1. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Chapter 15 Body Mechanics

2. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 2  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. It involves good posture, balance, and using your strongest and largest muscles for work.  Good body mechanics reduces the risk of injury.

3. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 3  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. 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. 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.

4. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 4  For good body mechanics: Bend your knees and squat to lift a heavy object. 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. Hold items close to your body and base of support.  This involves upper arm and shoulder muscles.  All activities require good body mechanics.

5. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 5  ERGONOMICS  Ergonomics is the science of designing a job to fit the worker. The goal is to eliminate a serious and disabling work- related musculoskeletal disorder (WMSD). The goal is to eliminate a serious and disabling work- related musculoskeletal disorder (WMSD).  WMSDs are injuries and disorders of the muscles, tendons, ligaments, joints, and cartilage. They also can involve the nervous system. They also can involve the nervous system.

6. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 6  The Occupational Safety and Health Administration (OSHA) has identified risk factors for WMSDs in nursing team members. Force means the amount of physical effort needed to perform a task. Force means the amount of physical effort needed to perform a task. Repeating action means performing the same motion or series of motions continually or frequently. Repeating action means performing the same motion or series of motions continually or frequently. Awkward postures are positions that place stress on the body. Awkward postures are positions that place stress on the body. Heaving lifting is manually lifting patients and residents who cannot move themselves. Heaving lifting is manually lifting patients and residents who cannot move themselves.

7. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 7  OSHA requires that employers provide employees with a safe work setting. The setting must be free of recognized hazards that are causing or likely to cause death or serious physical harm to employees. The setting must be free of recognized hazards that are causing or likely to cause death or serious physical harm to employees. The employer must make reasonable attempts to prevent or reduce the hazard. The employer must make reasonable attempts to prevent or reduce the hazard.  Back injuries are major threats. Signs and symptoms include: Signs and symptoms include:  Pain when trying to assume a normal posture  Decreased mobility  Pain when standing or rising from a seated position

8. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 8  POSITIONING THE PERSON  The person must be properly positioned at all times.  Regular position changes and good alignment: Promote comfort and well-being Promote comfort and well-being Promote breathing Promote breathing Promote circulation Promote circulation Help prevent pressure ulcers and contractures Help prevent pressure ulcers and contractures

9. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 9  Patients and residents may: Move and turn when in bed or a chair without assistance Move and turn when in bed or a chair without assistance Need reminding to adjust their positions Need reminding to adjust their positions Need help with position changes Need help with position changes Depend entirely on the nursing team for position changes Depend entirely on the nursing team for position changes  Whether in bed or chair, the person is repositioned at least every 2 hours. Follow the nurse’s instructions and the care plan. Follow the nurse’s instructions and the care plan.

10. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 10  Follow these guidelines to safely position a person: Use good body mechanics. Use good body mechanics. Ask a co-worker to help you if needed. Ask a co-worker to help you if needed. Explain the procedure to the person. Explain the procedure to the person. Be gentle when moving the person. Be gentle when moving the person. Provide for privacy. Provide for privacy. Use pillows as directed by the nurse for support and alignment. Use pillows as directed by the nurse for support and alignment. Provide for comfort after positioning. Provide for comfort after positioning. Place the signal light within reach after positioning. Place the signal light within reach after positioning. Complete a safety check before leaving the room. Complete a safety check before leaving the room.

11. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 11  Fowler’s position is a semi-sitting position. The head of the bed is raised 45 to 60 degrees. The head of the bed is raised 45 to 60 degrees. The knees may be slightly elevated. The knees may be slightly elevated.  The 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. 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. The person lies on one side or the other.  Sims’ position (semi-prone side position) This is a left side-lying position. This is a left side-lying position.

12. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 12  Chair position Persons who sit in chairs must hold their upper bodies and heads erect. Persons who sit in chairs must hold their upper bodies and heads erect. Feet are flat on the floor or wheelchair footplates. Feet are flat on the floor or wheelchair footplates. Backs of the knees and calves are slightly away from the edge of the seat. Backs of the knees and calves are slightly away from the edge of the seat. The nurse may ask you to put a small pillow between the person’s lower back and the chair. The nurse may ask you to 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. Some people require postural supports if they cannot keep their upper bodies erect.