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Focus On...Baths & Lifts

September 1, 2006
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The Miracle of Lifting Technology Based on an interview with Joe Jolliff, retired administrator of Wyandot County Nursing Home, Upper Sandusky, Ohio
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The miracle of lifting technology

Retired administrator Joe Jolliff continues to advocate for "no-lift" policies in nursing homes It's been an interesting, enlightening, and most of all, fulfilling journey for Joe Jolliff, former administrator of Wyandot County Nursing Home (WCNH) in Upper Sandusky, Ohio. Today, in his retirement, Jolliff continues to take his message of the benefits of a no-lift policy on the road, spreading the word about the "miracles" that can happen to staff, residents, and facilities. At WCNH, a 100-bed, county-run facility, he witnessed the toll that manual lifting was taking on his staff. From 1995 to 1996, three workers sustained serious injuries from manual lifting. "It broke my heart," says Jolliff. "I don't think those three people are back at work today."

Because of those injuries, Jolliff decided that enough was enough. Not only did he want to prevent harm first and foremost, he wanted to reduce the costs that injuries incur. Seeking to find out what the facility was doing wrong, he asked a representative from the Ohio Bureau of Workers' Compensation (OBWC) to observe the facility's moving, transferring, and repositioning procedures. "Joe," the rep said, "you're just like other nursing home administrators. You expect staff to keep people from falling. You expect them to lift people who might weigh anywhere from 200 to 300 lbs, and you don't appreciate your staff." This criticism got Jolliff's dander up, and after the OBWC representative left he told the director of nursing, "This woman has a screw loose." But, Jolliff reflects, "If she hadn't made me so mad, I might never have done the research that led to remarkable results and the miracles we've experienced."

Back in the mid-1990s, very little research on no-lift technology was available in the United States, so Jolliff searched the Internet and studied the results of interventions that were instituted in Sweden and Germany. For Jolliff, this information provided some relief; he now understood why staff were sustaining injuries, and he knew that he had to take WCNH in a new direction-away from manual lifting. "After I decided to initiate a 'no-lift' policy, I attended a seminar and saw my first sit-to-stand lift," says Jolliff. He arranged to have the lift brought to WCNH so that staff could have a chance to operate it and experience its benefits firsthand. "Staff were reluctant to try it," he says. "They said that they were 'too busy.'" Although the manufacturer left the apparatus in place for a week, staff still didn't try to work with it and it was returned. "At that point, I had to go back to the old system and form a committee," he notes.

Jolliff posted a sign-up sheet for potential committee members, but he didn't think there would be much response. To his surprise, 30 people wanted to participate. The selected committee was composed of nurses and nursing assistants representing each shift. They were given the research material that Jolliff had collected, and he urged them to gather more information. "At that time, there weren't any forms or procedures to use as a prototype for our policy," says Jolliff. Nevertheless, the committee took a look at the equipment available and made its final selections. "I stayed out of the decision-making process because, after all, these are the people who will be using the equipment."

By 1997, staff-selected sit-to-stand lifts and total lifts (portable sling-type lift devices equipped with universal/hammock slings or band/leg slings) were in place. "Along with this equipment," says Jolliff, "we started stretching exercises for our nursing assistants before the start of each shift."

Every few months, Jolliff would meet with staff to find out where they were still having difficulties in moving, transferring, or repositioning residents. "In 1997, staff also told me that walking some residents was very difficult, so mobile lifts that would help a resident ambulate were added to our program," he says.

In 1998, an OBWC grant program provided $40,000 in funding if the facility added $10,000 to that amount. "I didn't want to miss out on that," Jolliff says, laughing. The bureau recommended using fast beds-i.e., beds that go from high to low position in 20 seconds or less-and that's where WCNH wanted to invest the grant money. However, there weren't any such beds on the market, according to Jolliff. Of course, this tenacious administrator wouldn't let that inconvenience stop him. He contacted a bed manufacturer and worked with the manufacturer for more than a year to develop a 20-second fast bed for his facility. The fast beds were in place at WCNH by April 2000. Research has proven that any electric bed is better than a hand-cranked bed for staff and resident safety. "Although it doesn't sound like a long time," says Jolliff, "an electric bed that takes a full minute or more to raise or lower, that is a long time for a nursing assistant to wait to begin care." When a fast bed is used, the bed is already at a working height by the time the resident is told what he or she has to do. "Fast beds reduced our turnover more than all the other equipment combined," says Jolliff.

Research conducted in 1999 by William S. Marras, PhD, at Ohio State University concluded that there is no safe way to manually handle residents. Statistics indicate that the lifting, bending, and stretching that nurses and nursing assistants do in the process of moving a resident cause damage to the spine and impede blood flow. Staff become exhausted, are weakened, and are prone to injury.