Assessing Ambulatory Care Settings for Safe Patient Handling Resources and Training

Objectives: Discuss how to complete a survey assessment to evaluate learning needs. Discuss an interdisciplinary approach to creating an education bundle.

In July 2021, a patient required transfer assistance from wheelchair to exam table. Lift equipment and lift team resources were not in place to support the patient and clinic needs. Ambulatory care staff involved in shared governance escalated this issue to organizational leadership. It was discovered that the lack of available lift equipment and resources was not unique to this clinic alone.

While a standardized safe patient handling (SPH) training program and access to resources were well established in the inpatient setting, lift team support and training plans did not extend to ambulatory care clinics. SPH hands-on training was inconsistently utilized in the ambulatory care setting and knowledge of processes, policies, and scope of practice varied by department. Current SPH training (initial and ongoing) did not include ambulatory care-specific roles, guidelines, equipment, or space consideration in the ambulatory care setting. A workgroup was assembled to identify equipment, training needs, and a plan for sustainable ambulatory care-focused education.

The project leads gathered data from each clinic by conducting a survey of current SPH practices, education, resources, available lift equipment, a physical assessment of clinic space, and patient population needs. The survey had a 69% response rate and included feedback from 80 cost centers and 32 clinic locations and revealed 60% of staff never received education or orientation to SPH resources. The survey also provided a list of existing lift equipment in each location and frequency of SPH needs.

The survey identified lack of staff training and allowed for assessment of equipment needs in individual clinics. The workgroup was expanded to include a subject matter expert (SPH program manager), clinical nurses, and medical assistants. Together, this interdisciplinary team developed an ambulatory care-focused SPH education bundle that included a didactic learning module, hands-on skills training, and the expansion of a lift champion training model to all clinic departments in lieu of lift team support. Simultaneously, the SPH program manager utilized survey data to guide equipment recommendations. Due to space constraints and patient needs, not all clinics required the use of additional equipment.

As a result of the workgroup’s collaboration, 20 clinic locations were assessed, and five clinics obtained new lift equipment based on their patient population needs. Over 1000 staff members completed the new didactic module, demonstrating 98% training compliance, and 600 clinical nurses and medical assistants completed hands-on SPH training. Prior to this intervention, ambulatory care service lines had 22 SPH champions. Following the intervention, the number of SPH champions increased by 522%, 137 champions representing 80 cost centers. To ensure regulatory compliance and sustainability, the didactic module and hands-on training will be completed annually and within 30 days of hire for new staff members.

Implication for practice: The use of a needs assessment survey can be a powerful way to not only assess learning needs, but resource needs to support safe practice in the ambulatory care setting.