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Difficulty: Very hardErgonomics and Safe Use of Equipment

A practical nurse (PN) and an assistive personnel (AP) are preparing to transfer a client from the bed to a specialized chair using a mobile full-body mechanical sling lift. The client is two days postoperative following a right total hip arthroplasty (posterior approach) and experiences occasional confusion. Which action during this procedure represents the correct application of equipment safety and ergonomic principles?

  1. Keeping the caster brakes of the mechanical lift unlocked while initially raising the client off the bedAnswer
  2. B
    Crossing the leg straps of the U-sling between the client's thighs prior to attaching them to the spreader bar
  3. C
    Securing the client's hands to the sling with a soft cloth band to prevent them from reaching for the lift mechanisms
  4. D
    Administering a scheduled intravenous push (IVP) analgesic to the client to ensure comfort prior to the transfer

Answer

Keeping the caster brakes of the mechanical lift unlocked while initially raising the client off the bed
When operating a mobile full-body mechanical sling lift (e.g., Hoyer lift), safety and ergonomic guidelines require that the caster brakes (wheels) on the lift itself remain unlocked during the actual lifting phase. This allows the lift base to move slightly and automatically center itself under the client's weight, keeping the center of gravity directly over the base. If the brakes are locked, the diagonal lifting force can pull the machine forward, creating a high risk of tipping. Note that the brakes on the bed and the receiving wheelchair must be locked, but the lift's casters must remain free to adjust.

Step-by-Step Solution

1
Analyze the principles of mobile mechanical lift operation and center of gravity.
Identify that a mobile lift must be able to shift slightly during the vertical lifting phase to maintain balance.
If the lift brakes are locked while lifting a heavy patient, the center of gravity shifts outside the base, creating a severe tipping hazard.
2
Evaluate the client's specific surgical history and positioning precautions.
Recognize that a posterior total hip arthroplasty requires maintaining hip abduction and avoiding hip flexion greater than 90 degrees or internal rotation.
Standard sling application often involves crossing the leg straps, but this causes adduction and risks dislocation in THA patients. Straps must remain uncrossed.
3
Assess the remaining actions against legal regulations and the PN scope of practice.
Determine that applying a cloth band is an unauthorized physical restraint, and administering IV push medications is out of scope for a PN.
Safety encompasses not just ergonomics, but also adherence to legal scope and restraint protocols.
4
Select the only safe and appropriate action.
Conclude that leaving the lift's casters unlocked is the correct ergonomic and equipment safety practice.
It ensures the equipment operates as designed to prevent mechanical instability.

Key Concept

Mechanical Lift Safety and Postoperative Ergonomics
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Topics

Ergonomics and Safe Use of Equipment

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