Development and evaluation of a nursing risk assessment manual handling training program for moving patients with a stroke and other conditions affecting mobility: The Risk Assessment for Moving Patients (RAMP) program

The intervention (Risk Assessment for Moving Patients; RAMP) is a single, 4 hour, face-to-face manual handling training package for nursing staff. The training focuses on the moving and transferring of patients and will consist of a 30 minute introductory digital presentation followed by 2.5 hours practical time and 1 hour of concurrent practical assessments and case study practise. During the practical time, the trainer will select a patient transfer, guide participants through the relevant pages of the training manual and demonstrates the risk assessment relating to that transfer with one of the participating nurses acting as a patient model. Time will then be allowed for participants to immediately practise the demonstrated skills in small groups with reference to the training manual and roving feedback from the trainer. This process will be repeated for all groups of transfers presented in the training manual. In the final hour of the session, the trainer will observe each participant as they perform a mock patient scenario with another participant acting as the patient. During this scenario, the trainer will use the ‘Competency Tool – Trainee’ designed and piloted for this study to assess each participant’s ability to verbalise key concepts in risk assessment and to demonstrate appropriate manual handling techniques. While this is taking place, the rest of the participants will be divided into groups of 3-4 and will practise complex clinical scenarios which require risk assessment, clinical problem solving and practical completion of that scenario. The afternoon RAMP session will be delivered on the same day as a 3.5 hour morning organisational Work, Health and Safety (WHS) training session aimed at teaching practical skills for the use of common manual handling equipment such as hoists and standing machines. The equipment used in the RAMP session will be those commonly found in patients' rooms such as a hospital bed and chair and specific manual handling equipment such as slide sheets and leg lifters. Both sessions will be delivered in the hospital's simulation laboratory and staff attendance will be documented for each RAMP and WHS session. A WHS employee will deliver the morning WHS session and the RAMP session is delivered by a physiotherapist who is at least 4 years post graduation and has experience in neurological physiotherapy. During and after the training, staff will have access to a paper RAMP training manual detailing the risk assessment procedures and patient transfers learnt. Prior to and following the training, staff will have access to the RAMP course via an online education portal. The online course includes the RAMP training manual, purpose-filmed training videos and the post-training quiz. While completing the quiz, participants have access to the training manual and the intent therefore is that the quiz highlights and consolidates key areas of learning. The strategy for intervention adherence and sustainability is to have two nurses designated as 'clinical implementation leads' on each of the pilot wards. These nurses will be involved in the creation of the program and training manual, attend two RAMP training sessions rather than one (aimed to consolidate learning and confidence) and serve as a resource and encouragement to nursing staff on each of the pilot wards.