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

2. 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.

3. 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!

5. 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

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

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

8. 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

9. 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.

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

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

12. 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.

14. 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

15. 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.

16. 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.

17. 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

18. 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

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

21. Occupied Bed
Bed made while patients in it.

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

23. 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.

24. 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

25. The End!