Positioning, Turning, Moving, and Transferring patients. Nursing Skills Positioning, Turning, Moving, and Transferring patients.

Positioning, Turning, Moving, and Transferring Patients Must use correct body mechanics Alignment = Positioning body parts in relation to each other to maintain correct body posture Correct alignment helps pt. feel comfortable; prevent fatigue, decubitus ulcers and contractures.

Decubitus Ulcer Pressure sore or bed sore. Caused by pressure that interferes with circulation. Usually at bony prominences- coccyx, hips, knees, heels, & elbows First signs is a pale or reddened area on the skin Vesicle or blister may form at the site. Cells die, skin breaks down, and open sore (ulcer) develops. EASIER TO PREVENT THAN TO TREAT!

Prevent Decubitus Ulcers By: Good skin care Prompt cleaning of urine and feces from skin Massage in a circular motion around reddened area Light dusting of powder to prevent friction

Prevent Decubitus Ulcer By: Frequent turning and positioning Linen dry and free from wrinkles Use of pressure relieving surfaces

Carefully observe the skin during bathing for evidence of pressure sores….

CONTRACTURES Tightening or shortening of muscle due to lack of movement or usage Foot drop common contracture prevented by keeping foot at right angle to leg

CONTRACTURES ROM will help prevent contractures Weakened body parts must be supported with pillows, bed cradles, footboards, rolled blankets, or towels Patient must be turned frequently.

Transferring Be sure to protect patient and health care worker Be sure you know how to operate the wheelchair/stretcher Lock the wheels

Mechanical Lift Used to transfer weak or paralyzed pts. Be sure you have been instructed on the proper use Reassure patient during transfer.

When Turning and Transferring… Before moving patient, obtain proper authorization from immediate supervisor Watch the patient closely-pulse rate, respirations, and colors Observe for weakness, dizziness, increased perspiration, or discomfort If you notice abnormal changes, return the patient to a safe and comfortable position and notify your supervisor.

Moving The Patient Up in Bed Lower the head of the bed Place the pillow against the bed frame to protect the patient's head If pt. has trouble breathing, raise the head of the bed Ask the patient to flex the knees and brace the feet on the bed Place one arm under the patient’s head and shoulders. If the patient is unable to help, get someone to assist you

Moving the pt. Up in Bed Get a broad base of support and as close to the bed as possible Arrange a signal- “ on the count of three, push with your feet.” “On signal, shift your weight forward” Two people can use a draw sheet or lift sheet.

Turning Moving and Transferring Dangling Sitting on side of bed prior to standing Allows patient time to adjust If the patient c/o vertigo, weakness, or diaphoresis-return pt. immediately to supine position.

Turning the Patient Lower the siderail nearest you-be sure the opposite side is up If the patient is lying in the center of the bed, place hands under the patient towards you Place both hands under the hips and slide the hips towards you Place both hands under the legs and slide the legs towards you Cross the patient’s arms across his/her chest

Cont. Move the leg closest to you over the other leg Get close to the patient and roll the patient away from you Explain what you are doing to the patient Place your hands under the head and shoulders, then the hips, drawing the patient to the center of the bed

CLOSED BED Made after the patient is discharged and after terminal cleaning of the unit Purpose: Keep bed clean until new patient arrives

Occupied Bed Bed made while patients in it.

Open Bed Fanfold top sheets to welcome new patient or for ambulatory patients.

BED WITH CRADLE Cradle is placed under top sheets to prevent linen from touching parts of the patients body. Used for patients with burns, skin ulcers, blood clots, fractures, and other similar conditions.

BEDMAKING TIPS Observe correct body mechanics Keep linens arranged in the order of use Make one side of the bed completely, then on the other side Roll dirty linens away from your body and place in hamper immediately

The End!