Employee Training

Safety and Education

Friction Reducing Devices – A Better Solution

Within the healthcare industry, repositioning patients is always a serious concern. The science of lifting a human and gravity are important aspects to a safe move.

Repositioning, turning, and boosting patients up in bed are common sources of injury. These are high risk tasks that are performed several times during the course of a shift. Studies have shown that friction reducing sliding aids, most commonly referred to as slider sheets or repositioning devices, are a better solution over the traditional draw sheet.

To appreciate the value of friction reducing devices, we must understand the concepts of friction and force. Merriam-Webster defines friction as “the force that resists relative motion between two bodies in contact” and force as “strength or energy exerted or brought to bear.”

When sliding a patient up in bed, friction results between the patient and the bed. There is more friction generated with a traditional draw sheet as it slides over the bed than with a slippery slider sheet. Because sliding is more difficult with a draw sheet, the tendency is to lift up which causes more force.

As friction increases, momentum is reduced during the transfer, requiring more force on the part of the caregiver to perform the task.

Friction reducing slider sheets are becoming more widely used in the healthcare setting. When using these sheets, the patient’s weight actually feels lighter and moves with less friction and drag. These sheets also reduce the shearing forces on the patient’s skin.

Tips for using slider sheets:

Where possible, patients should be encouraged to move themselves or partially assist to the best of their ability.
Tilt the bed to a head down position to allow gravity to assist
Be sure to lock the wheels on the bed.
Close attention should be paid to proper body mechanics, body positioning during the lunge, and wrist positioning when using these sheets. It is important to slide the sheet and resist the tendency to lift up. Dragging your knuckles along the bed can help you to maintain the slide.

These same sheets can also be used to turn a patient, making it much easier for the caregiver. By using the sheets, it minimizes over reaching and the force necessary to turn a patient.

It is important to note the following:

Never leave the device under the patient unless the manufacturer specifically recommends it. This may put the patient at risk for falling out of bed.
Heavier patients may still require excessive force to move. Use of a mechanical lift to reposition a patient may be more appropriate.

Introducing repositioning slider sheets into your facility is not only safer for your employees, but for the patient too.

Lauren Caulfield

Follow up of a Medication Error

Employee Education

In home care we expect all nurses to use the 5 rights when administering medications. Remember the pharmacist may have made a mistake or the doctor may have made a mistake, but if you are the nurse administering the wrong medication you will be the first leg of a legal dispute. Your license will be placed on the line………

The premise is to not have a medication error as you have been very careful in administering your medications. If in the rare chance there has been a medication error or you have followed another nurse who made an error you are responsible for the following:

Do a head to toe assessment immediately after the incident is known, if there is any question of an immediate reaction, call 911 and send the individual to the ER via ambulance for the most immediate interventions.
If after your assessment is complete your client seems to be okay, the client’s MD will need to be notified as quickly as possible. The MD may want to hold the medication in question, or increase the medication depending on the scenario, the Dr. may want to see the client in his office to perform an examine.
If the parent/or other contingency prefers that the nurse not call the MD, the nurse will need to call the office (the nurse would need to call the office any time a med error occurs) and we will call the family member to let them know we are obligated to speak to the PCP to report the incident. We will give them the option to call the physician’s office and with the instructions to have the doctor’s office contact the agency. It is imperative that the agency speak directly to the physician, any recommendations will be communicated to the nurse in the home on duty.

· The nurse in the home will need to fill out an incident report, if one is not available let the office know and we will forward one to you.

· If you do have a conversation with an MD, detailed documentation needs to occur. Use a clinical note addendum to write the details if needed. Remember if you don’t document it, in a court of law, you didn’t do. In all situations you must have a Doctor’s order for all medications and treatments. This includes over the counter medications. If you do anything without and order you risking your license. ALWAYS MAKE SURE YOU HAVE AN ORDER FOR EVERY MED AND TREATMENT!!!

Please call the agency if you have any further questions regarding this process

Sincerely,

Jane Greenblatt RN BSN

Clinical Director

There are currently no employee training days scheduled.

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