Do active assist transfer devices improve transfer safety for patients and caregivers in hospital and community settings? A scoping review

Abstract

Background: Safe patient handling practices reduce injury risk for healthcare workers (HCW) and patients, but may conflict with goals of rehabilitation and person-centred care by minimizing (a) active participation in transfers and (b) autonomy and dignity while using mechanical lifts. Active assist transfer devices (AATDs) have potential to address both safety and support needs for appropriate clients.

Purpose: What is the scope and nature of the evidence to support the use of AATD for improving transfer safety for patients and caregivers in both hospital and community settings?

Methods: Scoping review of peer-reviewed and Gray literature, using systematic search strategies and multiple reviewers for identifying papers and extracting data.

Findings: Twenty-nine peer-reviewed publications, and 12 other documents (policy, technical) were included in the review. Half focused on HCW safety in the hospital setting, with only seven addressing patient safety in the community. Generally, literature was of low quality, with no controlled trials to support the benefit of this equipment, and often represented a nursing care perspective. However, positive outcomes reported included safety, satisfaction, and equipment utilization.

Implications: There is a need for rigorous research on use of AATDs in the community comparing rehabilitation outcomes across other forms of transfer equipment. Other important targets include injury risk for family caregivers, and potential to support early discharge. At present, utilization of AATDs within the rehabilitation field will continue to rely on best judgement of the care team. Implementation of AATDs should be considered a compelling target for practice-based research and quality improvements.

Implications for rehabilitation

• The use of active assist transfer devices is associated with their availability in the in-patient hospital setting.

• The use of active assist transfer devices is associated with positive patient experience, such as increased patient satisfaction and dignity. Improved patient adherence and cooperation with healthcare workers during mobilization and rehabilitation may follow.

• Most current evidence is focused on caregiver safety outcomes and is in support of decreased injury rates with increased active assist transfer device use. There is a limited amount of evidence focusing on the rehabilitation outcomes with active assist transfer device use.

• With current evidence, the use of AATDs should be used at the discretion of the care team.

Keywords:

• Device
• equipment
• mobility
• rehabilitation
• safety
• transfer

Acknowledgements

The authors thank Dr. Patricia Miller for her helpful comments on an early version of this manuscript.

Disclosure statement

The authors declare no conflict of interest.