1. Body Mechanics, Positioning and Bed Making
PN 1 Nursing Skill Labs

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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!!!!

9. 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

10. 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

11. 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

12. 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.)

13. 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

14. 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

15. 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

16. 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