Resident lift slings: a silent risk? Lift slings can wear out, like any other material item, and the resulting risks are serious--and preventable.

Use of resident lift equipment has grown over the past decade, and that has helped to reduce transfer-related injuries to nursing staff. Many facilities have implemented a no-lift policy and purchased the appropriate lift equipment, enabling them to provide both staff and residents a safe environment--almost. Why almost? Old, overused slings and belts that should have been removed from service are commonly in use throughout America's nursing homes and hospitals, subjecting residents and staff to risk of falls and injury. This risk is preventable.

When in Doubt, Throw It Out

Slings and belts are sewn pieces of fabric that deteriorate over time with use and laundering, regardless of the manufacturer or brand. As a result, facilities should require caregivers to inspect slings before every use; even daily inspections are not enough to catch a problem area. Incurring a small cost by removing slings from service a little early is a far better alternative than explaining to a resident's family that an accident involving a worn-out sling has occurred. When in doubt, throw it out!

Sling "Life Expectancy"

Several factors affect the life expectancy of a sling or belt: washing temperature, drying temperature, detergents and disinfectants, resident incontinence, frequency of use, and types and weights of residents.

Slings are designed to be washed in a soap solution with temperatures not exceeding 165[degrees]F. Although bleaching is a popular method for killing germs, it is too harsh for sling fabric and stitching and should never be used. If bleach spots are present, the sling/belt should be removed from service immediately. Once a sling has been washed properly, it should be rinsed thoroughly to ensure all detergents are removed. Slings can be tumble-dried up at up to 180[degrees]F but should not be placed in direct contact with the heat source of the dryer. Slings should never be dry-cleaned.

The number of times a sling is used, as well as the amount of weight it carries per use, will cause sling material to stretch and wear. Sling designs from any manufacturer should have already been tested to 1.5 times the maximum safe working load. However, continued use of the sling combined with laundering will cause deterioration of the sling over time. Every sling will eventually need to be replaced regardless of the load it has carried.

Unfortunately, there is no exact formula to determine when the integrity of a sling/belt will be compromised. Lift and sling manufacturer Medcare Products believes that the three best tools to combat sling failure are regular visual inspection, tracking the age of the sling, and staff training.

Sling/Belt Inspection Checklist

Visible wear and tear is a clear indication that slings should be removed from service immediately. However, slings that reach a certain age, regardless of visual signs of wear and tear, should be replaced, as well. To manage the risk associated with using worn slings, look for the following:

Discoloration. Straps or fabric may be discolored and/or lightened as a result of bleach and laundry detergents weakening the fabric. Slings/belts with discolored straps or fabric should be removed from service immediately.

Loose stitching. Any loose stitching on the sling, even if it is only supportive stitching, weakens that area and puts more strain on other areas of the sling. Slings/belts with loose stitching should be removed from service immediately.

Fraying. Any fraying of the material on the sling or belt is a clear indication that the fabric is in a weakened condition. Slings/belts that are frayed should be removed from service immediately.

Rips or burns in material. Tears in fabric can spread and cause excess strain to be put on other areas of the sling. Slings/belts with rips, tears, or burns should be removed from service immediately.

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Warranty tag. Even if the sling/belt appears to be in good condition, look at the date on the warranty tag. If it is more than two years old, we recommend replacing the sling/belt. If the numbers are faded or the tag is worn off or shredded, replace the sling/belt.

Beware of repair. Resewing or patching slings is not recommended. The initial stitching of the sling, while necessary, unavoidably weakens the fabric. Each time a sling is repaired, small holes or punctures are made and the fabric becomes progressively weaker. Remember that wear and tear in one area of the sling may put more strain on other areas. Essentially, if you try repairing an area with visible signs of wear, other areas on the sling are likely approaching failure.

Two-Year "Collect the Trash" Day

Slings may show no signs of wear and tear yet still be weakened from general use, environmental factors, and laundering. Remember the two-year rule: Dispose of all slings after two years of service, regardless of whether visual signs of wear and tear exist. When slings are purchased, track the serial numbers or date codes found on the sling tags and set a reminder in two years to throw away any slings within that range. If the slings do not have specific serial codes, write the month and year with permanent marker on the tag of the sling. If this handwritten date starts to fade and can no longer be read, it is a good indication that it is time to remove the sling from service.

Training Is Key

Training all levels of staff involved in patient transfer operations, supervision, and maintenance is critical to removing worn and unsafe equipment from service. Staff from directors of nursing to CNAs should all be properly trained in inspecting equipment and identifying wear and tear on slings/belts. Safety committee members should conduct regular inspections of all the facility's lift equipment, including slings. Additionally, appoint someone to be the final decision maker in determining if a sling/belt should be pulled from service and thrown away. Again, when in doubt, throw it out.

Also note that, if proper training is not provided, the wrong sling may be selected for a particular resident's need or size, or the sling may be applied improperly, thus increasing preventable wear.

Disposable Slings

Resident-specific disposable slings are becoming popular because of high laundering costs of regular slings and resident turnover. A disposable sling is intended to be used by the same resident and is not designed to withstand the harshness of washing and drying. Disposable slings still have the same lifting strength as regular slings, but the life expectancy is, of course, deliberately shorter. It is still important, however, to check disposable slings for wear and tear before every use.

Prevention Is Key

A sling in good condition promotes safe lifting and reduces the risk of injury to the resident. Early wear-and-tear detection can mean the difference between prevention and costly accidents. Can your facility afford to overlook this easy step?

Mark Flolo is the Technical Expert for Medcare Products, a manufacturer of resident lifting equipment. For further information, phone [phone], ext. 124 or visit www.medcarelifts.com. To send your comments to the author and editors, e-mail [e-mail].