The Gait Belt: A Useful Tool for Tough Transfers
The Occupational Safety and Health Administration (OSHA)
recommends that manual lifting of residents be minimized and eliminated when
possible. This OSHA guideline is specifically designated for skilled nursing
facilities, however the same guidelines can prove extremely helpful in the
acute care setting.
- Your facility may recommend the use of gait belts to be
worn by the patient when you are transferring or ambulating a person. The gait
belt provides a firm grasping surface for the staff person and protects the
patient from accidental trauma to the skin. The gait belt gives the patient a
sense of security as it is tightened. The belt also allows the staff person to
gradually lower a patient to the floor, if necessary, without injuring self or
patient.
- The gait belt is made of cloth or plastic, buckles securely
and is worn by the patient who is at risk or may need assistance. It is
buckled around the patient’s waist at the center of gravity, generally in the
lumbar area. It fits tightly, but still allows room for two persons to grasp
the belt for moving or assisting the patient. By using the gait belt when
transferring patients, assisting with ambulation or when a patient who is
falling or losing balance, you can safely help the patient and protect your
back at the same time.
- One challenge facing health care staff is to identify who
might need a gait belt. If your facility uses an assessment tool for patients,
independent patients are generally excluded from those needing gait belts.
Patients who are not independent are candidates for gait belt usage.
Relative contraindications for the use of a gait belt include
recent colostomy or ileostomy surgery, severe cardiac condition, severe
respiratory problems, recent abdominal, chest or back surgery, abdominal
aneurysm or a phobia regarding belts.
Prevention is the key. Do not over-rely on a gait belt; a gait
belt is not a substitute for good body mechanics when moving patients. Get help
when you need it. Using your head and a gait belt can reduce your risk of back
injury.
By Karen Siroky, RN, MSN, contributor, and Robin Varela,
RN, BSN, contributor
As a new nurse, your on-the-job responsibilities will often
involve lifting patient. In order to avoid injuring yourself at work, it’s
important to learn about the risk factors and conditions that can cause back
injury. By inspecting your workplace to look for hazards and applying safety
practices, you can reduce your risk of injury in the nursing environment.
Transfers and Repositioning
- Plan the move. Check the path of travel and make sure it is
clear.
- Never transfer alone. Use team lifts or mechanical
assistance. This also applies to patients who fall.
- Communicate. When moving a patient with the assistance of
another caregiver, the most important step of all is to communicate and
coordinate effort with the person assisting you. For example, “Move together
on my count of three: One, two, move.”
- Use a wide, balanced stance with one foot ahead of the
other. A wide base of support will stabilize you and prevent slipping and
jerking.
- Push whenever possible. It is easier and safer than
pulling. Ensure that your line of sight is clear.
Lifting
- Test the load. Test the weight of the load prior to lifting
to be sure it can be moved safely. Ask for help or use a mechanical lifting
device.
- Back belts are not a substitute for proper lifting habits.
Most studies show that they do not prevent back injuries and may give false
confidence.
- Bend at the knees, not at the waist.
- Get a good grip on the object with elbows bent. Use grips
or handles if available.
- Keep the lower back in its normal arched position while
lifting. An arched back distributes forces more evenly on support structures.
- Bring the load as close to the body as possible. This
reduces stress and keeps your back from acting as the fulcrum. Use both arms
and bend at the elbows.
- Keep the head and shoulders up and tighten the abdominal
muscles as the lifting motion begins. This causes the abdominal cavity to
become a weight-bearing structure and decreases the load on the spine.
- Lift with the legs and stand up in a smooth, even motion.
Decrease lower back stress by using the strength of the legs to straighten the
knees and hips.
- Use your arms and legs to bear weight, not your back.
Always use the largest muscles; for example, use the palms, not the
fingertips, to bear the weight.
- Pivot on your feet if a change in direction is necessary.
- To set a load down, squarely face the spot where the load
is to rest and bend your knees, feet apart.
- Avoid reaching above shoulder height. Use a stool or ladder
instead.
- Limit the number of lifts in one day.
Use Equipment and Devices
Devices and equipment can help reduce the weight you must
bear. Some of the devices and equipment you can expect to see and use include:
- Gait belt
- Lifting device or hoist
- Slide board
- Draw sheet or incontinence pad
- Low-friction mattress cover
- Slippery sheet or plastic bag
- Transfer mat
- Roller board or mat
- Transfer or pivot disc
- Shower or toilet chair
- Shower cart or gurney
- Pelvic lift device
Source: Workplace Safety and Patient Care Standards Course,
RN.com. Karen Siroky is the director of education for RN.com.