Lifting moving transferring DeWit

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Elsevier items and derived items © 2005, 2001 by Elsevier Inc
.


Principles of Body Movement for
Nurses

One of the most common injuries in health care

workers is lower back strain !


Get help whenever possible; ask patient to help if
able.


Two nurses moving a patient divides the work.


It is better to wait for help than to risk injury.


Use your leg muscles; bend and flex your knees.


Bend at the knees, not at the waist.



(Cont’d…)

Elsevier items and derived items © 2005, 2001 by Elsevier Inc
.


Principles of Body Movement for
Nurses


(…Cont’d)



Use the greatest number of muscles possible.


Use thigh, arm, or leg muscles rather than back
muscles, and use a wide base of support. Keep
feet approximately shoulders’ width apart.


Use smooth, coordinated movements; avoid
jerking or sudden pulling movements.

Elsevier items and derived items © 2005, 2001 by Elsevier Inc
.


Moving and Lifting Patients


Keep elbows close and work close to your body;
work at the same level or height as the object to
be moved. Keep the load near your center of
gravity.


Pulling actions require less effort than pushing or
lifting. Face in the direction of the movement.


Use arms as levers when pulling the patient
toward you. Lock the elbows and rock back on
your heels, using the weight of your body to move
the patient.

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.


Body Movement and Alignment for
Patients

Two basic principles

1.
Maintain correct anatomic position.

2.
Change position frequently.

Hazards of improper alignment


Interference with circulation, which may lead to
pressure ulcers


Muscle cramps and possible contractures


Fluid collection in the lungs

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.


Pressure Ulcers


Also known as
decubitus

ulcers
, or bedsores


Occur when pressure on the skin causes an area
of local tissue necrosis


Occur most often between a bony prominence
and an external surface


May be caused by shearing as force is applied
downward and forward on tissue beneath the skin
(as when a patient slides down in a chair)

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.


Goals and Expected Outcomes


Patient will experience no musculoskeletal injury.


Former level of mobility will be reattained within 6
months.


Skin integrity will remain intact while patient is on
bed rest.


Patient will not experience injury while
ambulating.


Patient should have full range of motion exercise
actively or passively performed several times a
day.

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.


Positioning

Accomplishes four objectives:

1.
Positioning provides comfort.

2.
Positioning relieves pressure on bony
prominences and other parts decreasing the
patient’s risk of developing bedsores.

3.
Positioning prevents contractures, deformities,
and respiratory problems.

4.
Positioning improves circulation.

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Common Positions and Variations


Supine


Patient lying on his or her back


Fowler’s


Supine with the HOB elevated 60 to 90 degrees


Semi
-
Fowler


Supine with the HOB elevated 30 to 60 degrees


Low Fowler’s


Supine with the HOB elevated 15 to 30 degrees


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High
-
Fowlers or
Orthopneic

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Fowlers versus
Trendelenberg

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.


Semi
-
Fowler’s

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Common Positions and Variations


(…Cont’d)



Dorsal recumbent


Supine with knees flexed and feet flat on the bed; used
for procedures and examinations


Side
-
lying/lateral


Patient lying on his or her side; alleviates pressure on
the bony prominences of the back


Sims’


A variation of side
-
lying used for examinations or
insertions of tubes or suppositories



(Cont’d…)

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Sim’s

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Left & Right Lateral Recumbent

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Dorsal recumbent

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Common Positions and Variations


(…Cont’d)



Prone


Patient lying face down


Often used for patients with spinal cord injury


Not generally well tolerated


Knee
-
chest


Face down, with chest, knees, and elbows resting
on the bed


Used for rectal examinations

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.


Prone & Supine

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Common Positioning Devices


Pillows


Used to support the body or extremities


Boots or splints


Maintain dorsiflexion


Footboards, high
-
top sneakers


Maintain dorsiflexion


Trochanter rolls


Prevent external rotation of the leg



(Cont’d…)

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The Need for Good Alignment

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A well
-
aligned resident

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Common Positioning Devices


(…Cont’d)



Sandbags


Used to immobilize an extremity, provide support,
and maintain body alignment


Hand rolls


Help prevent contractures and prevent dorsiflexion
of the wrist


Trapeze bars, side rails, bed boards


Enhance patient mobility, provide patient safety,
and support patient’s back

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Overhead trapeze bar

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Moving the Patient in Bed


Using a lift sheet


Requires at least two people standing on opposite sides
of the bed


Both face the bed and use the sheet to move the
patient up in the bed


Moving the patient is performed as a coordinated effort


Patient is lifted and moved, not dragged

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.


Logrolling


Turning the patient as a single unit


Body alignment maintained at all times


Used to change bed linen, can be performed with
or without a lift sheet


Requires two people if patient cannot turn

himself or herself


Leave a pillow under the patient’s head

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.


Logrolling

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Lifting and Transferring


Patients may transfer independently or may
require different levels of assistance.


Always dangle a patient at bedside before
transferring to a wheelchair, and observe for
dizziness or nausea.


Remember to lock the wheels on wheelchairs or
gurneys before attempting to transfer a patient.

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.


Bed to Wheelchair

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Bed To Stretcher

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Things to Remember


Determine how much help you will need to move
or transfer the patient.


Get help whenever possible.


Make sure wheels on beds, wheelchairs, and
gurneys are locked.


Use a transfer device when possible.


Dangle the patient before ambulating.


Use a gait belt when ambulating patients.

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Transfer Devices


Pull sheets


Mechanical lifts


Roller boards


Slide boards


Transfer or gait belts

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Gait Belt

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Hoyer Lift

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Standing Lift

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Slide Board