Using a Hydraulic Lift

1. When preparing for safe patient transfer using a hydraulic lift, the nurse performs which action first? A. Assesses the patient for weakness, dizziness, or postural hypotension B. Arranges for at least three healthcare personnel to assist in the transfer C. Makes sure the patient agrees to the intervention D. Applies clean gloves

A Rationale: Assessing the patient for weakness, dizziness, or postural hypotension will help ensure the patient's safety. Two nurses or NAP can safely transfer a patient with a hydraulic lift. The assistance of three healthcare personnel is not necessary. Securing the patient's agreement does not help the nurse prepare for a safe transfer. It is not necessary to wear gloves while transferring a patient with a hydraulic lift.

finishing steps

Apply a lap belt if necessary for patient safety. Provide the patient with their personal items and ensure the call light is within reach. Perform hand hygiene.

3. Which action would decrease a patient's pain before a transfer with a hydraulic lift? A. Stop the transfer if the patient expresses or displays physical signs of pain. B. Explain the procedure to the patient before beginning the transfer. C. Administer a prescribed analgesic 30 to 60 minutes before the transfer. D. Postpone the transfer if the patient reports having physical pain or anxiety before the transfer.

C Rationale: Administering a prescribed analgesic 30 to 60 minutes before the transfer helps prevent unnecessary pain during the transfer by allowing time for the medication to take effect before the patient is moved. The remaining actions do not pertain to pain prevention.

5. When using a hydraulic lift to transfer a patient from the bed to a chair, when does the nurse turn off the check valve? A. After the patient crosses the arms over the chest B. After the patient's eyeglasses are removed C. As soon as the patient has been placed in the chair D. When the nurse removes the straps

C Rationale: The nurse turns off the check valve as soon as the patient has been placed in the chair. After the patient crosses the arms over the chest and the eyeglasses are removed, the patient has not yet been moved to the chair, so the nurse does not turn off the check valve at these steps. By the time the nurse removes the straps, the check valve already will have been turned off.

2. Which position is used when applying the sling to transfer a patient from the bed to a chair with a hydraulic lift? A. Prone B. Side-lying C. Supine D. Sims

C Rationale: The patient is placed in the supine position before he or she is transferred from the bed to a chair with a hydraulic lift. Prone, side-lying, and Sims are not positions used to transfer a patient with a hydraulic lift.

4. What does the nurse do after attaching the hooks to the holes in the sling on a hydraulic lift? A. Lower the head of the bed. B. Remove the patient's eyeglasses. C. Have the patient cross the arms over the chest. D. Elevate the head of the bed.

D Rationale: The head of the bed is elevated immediately after the hooks are attached to the sling. The head of the bed is lowered before the sling is placed under the patient. If the patient wears eyeglasses, they are removed before the hooks are attached to the sling. The patient's arms are crossed over the chest after the head of the bed is elevated.

supplies

Mechanical/hydraulic lift with frame, hammock or sling, and chains or canvas straps Chair/wheelchair

Check the patient's sitting alignment, and correct it if necessary by making sure of the following:

The patient's head is erect. The vertebrae are in straight alignment. The body weight is evenly distributed on the buttocks and thighs. The thighs are parallel and in a horizontal plane. Both feet are supported on the floor or foot stand. The ankles are comfortably flexed. A 2.5- to 5-cm (1- to 2-inch) space is maintained between the edge of the seat and the popliteal space, on the posterior surface of the patient's knees.

ALERT

Use lifting and transfer devices when available. Verify the working order of the lift; lock wheels before using. Determine how many nurses are needed to safely move the patient with the lift. Do not begin move until required number of staff are in position. Know the pathological conditions that affect a patient's body alignment and mobility. Postural abnormalities affect body mechanics. Control factors that indirectly affect body mechanics by altering the safety of the environment. Know the patient's range of motion (ROM). Contractures or spasticity limit joint and muscle mobility. Determine the patient's level of sensory perception. Remove the patient's glasses, if he or she wears them, because the swivel bar is close to the patient's head and could break eyeglasses.

steps

Perform hand hygiene. Ensure patient privacy. Introduce yourself to the patient. Identify the patient using two identifiers according to agency policy. To use a hydraulic lift to transfer a patient from the bed to a chair, explain the procedure to the patient and ensure that he or she agrees to treatment. Place a chair near the bed, allowing adequate space to maneuver the lift. Make sure the chair breaks are locked. Determine the number of people needed to assist with the transfer. If needed for safe patient transfer, seek the assistance of a second health care worker. Move the bedside table out of the way. Remove patient glasses if applicable. Raise the bed to the high position, with the mattress flat. Make sure the bed breaks are locked. Remove blankets/sheets covering the patient. Raise the rail on the side of the bed on which the chair sits. Roll the patient onto his or her side, facing the chair side of the bed. Place the hammock or canvas strips under the patient to a form sling. With two canvas pieces, the lower edge (wide piece) fits under the patient's knees, and the upper edge (narrow piece) fits under the patient's shoulders. Lower the bed rail on the chair side of the bed and raise the bed rail on the opposite side. Roll the patient onto his or her opposite side, and pull the hammock (strips) through, keeping them smooth over the surface of the bed. Roll the patient into the supine position onto the canvas hammock. Bring the lift to the bedside or lower the ceiling lift and position it properly. Place the lift's horseshoe bar or wheelbase under your side of the bed (on the side with the chair). Lower the horizontal bar to the level of the sling by following the manufacturer's instructions. Lock the valve if required. Elevate the head of the bed. Attach the hooks on the strap (chain) to the holes in the sling. Short chains/straps hook into the top holes of the sling, middle chains/straps hook into middle holes and longer chains/straps (securing the legs) hook into the bottom holes of the sling. Cross the patient's arms over his or her chest. Explain what will happen to the patient and what they will feel. Ensure patient safety and comfort. Pump the hydraulic handle, using long, slow, even strokes, until the patient has been raised off the bed. If using a ceiling lift, turn on the control device to move the lift. Use the steering handle to pull the lift up from the bed and maneuver the patient into the chair. Roll the base of the lift around the chair. Slowly release the lift and lower the patient into the chair. If you are using a ceiling lift, use the control device to lower the patient into the chair. Lock the wheels on the lift and lower the patient to a sitting position. As soon as the patient is in the chair, remove the straps from the horizontal bar and remove the lift.