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

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

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

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

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

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

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

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!!!!

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

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

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

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.)

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

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

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

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