Safety in Bariatric Patient Transfers

Background: Bariatric patients are being seen more frequently in health care. Transferring these patients is a challenging and risky task. Objectives: To analyze safety and reduce risks for the musculoskeletal system of bariatric patients and health care workers during transfers from bed to wheelchair and back. Methods: Clinical intervention study of patient transfers using portable and ceiling lifts. The study was conducted in the largest freestanding rehabilitation center in North America. Forty transfers from bed to wheelchair and back involving eight bariatric patients (age: 46-62y, BMI: 42-48kg/m2) were observed systematically, and four were video-recorded to illustrate the analysis. Two proactive risk assessments were performed and compared using a scoring system to evaluate the risks during the processes of transfers using portable and ceiling lifts. Results: The bariatric patient transfer system using portable lifts was replaced by installing and using ceiling lifts. The safety of the processes involving the two systems was compared in relation to risk of injuries to staff and patients. Using of ceiling lifts as opposed to portable lifts resulted in 28% reduction of low detectability incidents, 26% reduction of moderate effect incidents, and decreased both high and moderate probability incidents (22% and 30% reduction, respectively). Finally, it resulted in approximately 25% reduction on the sum of risk scores for the failure modes and causes requiring action. Conclusions: The results suggest that using ceiling lifts is safer than using portable lifts for bariatric patient transfers. The remaining risks were alleviated by training the staff and elaborating standardized procedures to perform these transfers.