GB2459768A

GB2459768A - Patient turning apparatus

Info

Publication number: GB2459768A
Application number: GB0907615A
Authority: GB
Inventors: Helen Margaret Gutteridge; Philip Gareth Llewellyn Gutteridge
Original assignee: Individual
Current assignee: Individual
Priority date: 2008-05-01
Filing date: 2009-05-01
Publication date: 2009-11-11
Anticipated expiration: 2029-05-01
Also published as: GB0907615D0; GB0807975D0; GB2459768B

Abstract

A patient-handling apparatus 1 for turning over a patient into or out of a prone position comprises a support, e.g. flexible sheet 2, for the patient to lie on. The support 2 has distal side, a proximal side 4 and a cushion 3 on at least the proximal side 4 of the support which, in use, acts as an upstanding barrier to restrict proximal movement of a patient such that when the distal side of the support is pulled proximally, over the cushion 3, the patient is tipped over [shown in Figs. 23-261. The cushion 3 may be flexible foam inserted into a pocket 2a, or attached by hook and loop material. The support 2 may be attached to a bed frame using hook and loop fasteners 18. There may be straps [see e.g. Fig. 14a,b] detachably secured to handles 10 to aid pulling the support. Cushions may be disposed on either side of the support sheet. Also disclosed is a method for turning a patient and an arrangement which includes the patient handling apparatus and a slide sheet [40, Figure 33] .

Description

IMPROVEMENTS RELATING TO PATIENT HANDLING

This invention relates to an apparatus and a method for handling a patient. In particular, the invention relates to turning a patient between a supine position (lying face-up) and a prone position (lying face-down). The invention also encompasses turning a patient from and to any position between the supine and prone positions i.e. a lateral position in which the patient is on his or her side to some extent.

A system for the safe and efficient movement of patients to, from and around a hospital or medical facility is vital to ensure that patients receive timely care without compromising their health or the health of staff. For example, a hospital study reviewing manual handling activities and their associated injuries and consequences cited that two-thirds of all staff injuries were associated directly with patient care and especially lifting, moving, turning and transferring patients. It is apparent that hospitals may not have the necessary equipment and/or protocols in place to ensure that, where possible, injury is prevented. Further, adequate staff training may not have been provided covering the use of patient-handling equipment and/or patient-handling protocols. In any case, as will be described below, such equipment or training may still not facilitate the safe handling of a patient.

The particular manoeuvre used to handle a patient will depend on where the patient is to be moved -e.g. onto a trolley, theatre table, bed, couch or similar lying surfaces or a chair or wheelchair -and how the patient's body must be positioned after the manoeuvre.

A typical patient will be in a supine position or sitting up in a bed prior to transportation. If the patient does not need to be turned over for transportation, i.e. it is satisfactory for the patient to remain in the supine position, there are a number of acceptable methods for manoeuvring the patient. For example, slip-sheets or slide sheets are commonly used to assist staff to perform the transfer. However, in some cases, the patient will be going to surgical theatre and the surgeon may require his patient to be in the prone or lateral position before the procedure can begin, If the patient is anaesthetised, or conscious and unwell, the patient will be unable to adopt the prone or lateral position on the operating table or similar without assistance.

A method currently in use in hospitals for manoeuvring a patient from the supine position into the prone position is illustrated in Figures 1 to 6. Generally, hospital staff, such as orderlies and nurses, will be required to support the patient in some way during the manoeuvre, i.e. by lifting and pushing or catching the patient. However, this method of moving the patient suffers a number of disadvantages, which will be discussed in detail below.

Figure 1 shows a patient in a substantially supine position on a bed ready to be transferred to an adjacent operating table on the left-hand side of the picture. Typically, one staff member (for example an anaesthetist, situated in the middle of the picture) will need to support the patient's head as the patient is turned. A second staff member, standing opposite the first (not shown), will guide the patient's legs and feet during the transfer. A further two staff members positioned on the left-hand side of the trolley bed are bent over with their hands and arms outstretched, ready to catch the patient when he or she is rolled towards them.

As shown in the sequence of Figures 1, 2 and 3, at least one staff member on the right-hand side of the pictures is required to stretch forward in an awkward unstable position, leaning over the patient's bed to grip the patient's body firmly. This staff member must then support the patient's weight before simultaneously lifting and pushing the patient up onto his or her side. This is particularly dangerous for the staff member concerned because the reaching and stretching he is required to do puts excessive loading on his back and causes him to stand in an awkward and unstable semi-crouched position.

Figures 4 and 5 illustrate how this staff member leans further across the bed to push the patient over on to his or her front onto the operating table or similar surface. In Figure 5, the staff members on the left-hand side of the picture are bent over the operating table or similar surface catching the patient as he or she rolls over. They must fully support the patient's weight to ensure a smooth and controlled movement and to prevent the patient from rolling too far. Additionally, from this position, they are frequently required to lift the patient again on their forearms to fine-tune the patient's position on the prone support eg Montreal mattress, Wilson frame, D-rings, pillows or similar, prior to surgery.

Figure 6 shows, at the head of the patient, a further staff member supporting the patient's head as he/she rolls over.

The National Audit Office has established that back injury (to patients and staff) represents a third of all injury reported in the National Health Service (NHS). It is known too that back injury is commonly caused by lifting or pushing objects when an individual: i) does not/cannot adopt a safe stance and posture; ii) uses his or her waist to bend, rather than using the knee and leg muscles; iii) needs to bend forward to perform the lift; iv) lifts an object that is not close to the body; v) has an awkward to grip on the object; and/or vi) must twist whilst lifting. It is apparent that all staff involved in manoeuvring a patient using the technique shown in the previously-described figures are at an increased risk of suffering a back injury due to poor posture, reaching and/or stretching and spinal loading. The staff member shown on the right of the figures may be at the most risk, given the potentially dangerous posture he must adopt to push and lift the patient to initiate the roll into the prone position.

The risk of injury is increased further if, for example, too few staff members undertake the task of moving the patient and/or if the patient is very overweight. A great number of patients are likely to be overweight or obese given that two-thirds of the population in England are classified as such. Moreover, it is estimated that obesity has risen by 400% in the UK in the last twenty-five years, so it is important that a solution is provided to combat this risk.

Undertaking the above-described manoeuvre, even where it concerns an average-sized person, frequently requires the assistance of six or more staff members at one time, which disrupts the routine of a number of people in the hospital. This also adversely affects hospital costs as a surplus of staff may be required to help handle patients.

A further disadvantage of the above-described method is that the patient's body may be supported inadequately at times during the manoeuvre. It is apparent that having hands placed at various points along the patient's body does not provide uniform support. This can result in an increased risk that the patient wiJi adopt a posture which strains their back and/or the neck or otherwise causes injury. Furthermore, such a method relies on human control; having several people involved in the manoeuvre increases the risk that someone will make a mistake.

It is difficult too for the staff members to control accurately the position of the patient as he or she rolls over on the operating table or other lying surface. It is common that the patient will need to be centralised and positioned correctly before surgery can begin. The patient typically has medical apparatus such as a drip connected to his or her body and there is a risk that this apparatus could be disturbed or damaged during the transfer.

Due to the nature of the manoeuvre, standard procedures for transferring patients between adjacent lying surfaces -e.g. across a lateral transfer board -are not possible and this typically leaves a gap between the two surfaces that is an inherent danger to the patient being rolled over. It is possible that the patient's arms could become trapped and/or injured, for example, between two adjacent lying surfaces. This is clearly undesirable as it involves a risk of injury. Finding articles such as pillows etc to pad' the gap is not always possible, nor particularly satisfactory.

The invention arises from the Applicant's efforts to provide an apparatus and a method for patient-handling which overcomes at least some of the disadvantages of the prior art.

In a first aspect, the present invention resides in a patient-handling apparatus for turning a patient into or out of a lateral and/or prone position, the apparatus comprising: a support adapted for the patient to lie on, the support having distal and proximal sides; and a cushion on the proximal side of the support; wherein when the distal side of the support is pulled proximally over the barrier, the support tips the patient over the cushion to turn the patient.

The cushion can serve as an upstanding barrier to restrict proximal movement of the patient. Desirably, therefore, the cushion can act as a fulcrum co-operating with the support whereby the support can lift the patient efficiently and stably when the distal side of the support is pulled by an operator situated on the proximal side of the apparatus.

The person pulling the support can move the patient with far less effort, and with a safer posture, than was previously required in the method disclosed in the prior art.

It is also possible for the cushion to serve as a bridge or filler for filling a gap between the supporting surfaces between which the patient moves. In this case, for example, the cushion can be positioned over the edge of the patient's mattress. When using the apparatus of the invention in this mode, the patient's arm is rolled onto the cushion and is supported and protected by the cushion, rather than potentially slipping into a gap between the supporting surfaces and possibly suffering injury as a result.

Usefully, the invention requires relatively few staff members to manoeuvre the patient.

This is partly because it is not necessary for anyone to lift and push the patient laterally towards a receiving operating table or similar lying surface. As a further advantage, no staff member needs to adopt the awkward and dangerous body position of the staff member on the right in the prior art figures (Figures 1 to 6). For the few staff members that are involved in the patient's transfer, the body positions adopted are safer and more

comfortable.

The invention enables either a single staff member (for light patients only) or in other cases two staff members to pull the patient's weight efficiently. In minimum staffing requirements, only three staff members are required to handle the patient safely; a first supporting the patient's head, and two ideally to pull the distal side of the support to lift and turn the patient. Other staff members, if available, could support the patient's feet.

Extra staff, e.g. three staff members could be required to pull the distal side of the support when dealing with bariatric patients. The risk that these staff members will suffer injury in the previously described manner is reduced considerably. When the staff member(s) pull the distal side of the support or are otherwise to be present on the proximal side of the apparatus, this helps to control the patient's movement as the roll-over action is completed.

Optionally, handles on the distal side of the support may be used for the purpose of pulling, or handle attachments on the distal side of the support may enable straps to be attached for the purpose of pulling.

In a broad sense, the invention is not limited to a single cushion. For example, in some embodiments, the support may have cushions on both the distal and proximal sides to restrict movement. Here, which side is distal or proximal will depend on the direction of pulling.

It is preferred that the cushion is made of a flexible and preferably resilient material, such as foam or padding. Desirably, such a material cushions the patient's side as he or she is turned by the support thereby reducing the risk of the patient suffering an injury during the manoeuvre. A further advantage of the padded cushion is that any medical apparatus connected to the patient will be better protected from damage when the patient is turned.

It is preferred that the cushion extends as an upstanding barrier substantially along the proximal side of the support to substantially prevent the patient's shoulders and hips moving in a proximal direction so that the patient is tipped effectively by movement of the support. By restricting the patient's proximal movement, the cushion also prevents the patient's arm adjacent the cushion from hanging loosely from the body and possibly falling off the edge of the bed or trolley during movement.

Suitably, the cushion is substantially cuboidal and it preferably has a length in the range of 75cm to 95cm, although a cushion of a greater length (for example up to approximately two metres or more) is envisaged for larger and taller patients. It is helpful too that the cushion has sufficient width to bridge a gap between the patient's lying surface and receiving surface in use. Therefore, the width of the cushion is preferably no less than 15cm.

It is desirable for the cushion to have protection to prevent premature wear. Therefore, the cushion may comprise a cover enclosing a flexible material therein.

Usefully, the cushion may be releasably attached to the support. This optional feature allows staff to select cushions of different resilience and size and provides that the apparatus is easier to store and to clean as the cushion and support can be separated. It is also possible to position two or more cushions side by side or in a stacked arrangement to cater for larger patients or for wider or deeper gaps between adjacent supporting surfaces. However, the cushion could also be integral with the support.

The apparatus may comprise a pocket housing the cushion, the pocket being attached to or integral with the support. In this way the cushion can be secured to the support temporarily and is then substantially prevented from moving in relation to the support.

Preferably, the pocket extends along the proximal side of the support and the dimensions of the pocket correspond approximately with the dimensions of the cushion.

In some cases it is desirable that, in use of the apparatus, the cushion does not move or slip off an edge of the patient's bed. To this end, the patient-handling apparatus of the invention may further comprise at least one releasable fastener for securing the apparatus to a patient's bed frame. The fasteners are suitably positioned adjacent the cushion. The fasteners niay each comprise two parts, with each part being adapted to attach to the other. For example, the fasteners may comprise hook-and-loop material such as those found in Velcro �. They may also include buckles or other fastenings.

The number and position of the fasteners may vary. Where there is a plurality of fasteners, the fasteners are preferably spaced along the proximal side of the support and extend therefrom. This allows the apparatus to be used with various bed frame structures. However, fasteners are not essential to the invention in its broadest sense and so there may be no such fasteners at all in some embodiments of the invention.

Advantageously, the patient-handling apparatus of the invention comprises one or more handles or loops adapted to be pulled to effect the movement of the support. Handles or loops may be positioned on the distal side of the support opposed to the cushion.

Preferably, a plurality of handles or loops are positioned at or inboard of the distal side of the support. The handles or loops may, for example, extend in a line parallel to the distal side. The handles or loops may be present on top and/or bottom faces of the support.

This provides flexibility regarding the position at which the support is pulled.

More than one cushion may be used. Handles can be positioned on both sides of the support, being present on the top and/or bottom faces.

The patient-handling apparatus of the invention may further comprise one or more tensile members such as straps or other elongate members for pulling the support. The one or more tensile members enable a staff member using the apparatus to adopt a safer body position; he or she is not required to lean over one or two beds or trolleys to grip the support directly but can instead use an elongate tensile member to span this distance.

The tensile members extend from the distal side of the support and may be integrated therewith. However, it is preferred that the tensile members are adapted to attach to the aforementioned handles or loops.

In a preferred embodiment, the tensile members are straps. Optionally, but not essentially, the straps may comprise one or more gripping formations such as loop handles to enable to the strap to be held securely. Advantageously, a plurality of the gripping formations are spaced along the strap to enable the user to select the point along the strap that is to be gripped and to change the grip to shorten the taut length of the strap as the patient tips proximally during use. One or more of the gripping formations may comprise a fastener for releasably attaching the straps to the handles.

In an alternative approach, there may be no gripping formations such as loop handles. In that case, users simply adjust their grip to shorten the taut length of the strap and maintain a safe and stable posture.

The support of the patient-handling apparatus is preferably of a flexible sheet material, suitably able to wrap around the patient's body when the distal side of the support is pulled in the proximal direction.

The invention further resides in a patient-handling arrangement comprising a patient-handling apparatus, with any combination of the features of the invention mentioned above, and a slide sheet, wherein the slide sheet is positioned beneath the support to allow the patient to be re-positioned in use after, or before, being tipped over.

In a second aspect, the invention resides in a method for turning a person between supine and prone positions, including to or from a lateral position, the method comprising: supporting the person upon a support having a distal side; and pulling the distal side of the support in a proximal direction, the proximal movement of the distal side of the support tipping the person over about their proximal side into, or from, a supine, lateral or prone position.

Preferably, a proximal side of the person's body is restrained against proximal movement while pulling the distal side of the support in a proximal direction.

The method may further comprise securing the support to a bed by means of one or more fasteners extending from a proximal side of the support. However, this is not always necessary and/or possible and so is not crucial to the invention in its broadest sense.

The method may further comprise pulling the support by means of one or more handles extending from the distal side of the support.

The method may further comprise pulling the support by means of one or more tensile members extending from the distal side of the support.

The method may further comprise re-positioning the patient directly on the prone support by means of one or more slip-sheets arranged directly beneath the patient and removed once the final positional adjustment has taken place.

In order that the invention may be more readily understood, reference will now be made, by way of example, to the accompanying drawings in which: Figures 1 to 6, already discussed, are a sequence of pictures that illustrate a method of handling a patient according to the prior art; Figure 7 is a picture of patient-handling apparatus according to a first embodiment of the invention, showing its underside; Figure 8 is a picture of the top side of the patient-handling apparatus of Figure 7; Figure 9 is a perspective view of a pad of the patient-handling apparatus, the pad defining a cushion that serves as a barrier and/or as a cushioned bridge or filler; Figure 10 is a picture of the pad of Figure 9; Figure 11 is a picture of the barrier of Figure 10, partially inserted into a pocket in the support of the patient-handling apparatus of Figures 7 and 8; Figure 12 is an enlarged detail view of the patient-handling apparatus of Figure 7; Figure 13 is a plan view showing another patient-handling apparatus in a second embodiment of the invention; Figure 14 (a) and 14 (b) are perspective views of straps for use with various patient-handling apparatus in accordance with the invention; Figures 15 (a), (b), (c) and (d) are pictures of a strap variant akin to that shown in Figure 14 (b); Figure 16 is a schematic plan view showing a support mat usable with various embodiments of the invention; Figure 17 is a picture of a variant of the support mat of Figure 16; Figures 18 (a) and 18 (b) are pictures of a slide sheet usable with various embodiments of the invention, the slide sheet being shown in enlarged detail perspective view in Figure 18 (b); Figures 19 to 26 are a sequence of pictures that illustrate a patient being moved from a supine position into a prone position using a patient-handling apparatus of the invention; Figures 27 to 32 are a sequence of pictures that illustrate a patient being moved back into a supine position using a patient-handling apparatus of the invention; and Figure 33 shows elements of the invention in exploded form in conjunction with a Montreal mattress that does not form part of the invention but is apt to be used with it.

Where dimensions and materials are given in the following specific description, they are given only for the purpose of illustration and are not intended to limit the invention in its broadest sense.

Reference has already been made to Figures 1 to 6 of the drawings to illustrate the prior art. Turning now therefore to Figure 7, this shows a patient-handling apparatus 1 according to an embodiment of the invention, viewed from the underside. Here, a substantially rectangular support 2, being a comfortable sheet of padded non-woven material, is laid out flat. The support 2 has a first side 4 opposed to a second side 6, the latter being shown in the foreground as the reader views the Figure. The support 2 also has two opposed third and fourth sides 8 and 9 respectively.

The support 2 used in the apparatus of the invention can be made from any flexible material, whether organic, non-organic, natural or man made.

As best shown in the top-side view of Figure 8, the support 2 has an oblong pocket 2a positioned adjacent to and extending substantially along the first side 4 of the support 2.

The pocket 2a is filled with one or more cuboidal pads (not shown in this Figure) creating a bank or barrier 3 upstanding from the first side of the rectangular support 2, which is substantially flat. The barrier 3 assumes the shape of the pad and hence is generally cuboidal with generally rectangular faces.

Whilst the cushion defined by the pads is referred to in this description as an upstanding barrier 3 and is shown in the drawings as such, it is reiterated that the cushion can alternatively serve as a bridge or filler for filling a gap between the supporting surfaces between which the patient is to be moved. For example, the cushion can be positioned over the edge of the patient's mattress to support and protect the patient's side and arm during the turning procedure, preventing slippage into any gap between the adjacent supporting surfaces.

Two flaps of material 2b are situated one each side of the pocket 2a and each extends from a respective side 8 of the support 2. Each flap 2b is joined to a fastening 18 that extends orthogonally from the flap 2b.

A series of handles 10 is defined by a strip 5 of webbing material attached to the support 2 at intervals along the length of the strip. The strip 5 is situated adjacent to and parallel to the second side 6 of the support 2, extending along most of the length of the second side 6. The handles 10 enable a user of the apparatus 1 to grip the second end 6 of the support 2 so that the support 2 can be pulled toward and over the barrier 3. The handles may be gripped directly and used in this way if the support 2 is wide enough to extend well beyond the width of the patient's body, hence to be wrapped partially around the patient so that the staff members on the receiving side need not perform any reaching or stretching to grip the handles 10. However the provision of extended straps is preferred in terms of moving and handling, as will be described below.

When a patient is lying down on the support 2 of apparatus 1, his torso nearly spans the support 2 and his arm abuts the barrier 3. The length from the third side 8 to the fourth side 9 of the support 2 is sufficient to extend at least from the patient's shoulders to his hips when he is positioned correctly on the support 2 of apparatus 1, as will be seen in the pictures of Figures 19 to 26 illustrating the patient-handling apparatus in use.

Turning to Figure 9, this diagram shows the approximate dimensions of a pad 12 used in the patient-handling apparatus I of Figures 7 and 8. The pad 12 is generally cuboidal in shape and in this example has a length of 80cm, a width of 15cm and a depth of 7cm.

The pad 12 comprises a foam block or may take the form of other suitable stuffing material, e.g. feathers, hair or hay, enclosed by a cover 14. The cover 14 protects the pad 12 from damage during use. Figure 10 shows a picture of the pad 12 shown in Figure 9, but not to scale in terms of its proportion.

Figure 11 corresponds to Figure 8 but shows the pad 12 of Figure 10 partially inserted into the pocket 2a of the support 2. The pocket 2a of the support 2 is accessible by an aperture 16 positioned at one end thereof or optionally at both ends as shown. The pad 12 is inserted into the pocket 2a by feeding one end of the pad 12 through the aperture 16 and pushing it deeper into the pocket 2a. Once the pad 12 is fully inserted into the pocket 2a, the pad 12 is secured in position by closing the aperture(s) 16. A drawstring (not shown here, but visible in Figure 21) running around the edge of the aperture 16 is pulled to close the aperture and hence retain the pad 12 within the pocket 2a. Of course, other means of closing the aperture 16 are possible, e.g. elastic, Velcro� tabs or a zip fastener.

Figure 12 shows an enlarged detail view of the flap 2b and fastening 18 of Figure 1. The fastening 18 is a hook-and-loop arrangement, e.g. Velcro�, shown in an open position (unfastened) and which a strip 19 (e.g. hooks) of the Velcro� has been separated from its counter-strip (e.g. loops) 21, ready for use. The two strips 19 and 21 can then be wrapped round the framework of a bed on which the apparatus 1 is laid and mated together to secure the apparatus I to the bed.

A further embodiment of the patient-handling apparatus 1 is shown in Figure 13. Like numerals are used for like parts. Here, a rectangular transfer support 2 has two sides 8 and 9, a first side 4 and a second side 6. A cuboidal barrier 12 lies on the support 2 and extends almost the length of the first side 4, parallel to and slightly inboard of the first side 4. The length of the barrier 12 therefore almost spans the distance between the sides 8 of the support 2.

Three equally-spaced trolley fastenings 18 are releasably attached to the first side 4 of the support 2. Each fastening 18 has a hard hook 20 and a relatively soft loop of material 22 joined thereto, the fastening 18 extending from the first side 4 of the support 2 in a direction orthogonal to the first side 4. In use, the hook 20 is fixed or pivotable about its point of attachment 24 with the support 2 to enable the soft loop 22 to reach to and be secured around a bed frame.

As in the first embodiment, a series of webbing handles 10 or similar is aligned with and positioned slightly inboard of the second end 6 of the support 2 to be pulled on in use, or with the addition of attached straps, to move a patient by moving the support 2 of the apparatus 1.

In a variant of the above embodiment, the frame supports are omitted as such attachments are not always necessary or suitable.

Figures 14 (a) and 14 (b) show two different types of conventional strap 24, 25 which can be attached to the handles 10 in Figure 13. Each strap 24, 25 comprises a length 26 of webbing or similar material and a loop 28 at one end adapted to be opened via a squeeze-clip 30 or other fastening so that the strap 24 can releasably secured to a handle 10 of the patient-handling apparatus 1. As shown in Figure 14 (b), the strap 25 may have one or more additional loops 32, without fastenings; during use of the apparatus 1 the loop 32 enables the user to grip the strap 25 more effectively.

Figures 15 (a) to 15 (d) show pictures of embodiments of straps 25 akin to those of Figure 14 (b). However these embodiments differ from those of Figure 14 (b) because they show additional loops 32 spaced along the length of the straps 24. The user can thereby adjust the length of the strap 24 used to pull on the handle 10 by selecting an appropriate loop 32 to grip.

Straps can be padded to improve patient comfort and to prevent skin damage.

Figure 16 shows a firm plastic support mat 34 having a length of 105cm and a width of 50cm in this example. The mat 34 is generally rectangular with rounded corners, being defined by two opposed long sides 35 and two opposed ends 37. Typically, the mat 34 is positioned under a suitable proning support e.g. a Montreal mattress, Wilson frame, 0-rings, pillows or similar which is situated on the receiving surface, typically an operating table or appropriate lying surface, adjacent to a patient's bed. So, as a patient is transferred to the receiving surface from a supine position on the bed, he or she is rolled into the prone position on top of the proning support, with the mat 34 lying beneath and helping to prevent any unwanted slippage of the proning support, as well as helping to attach slide sheets.

The mat 34 comprises three pairs of opposed loops 36 spaced equally along the length of the mat 34. Each loop 36 is joined to a long side 35 of the mat 34 in alignment with its paired loop 36. A pair of trapezoid apertures 38 is spaced apart near each end of the mat 34. The loops 36 provide attachment points for strap handles that enable the mat 34 to be repositioned or pulled to effect movement of the patient.

Figure 17 is a picture of a support mat 39 being a variant of the arrangement shown in Figure 16. Like numerals are used for like parts. In this variant, two pairs of opposed loops 36 are spaced along the length of the mat 39. Further loops 41 replace the apertures 38 of Figure 16.

A slide sheet 40 is shown folded in Figures 18 (a) and in the enlarged view of Figure 18 (b). The sheet 40 has two straps 42 extending from opposite sides of the sheet 40 respectively, but shown here on top of one another as the sheet is folded. In use, a number of folded sliding sheets 40 can be placed over the proning support used and attached to mat 34 by the two straps 42 looping through apertures 38. The slide sheets are used to re-position a patient lying thereon once in a prone position. Using two narrow slide sheets 40 rather than one larger one solves the common problem of slide sheets becoming stuck beneath the patient's abdomen, especially in a hole characteristic of a proning support such as a Montreal mattress.

Moving on now to Figures 19 to 26, this sequence of pictures shows how a patient may be moved from the supine position into the prone position using the patient-handling apparatus of the invention.

In Figure 19 the patient support 2 of the patient-handling apparatus 1 is laid out across a patient's bed. A member of staff inserts one or more foam pads 12 (see Figure 10) into the pocket 2a of the patient support 2 (see Figure 11).

Figure 20 shows the staff member fixing the straps 18 to a frame of the patient's bed, thereby securing the pad 12 and support 2 in position relative to the bed (see Figures 12 and 13).

In Figure 21, the staff member then turns to a operating table or similar situated on the left of the picture and positions a mat 34 (see Figures 16 and 17) beneath a prone support (e.g. a Montreal mattress) ready to receive the patient. Whilst not shown in Figure 21, slide sheets 40 may be placed over the prone support and attached to mat 34 by the loops 42 through apertures 38. Slide sheets 40 are shown over a prone support in the form of a Montreal mattress in Figure 33, to be discussed later.

The patient is shown lying on the patient-handling apparatus 1 in Figure 22 in a supine position and the staff member is shown tucking the patient's arm next to the pad 12.

In Figure 23, the operating table or similar is shown aligned with the patient's bed and two staff members have positioned themselves on the far left of the picture. Two straps 26 (see Figures 14 and 15) having a plurality of loops 32 are attached to the handles 10 (see Figure 13) of the support 2 and are held taut by two staff members so that the support wraps up around the left side of the patient, shown to the right in these Figures.

Figure 24 shows a further member of staff supporting the patient's neck and head ready for the manoeuvre to begin.

In Figure 25, staff members to the left of the picture adopt a safe and stable posture and pull the straps 26 simultaneously, using the loops 32 to change the position of their grip on the straps 26 as they do so. This pulls the second side 6 of the support 2 towards them and the patient is tightly hugged by the pad 12 and the support 2. As the patient's proximal movement is restricted by the pad 12 when the second side 6 is pulled further toward the staff members, the pad 12 acts as a fulcrum co-operating with the support 2 enabling the patient to be turned efficiently and stably.

In Figure 26, the staff members have pulled the support 2 further towards themselves and the patient has fully rolled over into the prone position on the receiving surface (e.g. operating table or similar) ready to be operated upon.

Where sde sheets 40 are provided on top of the prone support and attached to the mat 34, these can be released by removing the loops 42 from the apertures 38 enabling further accurate repositioning of the patient prior to surgery. Thereafter, the slide sheets 40 may be removed from under the patient.

Figures 27 to 32 are a sequence of pictures showing how a patient may be moved, or moved back, from the prone position into the supine position using the patient-handling apparatus of the invention.

Figures 27 and 28 show two members of staff preparing the patient's bed ready for his or her return. Two folded slip sheets 40 (see Figure 18) are placed adjacent one another across the patient's bed. The patient-handling apparatus 1 is positioned over the sheets and secured to the frame of the bed (as described in Figure 20). As Figure 27 suggests, the apparatus 1 may be secured to the frame of the bed before the sheets 40 are placed on the bed; for this purpose, the apparatus 1 can be lifted and tilted about the point of attachment to the bed to give access to the mattress of the bed.

Figure 29 shows members of staff attaching straps 26 (see Figures 14 and 15) to the handles 36 on a mat 34 positioned beneath the patient on the operating table or similar (see previous Figure 21).

In Figure 30 the operating table or similar and the patient's bed are correctly aligned abutting each other and the patient's right arm is positioned comfortably against the barrier 3 defined by the pad 12 in the pocket 2a. One member of staff stands at the head of the bed ready to support the patient's head while two members of staff position themselves to the right of the patient's bed holding the straps 26 taut across the patient's body.

Figure 31 shows the staff members on the right pulling the straps 26 causing the mat 34 to lever the patient on to his or her right side. The pad 12 supports the patient from his or her shoulder to hip, keeping the patient stable as he or she turns. As the staff members continue to pull the straps, the patient rolls on to his or her back.

Figure 32 shows the patient back in a supine position on his or her bed. The patient can be centralised and repositioned on the bed using the slide sheets 40 positioned under the support 2. Once no longer required, the sheets 40 are removed first followed by the support 2 when no longer required.

It is also possible for the patient to be tipped back onto the support 2 without the use of the mat and straps as the mat 34 may not be applicable or suitable for some applications.

Figure 33 shows elements of the invention in exploded form. Those elements are shown in conjunction with a Montreal mattress 44 that does not form part of the invention but is apt to be used with it. It is envisaged that the elements of the invention may, optionally, be supplied as a pack containing two slide sheets 40 to lie on top of the Montreal mattress 44, a mat 34 to be disposed under the Montreal mattress 44, a support 2 having a removable pad 12, and straps 26 for optional attachment to the support 2 (as shown) or to the mat 34. However it is emphasised that the contents of the pack are shown in Figure 33 and described here by way of example only; some elements may be omitted from a pack and the numbers of certain elements may be varied in a pack.

Several variations are possible within the inventive concept. For example, variants of the support may have the cushion and handle arrangements mirrored along both sides of the support, hence having double cushions and double handles, each cushion and handle extending along opposed sides of the support. It is also possible for pockets to be provided on each side of the support, with each pocket being capable of receiving one or more pad selectively to define a cushion and to determine the width and/or thickness of that cushion. Thus a single pad may be moved between the pockets to create a barrier on the side of the support that will become the proximal side in use, depending on the direction in which the patient is to be pulled to be turned over.

The support 2 shown in Figure 33 has minor differences over the support 2 shown in the preceding Figures. Here, optional Velcro� hook-and-loop attachments 46 are situated on the first side 4 of the support 2 and each extends orthogonally from the first side 4 of the support 2. Where a support 2 has doub'e barriers and handles top and/or bottom (not shown), optional Velcro� hook-and-loop attachments would extend orthogonally from the sides 4 and 6 of the support 2.

In summary, the invention provides a unique system for turning patients to and from supine to lateral or to and from from supine to prone more safely in hospital environments such as operating theatres and the like. The task of proning, in particular, has been identified by health authorities as a hazardous manoeuvre. Current practice is untenable as it requires the involvement of a large number of staff to reduce the risk. Yet, some of those staff need to adopt static positions that are, potentially, very dangerous.

The invention provides a unique handling system that enables staff to prone patients quickly and efficiently, with a much lower risk of injury and with significantly reduced staffing levels. This cost-effective solution means that staff are at lower risk and that fewer staff are needed to manage the task safely. In some cases, only two theatre staff plus an anaesthetist will suffice. Staff can be trained easily and can readily train other staff in turn.

The system of the invention addresses issues of cross-infection as some parts are disposable and other parts are sealed to prevent ingress of moisture, dirt or other contaminants. For example, the straps and pads or cushions are preferably sealed and non-aberrant.

By virtue of the invention, the patient is at less risk of injury as handling is more controlled and comfortable. The patient can be positioned readily in the correct position on a Montreal mattress, Wilson frame or the like. Transfer and repositioning to the recovery surface is managed with much greater ease. As no other handling equipment or operations are needed, both time and money are saved.

Claims

CLAIMS1. A patient-handling apparatus for turning a patient, the apparatus comprising: a support adapted for the patient to lie on, the support having distal and proximal sides; and a cushion on at least the proximal side of the support; wherein when the distal side of the support is pulled proximally over the cushion, the support tips the patient over the cushion to turn the patient.
2. A patient-handling apparatus according to Claim 1, wherein the cushion is an upstanding barrier for restricting proximal movement of the patient.
3. A patient-handling apparatus according to Claim 1 or Claim 2, wherein the cushion is a bridge or filler member for filling a gap between supporting surfaces from which, and to which, the patient is transferred as the patient is turned over.
4. A patient-handling apparatus according to any preceding Claim, wherein the cushion is flexible.
5. A patient-handling apparatus according to any preceding Claim, wherein the cushion is resilient.
6. A patient-handling apparatus according to any preceding Claim, wherein the cushion comprises at least one pad.
7. A patient-handling apparatus according to any preceding claim, wherein the cushion is made of foam.
8. A patient-handling apparatus according to any preceding claim, wherein the cushion extends substantially along the proximal side of the support.
9. A patient-handling apparatus according to any preceding claim, wherein the cushion is substantially cuboidal.
10. A patient-handling apparatus according to any preceding claim, wherein the cushion has a length of up to approximately two metres and preferably in the range of 75cm to 95cm.
11. A patient-handling apparatus according to any preceding claim, wherein the cushion has a width of at least 15cm.
12. A patient-handling apparatus according to any preceding claim, wherein the cushion comprises a cover.
13. A patient-handling apparatus according to any preceding claim, wherein the cushion is releasably attached to the support.
14. A patient-handling apparatus according to any preceding claim and further comprising a pocket adapted to house the cushion.
15. A patient-handling apparatus according to Claim 14, wherein the pocket is attached to the support.
16. A patient-handling apparatus according to Claim 14 or Claim 15, wherein the pocket extends along the proximal side of the support.
17. A patient-handling apparatus according to any of Claims 14 to 16, wherein dimensions of the pocket correspond approximately with dimensions of the cushion.
18. A patient-handling apparatus according to any preceding claim, the apparatus further comprising at least one releasable fastener for securing the apparatus to a patient's bed frame.
19. A patient-handling apparatus according to Claim 18, wherein the at least one fastener is positioned adjacent the cushion.
20. A patient-handling apparatus according to Claim 18 or Claim 19, wherein the at least one fastener comprises first and second parts, the parts being adapted to attach to each other.
21. A patient-handling apparatus according to any of Claims 18 to 20, wherein the at least one fastener comprises hook-and-loop material.
22. A patient-handling apparatus according to any of Claims 18 to 21, wherein the apparatus comprises a plurality of fasteners.
23. A patient-handling apparatus according to Claim 22, wherein the fasteners are spaced along the proximal side of the support and extend therefrom.
24. A patient-handling apparatus according to any preceding claim and further comprising one or more handles for pulling the support.
25. A patient-handling apparatus according to Claim 24, wherein the handles are positioned on the distal side of the support opposed to the cushion.
26. A patient-handling apparatus according to Claim 24 or Claim 25, wherein the handles are present on a top face and/or a bottom face of the support.
27. A patient-handling apparatus according to any preceding claim, the apparatus further comprising one or more tensile members for pulling the support.
28. A patient-handling apparatus according to Claim 27, wherein the tensile members extend from the distal side of the support.
29. A patient-handling apparatus according to Claim 27 or Claim 28, wherein the tensile members are adapted to attach to handles, loops or apertures on the support.
30. A patient-handling apparatus according to any of Claims 27 to 29, wherein the tensile members are straps.
31. A patient-handling apparatus according to any of Claims 27 to 30, wherein the tensile members comprise one or more gripping formations.
32. A patient-handling apparatus according to any preceding claim, wherein the support is flexible.
33. A patient-handling apparatus according to Claim 32, wherein the support is a sheet.
34. A patient-handling apparatus according to any preceding claim and comprising a first cushion on the proximal side of the support, and a second cushion on the distal side of the support.
35. A patient-handling apparatus according to Claim 34, wherein handles are positioned on the distal and proximal sides of the support, adjacent to each of said cushions.
36. A patient-handling apparatus according to any preceding claim and comprising a first pocket on the proximal side of the support, and a second pocket on the distal side of the support, each pocket being selectively capable of housing one or more cushions.
37. A patient-handling arrangement comprising: a patient-handling apparatus according to any preceding claim; and a slide sheet, wherein the slide sheet is positioned beneath the patient once in a prone position or beneath the support to allow the patient to be re-positioned in use after, or before, being tipped over.
38. A method for turning a person, the method comprising: supporting the person upon a support having a distal side; and pulling the distal side of the support in a proximal direction, the proximal movement of the distal side of the support tipping the person over about their proximal side.
39. A method for turning a person according to Claim 38, wherein the proximal side of the person's body is restrained against proximal movement while pulling the distal side of the support in a proximal direction.
40. A method for turning a person according to Claim 38 or Claim 39, the method further comprising securing the support to a bed or trolley by fastener means on a proximal side of the support
41. A patient-handling apparatus or a patient-handling arrangement, substantially as hereinbefore described with reference to or as illustrated in any of Figures 7 to 33 of the accompanying drawings.
42. A method for turning a person, substantially as hereinbefore described with reference to or as illustrated in any of Figures 19 to 32 of the accompanying drawings.