Hoist and sling for safer patient use policy

1 Introduction

The use of hoists and slings has become an integral part of delivering health services within our organisation and brings with it legal responsibilities to the trust to ensure safe usage.

The policy guides the reader through key responsibilities and identifies what action must be taken to ensure safe use of hoists and slings.

2 Purpose

All employees using hoist and sling equipment need to be provided with knowledge, training and guidance to allow them to use this equipment safely. This policy is designed to ensure the safe use of hoists and to minimise the risk of injury to staff and their patients.

The hoist and sling for safer patient use policy supports the safer manual handling operations policy and the trust’s bariatric policy (care of the bariatric patient).

3 Scope

The purpose of this policy is to provide guidance to all staff on the legal and operational requirements for examination and maintenance of lifting equipment specified by the Lifting Operations and Lifting Equipment Regulations (LOLER) 1998 and to set out the arrangements put in place by the trust to comply with these regulations.

3.1 Definitions or explanation of terms used

Definitions
Term	Definition
Hoist	Lifting equipment, which is any work equipment for lifting and lowering loads, and includes any accessories used in doing so (such as attachments to support, fix or anchor the equipment)
LOLER	The Lifting Operations and Lifting Equipment Regulations 1998
Medical device	An instrument, apparatus, appliance, material or other article, whether used alone or in combination, together with any software necessary for its proper application, which is intended by the manufacturer to be used for the purposes of: diagnosis, prevention, monitoring, treatment or alleviation of disease diagnosis, monitoring, treatment, alleviation of, or compensation for, an injury or physical impairment investigation, replacement, or modification of the anatomy or of a physiological process control of conception

4 Scope

The contents of this policy apply to any trust employees (including temporary or agency staff) who in the course of their work may either have to use or be responsible for the safe storage and maintenance of patient lifting equipment. Hoist equipment is designated as high-risk medical devices equipment.

For the purpose of this policy lifting equipment is defined as any assessed equipment, attachments or accessories that are used to lift patients.

For further information about responsibilities, accountabilities and duties of all employees, please see section 5.

5 Responsibilities, accountabilities and duties

5.1 Chief executive

The chief executive is responsible for establishing and maintaining health and safety arrangements across the organisation.

5.2 Board of directors

The board of directors are responsible for having policies and procedures in place to support best practice, effective management, service delivery, management of associated risks to meet national and local legislation and, or requirements.

5.3 The trust

Therefore the trust must have systems in place for the on-going examination, and maintenance of all lifting equipment, and the training of staff in the safe use of this equipment.

Arrangements for the register of medical devices also need to be made for there to be a central register within the trust of all hoists as part of the central medical devices inventory.

5.4 Clinical service manager or modern matrons

Clinical service managers or modern matrons are responsible for:

the local medical devices inventory to be maintained for their clinical area by notifying any changes in this inventory to the medical device link person to update the database with service information
all lifting equipment within their specific area being maintained in a clean condition (in line with infection prevention and control practices) and all markings indicating the capacity of the equipment being clearly visible together with details on any temporary label attached to indicate the date of the last test, which will be not more than 6 calendar months prior to the date of use
lifting equipment being stored correctly to ensure health and safety is maintained
making available for examination by any relevant authority officer records of examination and test
taking out of service any equipment which has not been examined within the required six month period, black and yellow hazard tape should be wrapped around the hoist
arranging training and updates to keep their staff safe and competent in the use of the equipment
liaising with the Manual Handling team prior to purchasing any new lifting equipment
reporting any faults that occur to the contracts manager purchasing telephone at 07967 780475, records being available in the area of use and kept in a LOLER file

5.5 The staff member who is using the equipment or who has assessed the need for the equipment to be used

These staff will be responsible for:

ensuring they have undertaken trust provided training to enable them to use lifting equipment
being aware of the patient’s weight
using equipment which is appropriate to the weight of the patient and the task to be undertaken
undertaking a visual check of any slings which are to be used before use (see appendix A)
use person centred assessments that take into account the following
patient risk assessment
tissue viability
infection prevention and control
choking risk
task
individual capability of staff
patients functional independence measure (FIM score), body tone, head control, spasm pattern if any
environment
ensure the patient is care planned based on their need for hoist usage
maintaining privacy and dignity of the patient
Manual Handling team

5.6 The trust Manual Handling team

Advising managers on the purchase of lifting equipment to ensure compatibility with trust users, servicing and maintenance contracts and compatibility of equipment.
Providing training to all new staff within the trust at induction.
Coordinating the on-going training of staff in the use of safe manual handling techniques (including lifting equipment) through the trust key trainers.
Supervising and supporting the trust key trainers.
Providing feedback to service and senior management regarding when it has been identified in training that it is unsafe for certain staff to use the equipment.

5.7 Purchasing department

In conjunction with the Manual Handling team will update, monitor and review the competent person contract for LOLER and servicing as agreed in the specification of the contract.

6 Procedure or implementation

6.1 Quick guide

6.1.1 Purchasing and lifting equipment

Ensure equipment is in line with procedures and guidance from the medical devices management policy.
Request advice from the Manual Handling team prior to the purchasing of equipment to ensure it’s suitable for the task.
The hoist and sling should be compatible as identified in the manufacturers instructions.
All laundered slings must meet the requirements of decontamination.

6.1.2 Examination of hoists and slings

Ensure all hoists are examined by a competent person every six months as defined by LOLER 1998.
Before each use, the hoist and sling must be visually inspected by the user to ensure the safe working order.
Ensure the hoist has its sticker issued by the engineer following its service or LOLER inspection and clearly identifies its last and next inspection date.
Ensure a further visual check on a weekly basis, this should be recorded.
Ensure all slings are labelled appropriately in line with sling guidance in this policy.

6.1.3 Availability of tests or certificates

Ensure all test or examination certificates for each hoist and sling are kept within a LOLER file and are available to all users or inspectors and relevant authority officers.
Ensure all documentation is recorded on Safeguard Ulysses, the medical devices database.
In the event that the hoist and sling equipment has expired its service or LOLER inspection date it should be removed from use immediately and reported to the medical devices officer and the purchasing department.

6.1.4 Reporting defects

Ensure any faults or failures detected to the hoist or sling are reported to the senior person and are taken out of use immediately.
Ensure the defect is then reported to the purchasing contracts manager.
Ensure there is access to an additional hoist or sling until the repair or replacement is made.

6.1.5 Training

Ensure all operators using both hoist or sling have completed annual manual handling training which includes education and practical application of the safe use of hoist and slings.
Advice around hoist and slings can be sought through the local patient key trainer where available or by contacting the manual Handling team.

6.2 Purchasing lifting equipment

Purchasing equipment should be in line with procedures and guidance from the medical devices management policy.

Prior to the purchase of any lifting equipment, advise must be sought from the Manual Handling team in relation to the equipment’s suitability for the proposed task, and staff training requirements.

The sling and hoist must be compatible with each other, For example, a looped sling must be used with a hoist that has an attachment for loops. A sling with clips must be used with a hoist that has an attachment for clips.

Reusable slings must be able to withstand laundering at a temperature of 65C for ten minutes or 71C for three minutes for effective cleaning.

6.3 Examination of hoist (appendix C)

Hoists are required to be thoroughly examined every six months by a competent person (as defined in LOLER 1998 Approved Code of Practice and Guidance).
For the safety of the patient, prior to each use, the hoist should be examined visually beforehand. Failure to do so may result in patient injury.
In addition to this visual check, each week a further visual check is to be undertaken and recorded to detect any defects or weaknesses. If defects are identified, they should not be used. This is to be reported to the staff member in charge.
For the trust services, the competent person for thorough examination and test is provided by a contract agency, on a planned maintenance programme.
A central register for hoisting equipment is available through the designated purchasing manager.

6.4 Examination of slings (appendix A and B)

Labelling of reusable slings will be carried out by the sewing room prior to first use (appendix B)
All slings should be labelled with an in and out of date label not exceeding 5 years. For single patient use slings, the date the packet was opened should be recorded.
For the safety of the patient, any sling which is to be used with a hoist should be examined visually beforehand. Failure to do so may result in patient injury.
In addition to this visual check, each week a further visual check is to be undertaken and recorded (sling check document, see appendix A) to detect any visible defects or signs of weakness, such as: tears or fraying or loose threads in material, stitching, seams, straps, cracks or breaks in plastic back supports and clips. If defects are identified, they should not be used. This to be reported to the staff member in charge. Equipment records should be kept for 10 years.
All slings should also have marked on them clear and readable manufacturer’s instructions which include washing instructions and safe working load slings should be kept in individual patients lockers when in use.
Clean unused slings should be stored in the linen room.
If a sling becomes contaminated during use it must be sent to the hospital laundry once the patient is out of the infectious period or sooner if contaminated.
For patients with known long term infections or colonisation (for example, Methicillin-resistant Staphylococcus aureus (MRSA)) the slings must be cleaned when visibly contaminated and on a weekly basis).
Any slings which are brought in by patients or carers should only be used if they meet the requirements of this policy.
Appendices A, B and C (templates) to be stored in a centralised local folder within the environment of the equipment to ensure access to this is available to all staff using the equipment.

6.5 Availability of records or test certificates

The original test certificates that come with the equipment when new and the subsequent records of sling and hoist examination shall be made available for examination by any relevant authority officer and for staff to verify records.

Every service or LOLER examination record sheet should be kept within the LOLER file.
All documentation is saved on the “Safeguard or Ulysses” medical devices data base accessible by all departments in the trust.
Any overdue records in the trust are checked by the medical devices link person and medical devices officer and forwarded to the designated purchasing manager to contact the service and LOLER company to ensure complete recording in the trust.

6.6 Labels

Labels that the contract agencies apply following satisfactory examination and test must state:

the examination and maintenance carried out is in compliance with LOLER 1998
the date of service or LOLER as appropriate
the next examination date
the initials of the representative of the company carrying out the test

Certificates should in addition to the previous label requirements also include the date of the last LOLER date in compliance with schedule 9 of the LOLER regulations.

6.7 Reporting defects

All faults should be reported to the member of staff in charge. The equipment will be taken out of service ensuring it is clearly marked ‘do not use’. Where possible it should be stored away.

The defect should be reported to the contracts manager purchasing telephone on 07967 780475 an ad hoc requisition should be raised for this item.

Community staff finding defects with hoist and sling equipment in patient’s homes should report their findings to the local council’s equipment provider who have the responsibility for maintenance of this equipment.

Out of hours arrangements to request a number for hoist engineer is through switch board at Tickhill Road Hospital telephone 03000 213000.

6.8 Disposal of hoists

Disposal is as stated in the trust waste policy except for the following:

North Lincolnshire care group are to make special arrangements to return equipment to the Tickhill Road Site where it will be disposed of
Rotherham care group will dispose through the local estates provider for waste services

6.9 Disposal of slings

If slings are identified as having rips tears or holes in them a ward manager needs to cut the sling up and ensure disposal. Replacement should be sought.

6.10 Relocation of hoists

In the event of a hoist and, or slings being relocated, it becomes the receiving manager’s responsibility to update the changes in the medical device inventory.

6 Training implications

6.1 Manual Handling team training

How often should this be undertaken: Annually.
Length of training: 60 minutes.
Delivery method: Assessment.
Training delivered by whom: NBE, interagency passport module 5, or peer review.
Where are the records of attendance held: ESR.

6.2 Manual handling key trainers

How often should this be undertaken: Annually.
Length of training: 45 minutes.
Delivery method: Training and assessment.
Training delivered by whom: Interagency passport module 5 Manual Handling team.
Where are the records of attendance held: ESR.

6.3 Manual handling training, all inpatient, LD, older persons and clinical staff

How often should this be undertaken: Annually.
Length of training: 45 minutes.
Delivery method: Training.
Training delivered by whom: Manual handling key trainers.
Where are the records of attendance held: ESR or module 5 Interagency Passport.

7 Monitoring arrangements

7.1 Analysis of any incidents which involve the use of slings and hoists

How: Report, action and plan.
Who by: Manual Handling team.
Reported to: Health, safety and security forum, medical devices advisory group.
Frequency: As they occur and at the end of the financial year in the Annual report. Quarterly.

7.2 Monitoring of any staff sickness and absence due to an incident involving the use of a sling and a hoist

How: Report and action plan.
Who by: Manual Handling team and human resources department.
Reported to: Manual Handling team and human resources department.
Frequency: As they occur and at the end of the financial year in the annual report.

7.3 Staff compliance with training

How: Audit of training records.
Who by: Manual Handling team.
Reported to: Learning and development group, health, safety and security forum, medical devices advisory group.
Frequency: Quarterly.

7.4 Manual handling key trainer delivery

How: Audit of training records.
Who by: Manual Handling team.
Reported to: Health, safety and security forum, medical devices advisory group.
Frequency: Quarterly.

7.5 Hoist inspections and relevant paperwork

How: Audit of unannounced clinical visit.
Who by: Manual Handling team and clinical manager of that area.
Reported to: Health, safety and security forum, medical devices advisory group.
Frequency: Quarterly.

7.6 LOLER monitoring of appointed competent contractor

How: Emails to the appointed purchasing officer. Advice, regular meetings.
Who by: Advice by Manual Handling team re-equipment needs, meetings by back care advisor and interested parties.
Reported to: Medical devices advisory group.
Frequency: Annually.

8 Equality impact assessment screening

To download the equality impact assessment for this policy, please follow this link: Hoist and sling safer use policy EIA.

9.1 Privacy, dignity and respect

The NHS Constitution states that all patients should feel that their privacy and dignity are respected while they are in hospital. High Quality Care for All (2008), Lord Darzi’s review of the NHS, identifies the need to organise care around the individual, ‘not just clinically but in terms of dignity and respect’.

Consequently, the trust is required to articulate its intent to deliver care with privacy and dignity that treats all service users with respect. Therefore, all procedural documents will be considered, if relevant, to reflect the requirement to treat everyone with privacy, dignity, and respect, (when appropriate this should also include how same sex accommodation is provided).

9.1.1 How this will be met

All employees, contractors and partner organisations working on behalf of the trust must follow the requirements of this policy and other related policies, particularly those relating to Information Governance. All health employees must also meet their own professional codes of conduct in relation to confidentiality. The use of a Hoist and Sling should be used in a manner which has regard to the dignity, comfort and safety of the patient and promotes their health and well-being.

9.2 Mental Capacity Act

Central to any aspect of care delivered to adults and young people aged 16 years or over will be the consideration of the individual’s capacity to participate in the decision-making process. Consequently, no intervention should be carried out without either the individual’s informed consent, or the powers included in a legal framework, or by order of the court.

Therefore, the trust is required to make sure that all employees working with individuals who use our service are familiar with the provisions within the Mental Capacity Act (2005). For this reason, all procedural documents will be considered, if relevant to reflect the provisions of the Mental Capacity Act (2005) to ensure that the rights of individual are protected, and they are supported to make their own decisions where possible and that any decisions made on their behalf when they lack capacity are made in their best interests and least restrictive of their rights and freedoms.

9.2.1 How this will be met

All individuals involved in the implementation of this policy should do so in accordance with the guiding principles of the Mental Capacity Act (2005).

9 Links to any other associated documents

10 References

11 Appendices

12.4 Appendix D Safe use of hoists

Check service sticker or LOLER sticker is in place on hoist
Is the service sticker LOLER sticker current?
- yes, transfer patient
No, take out use with black and yellow tape.
Report fault to line manager.
Contact the purchasing manager on 07967 780475. Out of hours contact to request a number for hoist engineer call out 03000 213000.

Document control

Version: 6.1.
Unique reference number: 215.
Approved by: Clinical policies review and approval group.
Date approved: 29 January 2024.
Name of originator or author: Head of patient safety or manual handling trainer.
Name of responsible individual: Executive director of nursing and allied health professionals.
Date issued: 1 February 2024.
Review date: 28 February 2026.
Target audience: In-patient staff and community staff.

Page last reviewed: April 15, 2024
Next review due: April 15, 2025

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