1. Carlson, Elizabeth A.

Article Content

Safe Patient Handling and Movement: A Guide for Nurses and Other Health Care Providers edited by Audrey L. Nelson. New York: Springer Publishing Co; 2006.


The book is an excellent reference for any nurse or caregiver who participates in patient handling and movement. (In my estimation, this would eliminate only 1% or so of the caregiving population!!)


The book is divided into four sections. The first three chapters (section I) discuss the scope of the problem, myths and facts about back injuries, and consequences of unsafe handling and movement practices. "Variations in High-Risk Patient Handling Tasks by Practice Settings" (chapter 4) presents patient handling risks as specific to different practice settings and not as a "one size fits all" approach. As Nelson states, "It is the combination of frequency and duration of these high-risk tasks that predispose a caregiver to [horizontal ellipsis] injuries, and make some clinical practice settings more dangerous than others" (p. 48). Eight different practice settings are presented along with the high-risk tasks commonly found in the specific setting. Figure 4.1 (p. 54) is an assessment tool that can be used by any staff to identify and prioritize high-risk tasks, making it possible to tailor the risk assessment for each unique setting.


Section II discusses Best Practices. "'Evidence-Based Guidelines for Patient Assessment, Care Planning, and Caregiving Practices in Safe Patient Handling and Movement' (chapter 5) presents (1) an evidenced-based protocol for patient assessment related to patient handling and (2) algorithms to standardize decisions about the type of equipment needed and the number of caregivers needed to perform the task safely" (p. 59). Several examples given enable the readers to adapt the assessment and algorithms to their practice-setting needs. Chapter 6 reviews patient handling technologies allowing initial comparisons between devices.


Matz discusses After-Action Reviews (AAR) in chapter 7 as a method to tap employee knowledge about a situation and use this knowledge to both improve workplace safety and empower staff to improve their own safety. Once again, a detailed discussion of how to use the AAR is given. Case scenarios are found at the end of the chapter for use in training staff in the AAR process.


Chapter 8 presents lift teams as a proven method to reduce back injuries. Detailed discussion of how lift teams function and can be initiated, as well as, information on case studies found in the literature is presented. This section concludes with one chapter on unit-based peer safety leaders and a second chapter on safe lifting policies.


Section III: Special Challenges in Patient Handling contains three chapters devoted to particular patient situations. In chapter 11, the unique needs of selected patient populations (bariatric, combative, cognitively impaired, patients in severe pain, with extensive wounds, with neurological conditions, and pediatric patients) are presented. Chapter 12 discusses designing space for safe patient handling. Many suggestions for gathering information before making space design decisions are offered, as well as examples of room layouts with rationale for the space allocation and design. Chapter 13 offers the use of ergonomic workplace assessment as a way to analyze job tasks and identify risk factors so that job changes can be made and injury risk reduced.


Section IV looks at future directions. The Appendix beginning on page 241 is a "Sample Safe Lifting Policy for Hospitals/Nursing Homes." All 14 chapters have comprehensive reference lists and citations allowing further investigation on particular points.


Overall, this is an excellent reference for anyone involved in patient handling and movement.