Delivery, Setup and Education: Hoists and slings

By saraqscis •

In this phase, the trained health professional monitors the assistive technology (AT) delivery timeframe with the product specialist, supports correct setup at delivery, and confirms that required adjustments and education are completed. This ensures the AT is supplied as prescribed and functions as intended.

Delivery

Delivery should be arranged when the trained health professional, the person with spinal cord injury (SCI) and their support network (where relevant) are available.

Considerations for delivery  of hoists and slings:

  • the delivered hoist and slings should match the prescribed and approved items in the quote and funding application.
  • the person with SCI’s clinical presentation should be reviewed to confirm the prescription remains appropriate, particularly where there has been a delay between prescription and delivery.
  • the environment (e.g. home, clinic, facility) should be suitable for delivery and set up. Required interfacing AT and stakeholders should be available to support assessment of fit and function.
  • sufficient time should be allocated for education on safe use and maintenance. Written information should be provided where possible, and the person with SCI’s support network included as appropriate.
  • contact details for the product specialist and relevant stakeholders should be provided for ongoing support or further review as required
  • all required documentation should be completed, including any reports or forms specified by the funding source.
  • the need for a follow up appointment should be identified if necessary to review fit, function or safety.

Important

The trained health professional should finalise documentation to include:

  • the setup completed, including any adjustments made.
  • the context of the delivery, including all attendees
  • the AT supplied versus any errors or omissions, including a plan for the product specialist to correct

Setup and adjustment

The trained health professional should ensure the hoist and sling is set up and adjusted to optimise performance and safety for the person.

Consideration should be given to the person’s:

  • body dimensions
  • posture and comfort
  • functional abilities
  • environment
  • skin integrity
  • previous experience using AT
  • support network requirements.

Considerations for set-up and use of hoists and slings:

  • the sling should be confirmed as the correct style and size to ensure optimal fit and function. Changes in the person’s needs may occur between prescription and delivery.
  • all hoist functions should be checked to ensure correct operation i.e. that the powered pivot is functioning and boom is raising and lowering.
  • for slings with loop attachments, loop selection should support the person with SCI’s positioning, safety, and comfort during the hoist transfer.
  • transfers using the hoist between relevant AT (i.e. bed, wheelchair, mobile shower commode chair) should be completed to ensure compatibility.
  • education should address how set up and use of the hoist and sling influence safety.
  • ongoing monitoring of skin integrity should be encouraged, particularly where there is risk of pressure or shear.

Common adjustments to optimise hoist and sling use may include: 

AdjustmentClinical Considerations 
Sling loop attached to spreader bar  

The loop at the shoulder and legs of the sling which attach to the spreader bar/yoke.		The selection and positioning of sling loops influence posture and alignment during transfers:
– short shoulder loops and longer leg loops support a more upright position.
– short loops at both shoulder and leg increase hip flexion. longer shoulder loops increase recline.
– crossing leg straps may reduce hip abduction and external rotation. This is not appropriate for slings with clip attachments.  

If the person with SCI is positioned in too much recline, it may not be possible to position their bottom at the rear of the seat on other AT items, such as a wheelchair or mobile shower commode chair. This increases the need for additional manual handling to ensure correct positioning.  

Excessive recline when seated also encourages posterior pelvic tilt and forward sliding, which may increase pressure and shear at the sacrum and coccyx.  
Hoist leg position during transferHoist legs may be adjusted (open or closed) to interface with other AT. Positioning should support stability and maintain alignment with the transfer surface.
Boom height during transfer    Boom height should be adjusted to support safe clearance and positioning throughout the transfer.

LINK to features/accessories of AT item name.

Education

Education should be provided at the time of hoist and sling delivery and setup:

  •  Safe use
    • Education should be tailored to the person’s needs and level of experience.
    • Written information should be provided where possible.
    • The support network should be involved where relevant.
  • Product specialist support
    • Processes for contacting the product specialist for technical support or trouble shooting should be explained.
  • Servicing, maintenance, and repair processes
    • Routine servicing requirements should be outlined to support safe and ongoing use.
    • Information on reporting faults and accessing repairs should be provided.
  • Hoist and sling features and accessories
    • Education should include features and accessories, including: