Since the introduction of the first powered ‘hoists’ in the 1950s, there has been no fundamental change in the practise of transferring people with disabilities. All current transfer devices lift the person from above in a sling. From a basic engineering position, this approach is fraught. Dynamic forces are created when a person is suspended in the sling, which are very hard to control. Further, all such devices move the person on wheels: rolling resistance particularly for floor-mounted hoists becomes a cause of significant resistance to overcome. These combined forces render the operation of these machines by a sole carer to be unsafe.
The levels of occupational injury associated with the movement of people with disabilities is totally unacceptable. In 2019/20, Australia’s healthcare and social assistance workers had the highest proportions of serious claims of 18% (compared to the second highest, construction industry, at 13%) Among the serious claims made by healthcare and social assistance workers, almost 85% is related to injury and musculoskeletal disorders.
Consequently, numerous authorities worldwide mandate that a minimum of two carers be tasked with the transfer of people with disabilities. However, providing two or more capable and trained carers at any time is often not practicable, and in many environments not possible. In Australia, workforce shortages in residential aged care present a significant challenge for the aged care industry. It can also be highly undesirable to require two carers to conduct transfers, such as in the family home. Teams of workers in homes can have the effect of making the home environment more like an institutional environment, in terms of interpersonal relationships and organisational factors.
This new, patent-pending, cantilevered transfer system addresses the problem from a sound engineering position. People are lifted from below, on an inflatable mattress connected to a stationary lifting machine, which lifts them without need for carer assistance and moves them into a wheelchair with minimal effort by one carer. Because the user is in contact with the lifting device through the transfer mattress below them, dynamic forces are eliminated. As the device operates from a fixed base, rolling resistance is obviated.
Further, the inflatable mattresses are easily customisable to suit individuals who lack postural control, such as people with CP, and can therefore negate difficulties during transfer. As a Class One medical device, the systems rapid adoption in the correct environments requires thorough research from a specialist team with diverse skill sets. This will ensure that its efficacy is fully understood, and recommendations for support mattress designs made, so that it’s application and specification to the widest populations can commence. Further, a road map for future research into specific areas and applications of the technology will have been established.
The machine is versatile and can be used for sit-to-stand transfers, lateral transfers and other patient handling tasks including boosting up a bed and turning and holding a patient on their side. Possible attachment options would also allow for transferring clients from the
floor in the event of a fall or other misadventure. The water proof transfer mat is being explored as a leave-in option for showering to further reduce handling. A range of safety and usability enhancements are already flagged for implementation including simplified strut deployment, counterbalancing systems, transfer supports and device control interfaces.
Transfer Systems recently received a grant from the Cerebral Palsy Alliance, and are working with a multidisciplinary team from the University of Sydney to study the MODEL ONE and prove it can safely transfer users and significantly reduce the effort required by caregivers. The study will commence early next year. The study will be conducted with a minimum of 3 experienced healthcare workers with extensive transfer experience and 5 – 10 people with disabilities, being a representative sample of populations requiring transfer i.e. varying BMI, bone mass, postural presentation, motor control and muscle tone.
The healthcare workers will be asked to transfer the people with disabilities with procedures they use in their routine work. We will assess several specific tasks including turning the person in the bed and transferring the user from a supine position in a bed to sitting in a wheelchair with existing floor mounted and ceiling mounted hoists. The healthcare workers will then be asked to perform these transfer tasks, using the same methods, with the new transfer system.
As well as collecting this direct data from the healthcare workers, we will also collect feedback from them as well as the people with disabilities about their perception of the comfort and safety during the tasks, using surveys such as nominal group techniques with Likert scales. This is of crucial importance for accurately deriving sound feedback for improving the transfer system design to achieve the optimum experience for both users and healthcare workers.
As well as those people involved in the central ergonomic study, questionnaires will be prepared to survey a wider audience. The inclusion of a health economist in the research team will ensure the requirements and cost structures of institutional care will be surveyed through a mix of direct contact and questionnaire using appropriate channels within Health NSW, workers compensation providers such as icare, the Aged Care Industry Association and Australian Rehabilitation Providers Associations. It is envisaged that video presentations of the operation of the system will provide the catalyst for this engagement. The surveys will also look at patterns of care and the impacts on families as well as institutions to provide two or more carers at any time of day. The input and opinions of nurses and carers, as users of hoists, will be sought by approaches through member associations such as the Aust. Nursing and Midwifery Federation and Carers Australia.
The research evidence will lead to widespread use of the system, which will lead to a marked reduction in the required physical effort for persons tasked with the movement of people with disabilities. Commensurate reductions in lost time injuries will be observed and cost savings for health systems and family units will accrue. People with disabilities and their families will benefit through greater independence, increased mobility, reduced cost of care and improvement in their home environment. Nurses and carers will see a marked reduction in the physical demands of their work, improved job satisfaction leading to a greater retention rate of skilled people within these professions and markedly reduced attendant occupational injury. Health systems will realise improved economies and reduced demand for care.
