1. Patient Safety and Positioning
Unit 15
Patient Safety and Positioning

2. Objectives Spell and define terms.
Identify patients who are at risk for having incidents.
List alternatives to the use of physical restraints.

3. Objectives Describe the guidelines for the use of restraints.
Demonstrate the correct application of restraints.

4. 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.

5. Objectives Describe correct body alignment for the patient.
List the purposes of repositioning patients.

6. Objectives
Demonstrate these positions using the correct supportive devices:
Supine, semisupine, prone, semiprone, lateral, Fowler’s, and orthopneic

7. Objectives Demonstrate the following procedures:
Procedure 14 Turning the Patient Toward You
Procedure 15 Turning the Patient Away from You

8. Objectives Demonstrate the following procedures:
Procedure 16 Moving a Patient to the Head of the Bed
Procedure 17 Logrolling the Patient

9. 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

10. Use of Physical Restraints
In the past
Restraints were often used routinely as a preventive measure to avoid falls

11. 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

12. 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

13. Alternatives to the Use of Restraints
Nursing assistants can take a number of actions to help reduce the need for restraints

14. Potential for Side Rail Injury
Mattresses are sometimes replaced
Replacement may not be as large as the original mattress

15. 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 15-10A and 15-10B

16. 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

17. Potential for Side Rail Injury

18. 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

19. Prevention of Other Incidents
Some incidents that can be prevented are:
Accidental poisoning
Thermal injuries
Skin injuries
Choking

20. 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

21. 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

22. Body Alignment and Positioning
Means maintaining a person in a position in which the body can properly function

23. Complications of Incorrect Positioning
Complications can occur when body alignment is not maintained
Or when the patient’s position is not changed often enough

24. Basic Body Positions
There are four basic positions, each with variations:
Prone
Supine
Lateral
Fowler’s position

25. 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

26. 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 15-40B

27. Chair Positioning
Remember that repositioning and pressure relief are needed when the patient is up in the chair

28. Chair Positioning

29. Chair Positioning Refer to file entitled “pre-post procedure”
For a review of beginning procedure actions and procedure completion actions