission, but differed in terms of mean age and length of stay, as well as the distribution of impairment codes.
The change in mobility scores from admission to discharge was not significantly different between the no-SPH group of 507 patients (FIM mobility score rose from 12.4 to 23.2) and the 784 patients in the SPH group (FIM mobility score rose from 12.4 to 23.5). For patients who had high admission mobility scores (15.1 or higher), the researchers’ regression model indicated patients in the SPH group had higher mobility FIM scores at discharge after controlling for admission mobility FIM, age, length of stay, and diagnosis. However, the differences were small and may not have reflected clinically significant differences.
The researchers recommend further studies, because they did not collect evidence on how thoroughly the SPH program was implemented and because other predictors, such as body mass index, were not included. The study was funded in part by AHRQ (HS20723).
More details are in "Effect of safe patient handling program on rehabilitation outcomes," by Marc Campo, P.T., Ph.D., Mariya P. Shiyko, Ph.D., Heather Margulis, P.T., M.S., and Amy R. Darragh, O.T.R./L., Ph.D., F.A.O.T.A., in the January 2013 Archives of Physical Medicine and Rehabilitation 94(1), pp. 17–22.