© 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Patient Safety and Positioning Unit 15

© 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Objectives Spell and define terms. Identify patients who are at risk for having incidents. List alternatives to the use of physical restraints. 2

© 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Objectives Describe the guidelines for the use of restraints. Demonstrate the correct application of restraints. 3

© 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Objectives Describe two measures for preventing these types of incidents: –Accidental poisoning, thermal injuries, skin injuries, and choking List the elements that are common to all procedures. 4

© 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Objectives Describe correct body alignment for the patient. List the purposes of repositioning patients. State the purpose of assistive moving devices. 5

© 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Objectives Demonstrate these positions using the correct supportive devices: –Supine, semisupine, prone, semiprone, lateral, Fowler’s, and orthopneic 6

© 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Patient Safety In Unit 14 –You learned how to maintain a safe environment and avoid personal injuries –The prevention of patient injuries is another very important part of your job as a nursing assistant 7

© 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Use of Physical Restraints In the past –Restraints were often used routinely as a preventive measure to avoid falls 8

© 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Use of Physical Restraints Research has shown that side rails and other restraints do not necessarily accomplish this purpose –Restraints may be used for other preventive measures 9

© 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Alternatives to the Use of Restraints Alternatives to restraints should be tried before restraints are applied Restraints are used only as a last resort in situations in which a patient may harm himself or herself or others 10

© 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Nursing assistants can take a number of actions to help reduce the need for restraints 11 Alternatives to the Use of Restraints

© 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Potential for Side Rail Injury Mattresses are sometimes replaced –Replacement may not be as large as the original mattress 12

© 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Potential for Side Rail Injury Gaps between the mattress and bed frame or rails –Can be caused by movement or compression of the mattress due to patient weight, movement, or bed position Refer to Figures 15-13A and 15-13B 13

© 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Potential for Side Rail Injury 14

© 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Potential for Side Rail Injury If you observe a gap that is wide enough to entrap a patient’s head or body part –Inform the nurse promptly 15

© 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Prevention of Other Incidents Many situations can result in an incident that may harm a patient Incidents can be prevented when all staff members are aware of appropriate preventive measures 16

© 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Prevention of Other Incidents Some incidents that can be prevented are: –Accidental poisoning –Thermal injuries –Skin injuries –Choking 17

© 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Introduction to Procedures Caring for patients safely means that you must faithfully and carefully carry out specific routines The normal manner of carrying out a task is called a procedure 18

© 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Body Mechanics for the Patient Body mechanics for the patient –Similar to those for the health care team Although the patient probably will not be doing any lifting –Good posture habits should not be neglected 19

© 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Body Alignment and Positioning Body alignment –Means maintaining a person in a position in which the body can function properly 20

© 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Complications of Incorrect Positioning Complications can occur when body alignment is not maintained –Or when the patient’s position is not changed often enough 21

© 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Basic Body Positions There are four basic positions, each with variations: –Prone –Supine –Lateral –Fowler’s position 22

© 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Positioning the Patient After you have turned and moved the patient into proper body alignment –Place pillows and other supportive devices to help the patient maintain the position –Instructions are provided in the textbook for the four basic positions and their variations 23

© 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Chair Positioning Proper chair positioning begins with the feet Feet should be supported on the floor or wheelchair footrests Support the patient in the position while sitting in the chair Refer to Figure 15-35B 24

© 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Chair Positioning 25

© 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Chair Positioning Remember that repositioning and pressure relief are needed when the patient is in the chair 26

© 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Pre and Post Procedure Actions Refer to file entitled “pre-post procedure” –For a review of initial (beginning) procedure actions and ending procedure (procedure completion) actions 27