Hoyer Lift Competency Checklist
Completed by the nurse while evaluating an Employee's Hoyer Lift Competency. The Nurse and the Employee must sign the completed checklist at the time of evaluation.
Employee Name:
First Name
Last Name
Employee Title:
Please Select
Direct Support Professional
Team Lead
Site Lead
Administrative Assistant- East
Administrative Assistant-BE
Art Specialist
Asst. Vice President of Programs
Camp Lead
Career Discovery Experience Facilitator
Director
Director, Community Integration
Director
Planning & Program Manager, Respite
Program Manager
Quality Support Coordinator, Community Living
Other
Title:
Trainer:
Please Select
Karen Gray, Nurse
Joanne Hester, Nurse
Lucy Byrnes, Nurse
Marlin King, Nurse
Annabelle Hardwick, Nurse
Chad Linn, VP of Compliance & Operations, Nurse
Other
Time
Hour Minutes
AM
PM
AM/PM Option
Date:
-
Month
-
Day
Year
Date
Duration:
Please Select
0.25
0.50
0.75
1.0
1.25
1.50
Location of Training:
Please Select
Noble East
Noble West
Noblesville
Other
Location:
Lift Use General Knowledge
Pass
Fail
NA
Operates the lift with two staff present and voices importance of not using lift without two staff. (Not Applicable for Community Living)
Voices understanding of the names of different lift parts (cradle, boom, mast, etc.)
Demonstrates ability to raise and lower lifter.
Only raises lifter with the base of lifter spread to widest possible position to maximize stability.
Lift Use During a Transfer from a Wheelchair or Chair
Pass
Fail
NA
Explains procedure to the individual before beginning.
Folds sling correctly to place behind individual.)
Leans individual forward and places his/her arms on his/her knees for stability. Standing in front of the individual, puts the folded sling behind the individual's back and presses it down until it touches the seat of the chair.
Pulls the leg sections of the sling forward and beneath the individual's thighs by the long loops. Crosses the loops in front of the individual.
Moves the lifter base around the chair and under the legrests with individual's feet straddling the mast. Attaches both sides of sling (4 points) appropriately to the cradle.
Locks wheelchair brakes. Raises individual above seat height. Makes sure footrests are in up position and out of the way. Does not use the lift brakes when lifting the individual.
Ensures individual's privacy and safety during transfer.
Lower's individual slowly and safely at destination (toilet, changing table, etc.).
Lift Use During a Transfer from a Changing Table
Pass
Fail
NA
Explains procedure to the individual before beginning.
Folds sling correctly to place under the individual.
Rolls the individual safely and places sling under the individual. Rolls individual onto his/her back. Pulls the leg loops forward and under the thighs. Crosses the loops.
Rolls the base of the lifter as far under the changing table as possible locating the cradle over the individual. Takes care not to lower the frame onto the individual.
Before lifting the individual makes sure the lifter arm is centered over the individual. Does not use the lift brake when lifting the individual.
Attaches both sides of sling (4 points) appropriately to the cradle. Raises the individual slowly.
Raises individual until buttocks are just above the changing table. Grasps individual's legs and turns him/her so legs dangle off side of changing table. Does not push or pull the individual off of the bed.
Grasps steering handles and moves lifter away from changing table. Moves the individual into position over the seat of a locked wheelchair or toilet.
Lowers individual into wheelchair or onto toilet slowly. Positions individual and applies seat belt as appropriate. If transferring onto a toilet, maintains individual's safety once on the toilet.
Ensures individual's privacy and safety during transfer.
Employee Signature:
Based on this Competency Tool, it is determined that the employee is competent to use the lift for transfer of individuals.
Yes
No
Nurse Signature:
Submit
Submit
Employee Hoyer Lift Competency Checklist: Created 2/27/25
Should be Empty: