What does 'Physical Therapy (PT) to be out of bed (OOB) daily with Hoyer (lift)' mean on a patient's chart?

From the Guidelines

"PT to be OOB daily with Hoyer" on a patient's chart means that the patient should be gotten out of bed (OOB) each day using a Hoyer lift, as this intervention is associated with a low risk of serious safety events or harm, as supported by the findings of 1. This is a medical instruction indicating that the patient requires assistance to transfer from their bed to a chair or other location, and specifically needs a mechanical lifting device called a Hoyer lift to do so safely. The PT likely refers to the patient, though it could also refer to physical therapy in some contexts. Some key points to consider when implementing this instruction include:

• The importance of preventing complications of prolonged bed rest such as pressure ulcers, muscle atrophy, pneumonia, and blood clots
• The need for early mobilization, as recommended by 1, which suggests that patients should start to be mobilized early, between 24 hours and 48 hours of stroke onset, if there are no contraindications
• The use of a Hoyer lift to ensure both patient and staff safety during transfers, as it is a mechanical lifting device that can assist with transferring patients who cannot bear weight or transfer with minimal assistance
• The low risk of serious safety events or harm associated with rehabilitation/mobilization, as reported in 1, which found that serious safety events or harms were rare, with only 15 reported during greater than 12,200 sessions across 13 studies. Overall, getting patients out of bed daily, even when they cannot transfer independently, is a standard care practice to maintain physical functioning and overall health, and the use of a Hoyer lift can help to ensure safe transfers and minimize the risk of complications.

From the Research

Physical Therapy (PT) to be out of bed (OOB) daily with Hoyer (lift)

• The notation 'Physical Therapy (PT) to be out of bed (OOB) daily with Hoyer (lift)' on a patient's chart indicates that the patient is required to participate in physical therapy sessions daily, with the goal of getting out of bed, and a Hoyer lift will be used to assist with this process 2.
• A Hoyer lift is a type of mechanical lift used in rehabilitation settings to safely transfer patients with mobility impairments, allowing them to participate in physical therapy activities such as walking, transferring, and exercising 2.
• The use of a Hoyer lift in physical therapy is an example of safe patient handling and mobility (SPHM) equipment, which is increasingly being used in rehabilitation settings to assist patients in reaching their rehabilitation goals 2.
• Physical therapy goals, such as getting out of bed daily, are typically patient-centered and functional, meaning they are tailored to the individual patient's needs and abilities, and are designed to improve their overall functional ability and quality of life 3, 4.
• Research has shown that physical therapy interventions, including the use of SPHM equipment like Hoyer lifts, can improve patient outcomes, such as mobility status and discharge disposition, in a variety of patient populations, including those with COVID-19 5.