SimPull (see picture) is a novel device developed by The Patient Company to automatically move patients from one flat surface to another, commonly referred to as a lateral transfer. The purpose of this device is to remove the physical effort needed from clinical staff and thus reduce caregiver burden, injury, and the amount of people required to move patients safely.
When a lateral transfer is completed manually (clinical staff reaching and pulling the patient) it results in a higher risk of injury to clinical staff and can require a multitude of clinical staff members depending on patient weight and condition.
The Occupational Safety and Health Administration (OSHA) recommends a single person lifting limit of 35 pounds for safe patient handling (OSHA, n.d.).
A study completed by Knapik and Marras (2009) analyzing safe pushing and pulling limits in any industry stated that it is safe to push 20% of your body weight and pull 30% of your body weight. Unfortunately, no currently available technology has been widely accepted as efficient and cost effective so clinical staff continue to opt for manual methods.
Thus, U.S. healthcare workers remain in the top quartile of occupations with high incidence of workplace musculoskeletal injury, with nursing assistants ranking 2nd and registered nurses ranking 6th (Halim, Ripin & Ridzwan, 2022).
Many studies show that education & training in safe patient handling alone does not reduce injury warranting the need for continued research in effective product design (Wahlin, Stigmar & Strid (2021).
Corewell Ludington Hospital Med/Surg staff were trained on the use of the SimPull. Once a patient had been consented, two caregivers would use the device to complete the lateral transfer. One caregiver would passively guide the feet during the transfer and the other caregiver would operate the SimPull device. The lateral transfer was timed using a simple stopwatch. Following each lateral transfer, anonymous surveys were completed by the Corewell caregivers.
The primary objective was to utilize SimPull as an alternative to current lateral patient transfer methods, evaluating if SimPull is feasible as a primary means of lateral patient transfer. Corewell Health Ludington’s Med/Surg and CCU department is a 36-bed unit is where the pilot took place.
The intention was that over a 3-month period 200 patient transfers were to be completed: 100 with the SimPull device, 100 done manually. IRB approval was obtained before this study was started. Consent was obtained by a co-principal investigator and CITI trained staff from the patient prior to participation. A descriptive action research design was used.
Exceptions to Methods:
During the pilot, certain uncontrollable circumstances slowed the rate of lateral transfers on the Med/Surg care floor. These circumstances include but are not limited to, consenting of patients, research coordination (loss of surveys, CITI training, etc.), building construction, location of many transfers being done just off of the floor IE in the hallway between med/surg and ED.
So, at roughly 6 months into the study (roughly 3x the expected amount of time to complete the study) 17 of each type of transfer had been recorded and the decision was made to end the pilot.
The data shows that the last 15 of 17 transfers with SimPull were completed in under 3 minutes on average with two caregivers and were rated an average of good or better. However, in Radiology there was a specific need for support with a lateral transfer during a night shift when a patient who was difficult to move from stretcher to MRI table. With no safe way to move the patient the radiology staff sought the help of SimPull by way of night shift and early morning staff.
“Throughout our pilot with SimPull transfers made with SimPull garnered positive feedback from our clinicians and patients”
In conclusion, though there were few transfers during the extended research period, SimPull has been determined a feasible primary means of lateral patient transfer. When asked, the study coordinator, answered that 4-16 transfers were likely to have taken place daily during the study. The successful use with the population of patients that did suit the inclusion criteria in this environment along with getting requests for use elsewhere within the same facility warranted the decision to end the pilot. The data shows that the last 15 of 17 transfers with SimPull were completed in under 3 minutes on average with two caregivers and were rated an average of good or better. Manual transfers also rated good or better and under 3 minutes average in the last 15 of 17 transfers, though manual transfers ALSO had a perceived risk of maybe or higher in 6 of the recorded transfers, meaning over 35% of transfers the staff completing them knew themselves to be at risk and continued anyway, for the sake of the patient.
“When SimPull was used during our transfers, our clinicians identified no risk of injury for the clinicians or patients”
During the duration of the pilot SimPull was used on our Med/Surg floor to directly compare manual transfers to lateral patient transfers using SimPull. We were able to determine SimPull was an effective method of transfer. SimPull was able to decrease the perceived injury risk throughout a transfer for both the clinician and patient. During the pilot on the med/surg floor there was also perceived need for SimPull in other units of the hospital. While unable to conduct transfers, the Emergency Department, Radiology/Imaging, and the CCU were all showed interest and had support to use SimPull.
Patient details: All participating patients were alert and oriented and deemed their own person. Some were vented, required feeding tubes, chest tubes, wound vacuum treatment, or had lower extremity amputations.
One of the most interesting things we learned about the survey data was when comparing the believed risk of transfers. Clinicians believed there was not risk when transferring manually! This was something we did not expect, knowing the incredible risk of injury during manual transfers. This brought up a large part of safe patient handling, which is education.
Being the first research pilot at Corewell Ludington, we were able to work with The Patient Company very closely during the deployment of the research units in the system. Through the training process for SimPull to the supervisors CITI training this was a positive experience that led to the desired outcomes.
This technology was co-developed by The Patient Company's CEO (Andrew Heuerman) and other Spectrum Health staff at Spectrum Health in 2017. The need for SimPull originated from a patient transport manager who had identified a high volume and severity of injuries to his staff while performing lateral patient transfers. In 2019, The Patient Company licensed the co-developed intellectual property.
In 2022, Sparrow Health performed a very similar study with equally convincing, but entirely different results. This may be attributed to the environmental differences such as that one is a Long-Term Acute Care Floor, while the other is a Med/Surg care floor. The write up provided by Sparrow Health can be found here: NEED TO GENERATE A LINK OR SEND SEPARATELY
Following this study, The Patient Company was able to achieve the necessary regulatory approvals to proceed to bring SimPull to market commercially. If you are interested in learning more about SimPull and the dangers of lateral patient transfer, you can find more information at: www.ThePatientCompany.com
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