Positioning and Bed

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Nov 2, 2013 (3 years and 8 months ago)

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Body Mechanics,
Positioning and Bed
Making

PN 1 Nursing Skill Labs

Physiology of movement


involves skeletal system, muscular system and
nervous system


body mechanics is the efficient use of the body
as a machine and a means of locomotion


concept of body mechanics includes body
alignment or posture, balance, coordinated
body movement and postural balance

General principles…………...


develop good posture


use the longest and strongest muscles of
the arms and legs


use the internal girdle and a long midriff
when stooping, reaching, lifting or pulling


work as closely as possible to object


use weight of body as a force for pulling
or pushing


Before you ambulate the
pt……….


assess pt capabilities


administer pain med if needed


plan what you are going to do and make
sure you have the right number of
helpers, the right equipment etc.


explain to patient what is going to
happen and what their role is



make sure the area is free of obstacles


elevate bed, lock wheels etc.


watch body mechanics of both you and
your patient


protect patient from harm if dependent


avoid friction on patients skin


move smoothly using a rhythmic motion



use mechanical devices as indicated but
make sure you know how to use them
safely !!!!


be realistic about what you can do safely
and without injury


dangle patient prior to standing to avoid
incidents related to postural hypotension


Bed making guidelines


usually only changed as needed ($) or
scheduled


consider body mechanics
-

put bed at
proper height for you



tidy room


keep soiled linen away from uniform


don’t put sheets on floor
-

bring laundry
hamper with you if possible



check linen for personal belongings!!


dispose of linen in proper containers


make one side then the other


leave bed at safe height


call bell reattached, side rails up PRN


ensure patient is comfortable and safe
when you leave room!!!!



Making an occupied bed…….


only do this when needed


movement good for pt. so get pt up if
possible


make 1/2 the bed, then the other


use side rails for safety


may work side to side or top to bottom
depending on patient ability to help


Moving the patient up in bed
-

1
nurse…….



many patients can assist by using over
bed bars, pushing with their feet, using
the side rails etc.


Assess the patient’s capabilities before
beginning


Be clear when instructing the patient
about the move


on count of 3, move with patients help

Moving the patient up in bed
-

2
nurses…...


explain what you’re doing to patient


raise bed to comfortable position


remove pillow and place at head of bed


place lift sheet under patient


have patient flex knees if able to assist


place pts arms across chest and flex
neck



stand at pt center point, knee on bed


roll draw sheet in towards pt and grasp
firmly


shift your weight as you move patient
upwards on count of three


position pt comfortably and leave in safe
manner (side rails, call bell etc.)


Positioning the head of the bed


Low or semi Fowler’s
-

30º head of bed
elevation


Fowler’s
-

semi sitting, 45º
-
60º


High Fowler’s
-

90º head of bed
elevation


buttocks bear the main weight of the
body so need to be assessed frequently


Positioning Patients


prone position
: on abdomen, flat on bed, head
to side


orthopneic
: 90º head, arms rest on overbed
table


supine
: on back, legs together, sight bend in
knee


Sim’s position
: S shape, side lying, lower arm
behind body, knees bent, upper knee bent
more


side lying
: lower arm forward


Supportive equipment……..


pillows: support prevent pressure,
elevate parts, splints


mattresses: spring, foam, air, pressure,
kevlar, water


adjustable beds: heads, height, knee
gatch


trapeze bar attached to frame, moving,
exercises


Supportive equipment……..


foot boards: prevent plantar flexion or
footdrop


cradles: keep weight of sheets off legs


sandbags: prevent external rotation,
immobilize a part


trochanter rolls: to support hips from
rotating externally