A biomechanical evaluation of potential ergonomic solutions for use by firefighter and EMS providers when lifting heavy patients in their homes.

Firefighters and EMS providers continue to be challenged when lifting heavy patients in their homes. This study investigated the biomechanical efficacy of four devices that could be used by two-person teams when lifting patients from the floor, from a reclining chair, or from a Simulated Inflatable Seat at chair height. Fourteen firefighter-paramedics, working in two-person teams, were instrumented with motion capture and electromyographic sensors. The Binder Lift™, the Simple Strap, and the Slip Preventer were used to lift patient actors, and were compared to current lifting methods. Postural data and the peak dynamic spine shear forces at the L5/S1 level were reduced when using the Simple Strap, the Binder Lift, and the Simulated Inflatable Seat. The Slip Preventer reduced spine flexion when the Binder Lift was not used. In summary, the tested devices can potentially reduce the biomechanical loads experienced by EMS providers as they lift and move patients.

Safe Practice Recommendations for the Use of Copy-Forward with Nursing Flow Sheets in Hospital Settings.

BACKGROUND: In early 2016 the Partnership for Health IT Patient Safety released safe practice recommendations for the use of copy-paste for electronic health record (EHR) documentation. These recommendations do not directly address nurses' use of copy-forward to document patient assessments in flow sheet software in hospital settings. Similar to clinicians' use of copy-paste and copy-forward with progress notes, concerns exist about patient safety issues from the use of potential inaccurate or outdated information to achieve increased efficiency of documentation. METHODS: A multiple-methods approach-which included a literature review, litigation search, stakeholder analysis, and consensus opinion from experts from multiple disciplines-was employed. RESULTS: Four recommendations correspond closely with copy-paste guidance for EHR documentation from the Partnership: (1) Provide a mechanism to make copied-forward content easily identifiable, (2) Ensure that the provenance of copied-forward content is readily available, (3) Ensure adequate staff training and education regarding the appropriate and safe use of copy-forward in flow sheet software, if available, and (4) Ensure that copy-forward practices are regularly monitored, measured, and assessed. A fifth additional recommendation is made to improve the efficiency of data entry mechanisms, which may reduce patient safety risk. Emerging promising areas for innovation are to optimize interface usability and flow sheet content, use templates, use digital photographs, and eliminate work-flow steps with better methods for authentication and data entry. CONCLUSIONS: A thoughtful and measured approach to safe use of copy-forward in flow sheets by nurses in hospital settings is expected to result in improvements in efficiency of documentation, work flow, and accuracy of information.