Transferring Patients to and from the Operating Table

Surgical staff may need considerable support and assistance to move patients onto or off of operating tables.

Hazards

• Pushing or pulling to position gurneys and wheelchairs prior to transferring patients can require exertion of significant force, especially when dealing with bariatric (obese) patients or poorly maintained wheels and casters.
• Assuming awkward postures such as bending, twisting or reaching when moving patients from gurneys to the operating table. Awkward postures, especially when combined with the exertion of force, increase the risk of injury to the back, shoulders, and lower and upper extremities.
• Using significant force when lifting bariatric patients from gurneys increases the risk of injury to the back and shoulders.

Recognized Controls and Work Practices

Safe Patient Handling Programs and policies that limit or prohibit manual lifting have been shown to be effective in reducing MSDs in hospital and nursing staff. Research has shown that the use of mechanical lifting equipment and a Safe Patient Handling Program can significantly reduce injuries to hospital staff.

Minimize manual lifting of patients in all cases and eliminate manual lifting when possible. Focusing solely on “proper body mechanics" during lifting is not sufficient to prevent MSDs.

• Use mechanical powered transfer devices such as lifts or hoists to move patients (especially bariatric or non-ambulatory) from gurneys and in the Post Anesthesia Care Unit (PACU).
• Use an air mattress for lateral patient transfers between the gurney and operating table.
• When appropriate, use multi-use devices such as chairs that can open up into beds. These allow patients to move from a sitting position to a prone position without transfer.
• Train staff in the use of adjustable height beds and use fixtures to support patient limbs, pannus, and staff in prolonged operations.
• Use additional employees to assist in moving and transferring patients if:
  • A mechanical powered device is not available.
  • Awkward postures must be used.
  • Push force exceeds about 50 pounds.

Additional Information

• Worker Safety in Hospitals: Caring for Our Caregivers – Safe Patient Handling. OSHA.
• Safe Patient Handling. OSHA Safety and Health Topics page.
• Safe Patient Handling: Preventing Musculoskeletal Disorders in Nursing Homes. OSHA Publication 3708, (February 2014).
• Improving Patient and Worker Safety: Opportunities for Synergy, Collaboration and Innovation. The Joint Commission.
• Guidelines for Nursing Homes: Ergonomics for the Prevention of Musculoskeletal Disorders. OSHA Publication 3182, (2003, Revised March 2009). Section III, Identifying Problems and Implementing Solutions for Resident Lifting and Repositioning, includes an assessment of resident handling tasks that can help to determine the safest methods for performing necessary tasks for individual patients without injuring workers. A list of sample equipment solutions for patient lifting and repositioning tasks is also included.
• Ergonomics. OSHA Safety and Health Topics Page.
• Inspection Guidance for Inpatient Healthcare Settings. (June 25, 2015). OSHA memorandum establishing guidance for inspections conducted in inpatient healthcare settings.
• Also see Hospital-wide Hazards - Work-related Musculoskeletal Disorders.