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Moving and turning the client in bed

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this ppt describes the principles and procedures to be followed while shifting the patient from bed to stretcher, bed to wheel chair and vice verca

Published in: Health & Medicine
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Moving and turning the client in bed

  1. 1. Presented by: M. Sivanandha Reddy
  2. 2. Definition of transferring Transferring refers to moving a patient from bed to a chair or to a stretcher, or to a wheelchair with maximum comfort and safety for patient and nurse.
  3. 3. Reasons for transferring Improvement of the patient’s condition (from ICU to medicine unit .  Worsens of patient’s condition ( to ICU)  The need for surgery or X ray  Transfers at the patient’s request  For any other diagnostic tests.
  4. 4. Reasons formoving Change position Repositioning the client Client’s slid down in bed from fowler’s position Changing the bed linen
  5. 5. Methods of transferring By wheel chair By stretcher By a movable bed
  6. 6. Assess:  The client’s physical abilities  Ability to understand instructions  Degree of comfort ordiscomfort when moving  Client’s weight  Presence of orthostatic hypotension  Yourown strength and ability to move the client
  7. 7.  If indicated, use pain relief modalities ormedication prior to moving the client  Prepare supportive equipment (pillows)  Obtain required assistance  Explain the procedure to the client and listen to any suggestions the client
  8. 8.  Wash hands  Raise the height of the bed to bring the client close to yourcenterof gravity  Lockthe wheels on the bed and raise the rail on the side of the bed opposite you to ensure client safety  Face in the direction of the movement to prevent spinal twisting
  9. 9. Transferring the patient frombed to wheel chair: 1.Review the medical record and nursing plan of care forconditions that may influence the patient’s ability to move orto be positioned 2.Performhand hygiene and put on PPE, as indicated. Identify the patient. Explain the procedure to the patient 3.Provide privacy 4.Raise the head of the bed to a sitting
  10. 10. 5.Make sure the bed brakes are locked. Put the chairnext to the bed. If available, lock the brakes of the chair. If the chairdoes not have brakes, brace the chairagainst a secure object 6.Lowerthe side rail, if necessary, and stand nearthe patient’s hips. Stand with yourlegs shoulderwidth apart with one foot nearthe head of the bed, slightly in front of the other foot 7.Assist the patient to sit up on the side of Transferring the patient from bed to wheel chair:
  11. 11. 8.Wrap the gait belt around the patient’s waist, based on assessed need and facility policy 9.Stand facing the patient. Spread yourfeet about shoulderwidth apart and flex your hips and knees 10.Askthe patient to slide his orherbuttocks to the edge of the bed until the feet touch the floor. 11.Position yourself as close as possible to the patient, with yourfoot positioned on the out Transferring the patient from bed to wheel chair:
  12. 12. 12.Using the gait belt, assist the patient to stand Rockbackand forth while counting to three. On the count of three, use yourlegs (not yourback) to help raise the patient to a standing position . If indicated, brace your front knee against the patient’s weakextremity as he orshe stands 13.Pivot on yourbackfoot and assist the patient to turn until the patient feels the Transferring the patient frombed to wheel chair:
  13. 13. 14.Askthe patient to use an armto steady him- orherself on the armof the chairwhile slowly lowering to a sitting position . Continue to brace the patient’s knees with yourknees and hold the gait belt. Flex yourhips and knees when helping the patient sit in the chair. 15.Assess the patient’s alignment in the chair. Remove gait belt , if desired. Depending on patient comfort, it could be left in place to use when returning to bed. Coverwith a blanket, if needed. Transferring the patient frombed to wheel chair:
  14. 14. Transferring the patient from bed to stretcher and from the stretcher to the bed is done to patients who cant help themselves and need help. The selection of transfer technique is individualized. The following methods can be used. 1.Draw sheet method 2.Patient is lifted by three persons 3.Mechanical devices like hydro ureter lift
  15. 15. Lowerthe head of the bed until it is flat. Raise the bed so that it is slightly higherthan the surface of the stretcher. Ensure that the wheels on the bed are locked. Pull the draw sheet out from both sides of the bed.
  16. 16. Fournurses orhelpers are required. One stands at the opposite side of the bed. Remaining three stands across the stretcherone supporting the head and shoulders, second one supporting the hips and thighs and the third
  17. 17. 1.Grasp the draw sheet tightly 2.Co-ordinate lifting by counting the numbers of 1, 2, 3 and receive the patient in stretcher by pulling the draw sheet and the patient towards the stretcher, quickly and gently. 3.The sheet can be removed by turning the patient from side to side.
  18. 18. Three persons lifting the patient 1.Three people, all standing on the same side of the patient, slip their hands, palms facing up, beneath the patient. 2.First person holds the head and shoulder, second person holds the trunk upto thigh and the third person holds the legs. 3.Cradle the patients in the arms so that the patients weight rests against the nurses chests and the patient faces nurses.
  19. 19. Three persons lifting the patient 4.Care must be taken so that the patient will not be dropped down suddenly. 5.The nurses should bend over and release the weight of the patient gradually and until it rests gently upon the bed or stretcher.
  20. 20. Moving the client up in bed 1.Review the medical record and nursing plan of care for conditions that may influence the patient’s ability to move or to be positioned. 2.Assess for tubes, IV lines, incisions, or equipment that may alter the positioning procedure. Identify any movement limitations. 3.Consult patient handling algorithm for moving the patient.
  21. 21. 5.Perform hand hygiene and put on PPE 6.Identify the patient. Explain the procedure to the Patient 7.Close curtains around bed and close the door to the room, if possible 8.Adjust the head of the bed to a flat position 9.Remove all pillows from under the patient. Leave one at then head of the bed, leaning Moving the client up in bed
  22. 22. 9.Position at least one nurse on either side of the bed, and lower both side rails 10.Ask the patient (if able) to bend his or her legs and put his or her feet flat on the bed to assist with the movement. 11.One nurse should be positioned on each side of the bed 12.Grasp the friction-reducing sheet securely, close to the patient’s body Moving the client up in bed
  23. 23. 13.Flex your knees and hips. Tighten your abdominal and gluteal muscles and keep your back straight 14.On the count of three, move the patient up in bed 15.Assist the patient to a comfortable position and readjust the pillows and supports, as needed. Return bed surface to normal setting Moving the client up in bed

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