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

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

Principles of Body Mechanics Body alignment (posture) is the way the head, trunk, arms, and legs are aligned with one another. Good alignment lets the body move and function with strength and efficiency. Base of support is the area on which an object rests. A good base of support is needed for balance. Use your strongest and largest muscles in the shoulders, upper arms, hips, and thighs to handle and move persons and heavy objects. When standing, your feet are your base of support. Stand with your feet apart for a wider base of support and better balance. Using smaller and weaker muscles causes fatigue and injury. Back injuries are a major risk. Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

Principles of Body Mechanics (cont’d) For good body mechanics: Bend your knees and squat to lift a heavy object. Do not bend from your waist. Hold items close to your body and base of support. This involves upper arm and shoulder muscles. All activities require good body mechanics. Follow the rules in Box 16-1 on p. 247 in the Textbook. Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

Ergonomics Ergonomics is the science of designing a job to fit the worker. The goal is to eliminate a serious and disabling work-related musculo-skeletal disorder (MSD). MSDs are injuries and disorders of the muscles, tendons, ligaments, joints, and cartilage. They can involve the nervous system. MSDs are caused or made worse by the work setting. Ergonomics involves changing the task, workstation, equipment, and tools to help reduce stress on the worker’s body. Work-related musculoskeletal disorders (MSDs) are workplace health hazards. Early signs and symptoms of MSDs include pain, limited joint movement, or soft tissue swelling. According to the U.S. Department of Labor, nursing assistants are at great risk. Always report a work-related injury as soon as possible. Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

Ergonomics (cont’d) 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. Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

Ergonomics (cont’d) OSHA requires a safe work setting. The setting must be free of hazards that cause or are likely to cause death or serious physical harm to staff. The employer must make reasonable attempts to prevent or reduce the hazard. Back injuries are major threats. Signs and symptoms include: Pain when trying to assume a normal posture Decreased mobility Pain when standing or rising from a seated position Back injuries can occur from repeated activities or from one event. To help prevent back injuries Follow the rules in Box 16-1 on p. 247 in the Textbook. Be extra careful when performing tasks that are associated with back injuries. Review the Promoting Safety and Comfort: Back Injuries Box on p. 249 in the Textbook. Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

Positioning the Person 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. 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. Follow the nurse’s instructions and the care plan. Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

Positioning the Person (cont’d) To safely position a person: Use good body mechanics. Ask a co-worker to help you if needed. Explain the procedure to the person. Be gentle when moving the person. Provide for privacy. Use pillows as directed by the nurse for support and alignment. Provide for comfort after positioning. Place the signal light within reach after positioning. Complete a safety check before leaving the room. Review the comfort measures listed on the inside of the front Textbook cover. Review the safety measures listed on the inside of the front Textbook cover. Review the Focus on Communication: Positioning the Person Box on p. 249 in the Textbook. Review the Delegation Guidelines: Positioning the Person Box on p. 249 in the Textbook. Review the Promoting Safety and Comfort: Positioning the Person Box on p. 249 in the Textbook. 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. 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. Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.