Presentation on theme: "MOVING THE CLIENT IN & OUT OF BED PRESENTED BY: MS. AHDAB FAISAL ESKANDAR Fundamentals Of Nursing."— Presentation transcript:
MOVING THE CLIENT IN & OUT OF BED PRESENTED BY: MS. AHDAB FAISAL ESKANDAR Fundamentals Of Nursing
OBJECTIVES 1. Differentiate between manual and assistive technique. 2. Enumerate the common purposes for moving client. 3. Assess client`s status needs and environment. 4. Mention required equipment. 5. Demonstrate the steps of each procedure.
OUTLINE: Introduction Purpose of moving client Needed assessment Required equipment Types of transfer Procedure transfer Conclusion Reffrance
*ill people usually have difficulty moving in bed. How much assistance clients required depends on? people to function independtly their need for assistance to move *Nurse should be sensitive to both the need of people to function independtly and their need for assistance to move. Introduction
1. Maintains body alignment 2. Maintains skin integrity and facilitates pressure distribution 3. prevent friction and shear on tissue 4. Promote comfort 5. Promote optimal lung expansion 6. Prevent injury and deformities of musculoskeletal system 7. Position clients for a variety of clinical procedures Purpose
Before moving a client assess the following : Clients weight, age and medical diagnosis. Client physical abilities (e.g. muscle strength,presence of paralysis). Clients ability to understand instructions.
Assessments cont: Integumentary and musculoskeletal assessment. Doctor orders for specific restrictions in positioning client surrounding area and attached equipment such as( IV-urinary catheter-drain etc) Nurse strength and types for assistance
Support devices required by clients(e.g. Draw sheet Sliding sheet Foot board Sandbags Hand rolls Foam wedges Pillows for head,extra pillows Gloves EQUIPMENTS:
Slide sheet ( made from low friction material ) Bed pole (trapeze) and leader Wedges Transfer ( walking) belt
DEPENDENT TRANSFERS Before specially adapted equipment for transfers was introduced, hospitals had to rely on dependent manual techniques to get the patient in and out of bed.
Assisted transfer Overhead lifts. Manual lifts Overhead lifts can be used to aid in the transfer of medically fragile patients. Often they are permanently mounted to the ceiling with a secure rail system.
Assist client to sit on side of bed Assist client to move up in bed Transferring between bed and chair Logrolling client Transferring between bed and stretcher
Moving client up in bed Equipment Equipment :pull sheet or sliding bar. Purposes Purposes: clients slide down or being pulled by traction Preparation Preparation :determine(assistive device-attached IV or heavy cast-medications-assisted personal)
Moving client up in bed Performance Performance: Explain to the client and listen for his questions Wash hands and provide privacy Lower head of the bed and raise the bed to your center of gravity lock the wheels and raise the side rail opposite to you
Performance cont: Remove the pillows and place one only against the head of the bed Ask client to flex hips and knees and position feet so that they can be used for pushing Ask client to :- A. Grasp the head of the bed with both hands and pull during move or B. Raise upper part of body on elbows and push with hands and forearm during the move
Two nurses using a hand interlock Two people required to move clients who are unable to assist because of their condition or weight. The second staff member on the opposite side of bed, both of you interlock your forearm under clients thighs and shoulders and lift client up in bed
Upper extremities: Flex hips and knees Arms across chest Flex neck during movement Place one arm under clients back and shoulders and other under clients thigh Shift your weight two nurses using turn sheet. Other methods for moving client up in bed
ASSISTING CLIENT TO SIT ON SIDE OF BED Purpose: Purpose: before walking, moving to chair, eating or performing other activates Performance : Assist client to lateral position facing you Raise head of bed slowly to highest position
Assisting client to sit on side of bed Stand beside clients hips and face far corner of bed Lean your trunk forward and flex your hips, knees and ankles Move client to sitting position (place one arm around client shoulder and other beneath both clients thigh near knees Tighten your muscles and lift client thighs slightly
continue Pivot on balls of your feet in desired direction facing foot of bed while pulling client feet and legs off bed ( prevent twisting of nurse supine) Support client well ( this movement may cause some clients to faint ) Assess vital signs as indicated by clients health status
Logrolling client Purpose Purpose: to turn client whose body most all times be kept in straight alignment Performance Performance: Stand on the same side of bed and broad base of support with on foot ahead of other Place clients arms across chest Lean your trunk and flex your hips knees and ankles
Logrolling Place your arm under client Pull client to the side of the bed Move to the other side and place supportive devices Roll and position clients in proper alignment
TRANSFARING BETWEEN BED AND CHAIR Equipment : Equipment : appropriate clothes and slipper –transfer belt Preparation : Preparation : Plan of what to do and how to do it Obtain equipment and check for function well Remove obstacles from areas Performance: Performance: Place wheelchair parallel to bed as close as possible and lock the wheels and raise the foot plate.
continue Assist client to sitting position on side of bed Place transfer belt around the waist of clients Ask client to move forward and sit on the edge of bed lean forward slightly from hips Place strong foot beneath edge of bed and the other forward Place client hands on bed surface or on your shoulders( so they can push while standing ) Mirror the placement of the clients feet (prevent loss of balance during transfer)
continue Encircle clients waist with your arms and grasp the belt at client back Assist the client to stand, and then move together toward the wheelchair Assist the client to sit.
Transferring from bed to chair Ask the client to: Back up to the wheelchair and place the legs against the seat Place the foot of the stronger leg slightly behind the other Keep the other foot forward Place both hands on the wheelchair arms or on your shoulders Ask the client to push back into the wheelchair seat. Lower the footplates, and place the client’s feet on them
TRANSFERRING BETWEEN BED AND STRETCHER Performance: Lower the head of the bed Raise the bed slightly higher than the stretcher (easier for client to move down ) Pull draw sheet out from both sides of bed Place the stretcher parallel to bed and fill the gap with blankets Roll the sheet against client,flex hips and pull onto stretcher Ask client to flex neck and place arms across chest Ensure clients comfort and raise the side rails of stretcher
Documentation Document all relevant information:- Time and change of position moved from and position moved to Any signs of pressure areas Use of support devices Ability of client to assist in moving and turning Response of client to moving and turning
? ANY QUESTION
References Fundamentals of nursing concepts,process and practice,7 th edition written by kozier 2005 Nurses guide to clinical procedures 5 th edition written by jean smith temple and Joyce young Johnson 2007 handling.html handling.html