Chapter 16 Body Mechanics Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

Body mechanics means using the body in an efficient and careful way. It involves good posture, balance, and using your strongest and largest muscles for work. Good body mechanics reduces the risk of injury. You need to focus on the person’s and your own body mechanics. Review the contents of Box 16-1 on p. 247 in the Textbook. Body Mechanics Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

The Occupational Safety and Health Administration (OSHA) has identified MSD risk factors for the nursing team. Force—the amount of physical effort needed to perform a task Repeating action—doing the same motion or series of motions continually or frequently Awkward postures—assuming positions that place stress on the body Heavy lifting—manually lifting people who cannot move themselves An MSD is more likely if risk factors are combined. Example: A task involves both force and repeating actions. Ergonomics (cont’d) Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

Examples of good positioning Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

Positioning the Patient The person must be properly positioned at all times. Regular position changes and good alignment: Promote comfort and well-being. Promote breathing. Promote circulation. Help prevent pressure ulcers and contractures. A contracture is the lack of joint mobility caused by abnormal shortening of a muscle. Positioning the Patient Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

Positioning the Person (cont’d) Patients and residents may: Move and turn when in bed or a chair without assistance Need reminding to adjust their positions Need help with position changes Depend entirely on the nursing team for position changes Whether in bed or a chair, the person is repositioned at least every 2 hours. Positioning the Person (cont’d) Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

Positioning the Person (cont’d) Fowler’s position is a semi-sitting position. The head of the bed is raised 45 to 60 degrees. The knees may be slightly elevated. Supine position (dorsal recumbent position) is the back-lying position. Prone position The person lies on the abdomen with the head turned to one side. Lateral position (side-lying position) The person lies on one side or the other. Sims’ position (semi-prone side position) is a left side-lying position. Refer to Figure 16-6 on p. 250 in the Textbook. Refer to Figure 16-7 on p. 250 in the Textbook. Refer to Figure 16-8 on p. 250 in the Textbook. Refer to Figure 16-9 on p. 250 in the Textbook. Refer to Figure 16-10 on p. 251 in the Textbook. Refer to Figure 16-11 on p. 251 in the Textbook. Positioning the Person (cont’d) Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

Patient Positions Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

Positioning the Person (cont’d) Chair position Persons who sit in chairs must hold their upper bodies and heads erect. Feet are flat on the floor or wheelchair footplates. Backs of the knees and calves are slightly away from the edge of the seat. The nurse may have you put a small pillow between the person’s lower back and the chair. A pillow is not used behind the back if restraints are used. Some people require postural supports if they cannot keep their upper bodies erect. Refer to Figure 16-12 on p. 252 in the Textbook. The person’s back and buttocks are against the back of the chair. Never leave feet unsupported. Paralyzed arms are supported on pillows. Some persons have positioners. Others require postural supports. The person’s safety, dignity, and function are considered. Positioning the Person (cont’d) Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.