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body mechanics ppt 2.pptx FUNDAMENTALS OF NURSING GNM TOPIC

The document outlines advanced nursing practices for safely moving, lifting, and transferring patients, detailing procedures and principles aimed at preventing injury to both patients and nurses. It covers definitions, purposes, detailed procedural steps from pre-assessment to post-care, and emphasizes the importance of body mechanics and appropriate equipment like gait belts. The guidelines include specific techniques for various situations, ensuring patient safety and comfort during movements.

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Advanced Nursing Practice Procedure on moving, lifting and transferring the patient
CONTENTS • Definition of moving, lifting and transferring the patient • Purposes • Principles • Articles • Preliminary Assessment • Preparation of patient and unit • Steps for moving the patient to one side of the bed. • Steps of moving a helpless patient up in bed. • Steps of turning a patient to one side of the bed. • Transferring a helpless patient from bed to stretcher. • Steps of assisting a patient from bed to chair or wheel chair.
DEFINITION Moving and lifting the patient means transferring the patient from one place to another or changing the position of the patient.
Purposes • Change the position of the patient to prevent bedsores. • Facilitating body movements without muscle strain and excessive use of muscle energy. • Maintaining adequate muscle tone. • Preventing fatigue and deformities • Reducing energy expenditure
Principles • The wider the base of support, the greater the stability of nurse. • The lower center of gravity, the greater the stability of nurse. • The equilibrium of an object is maintained as long as the line of gravity passes through its base of support. • The stronger the muscle group, the greater amount of work that can be safely done by it.
Base of support Centre of Gravity Line of Gravity
Continue... • Facing the direction of movement prevents abnormal twisting of spine. • Dividing balanced activity between arms and legs reduces the risk of back injury while lifting or moving an object. • Sliding, rolling, turning or pivoting requires less work than lifting.
Principles • When friction is reduced between the object to be moved and surface on which it is moved, less force is required to move it.(Friction is a force that occurs in a direction to oppose movement) • Reducing the force of work reduces risk of injury. • Maintaining good body mechanics reduces fatigue of muscle groups. • Alternating periods of rest and activity help reduce fatigue.
Articles Articles required depends upon from where we have to shift the patient and to which place: • Wheel chair if we have to shift the patient to wheel chair. • Stretcher if we have to shift the patient to stretcher. • Foot stool if needed.
PROCEDURES FOR MOVING, LIFTING AND POSITIONING OF PATIENTS
Preprocedural steps Preliminary Assessment • Check the diagnosis and specific precaution regarding the movement of the patient. • Check the level of consciousness and ability to follow instructions. • Check for attachments e.g. catheters and I/V connections. • Check the number of personnel required and available to move the patient safely. • Provide privacy to the patient.
Preprocedural steps Preparation of patient and unit • Provide privacy to the patient. • Explain procedure to the patient and seek his/her participation. • Adjust the bed to the working height, lower side rails and lock wheels of the bed, wheel chair or stretcher etc. • Remove all comfort devices used for the patient. • Fanfold the top linen to the foot end or remove them leaving a sheet over the patient. • Attach the IV pole to the stretcher to hang the IV bottle.
Steps for moving the patient to one side of the bed Intraprocedural • Stand facing the patient at the side of the bed in which he is to be moved. Stand with a wide base of support with knees and hips flexed to bring the arms to the level of bed. • Wide base provides a stable base. Flexed knees,bring the nurses’ arms to the bed level .
Continue... • Place the arms of the patient on his or her chest. • This will help prevent an injury and will not hinder movement. • Place one arm under the shoulders and neck and the other under the patients back. • Helps to move the patient’s body in unison. • Shift own body weight from front foot to your back foot as you rock backward, bringing the patient towards you to the side of the bed. • Avoids strain on the patient’s as well as the nurse’s muscles.
Continue... • Move the middle part of the patient in the same manner by placing one arm under his back and one under his thighs. • Helps to move the patient’s body in unison • Then move the feet and lower legs with the same motion. • Avoids any injury to the patient and the nurse.
Steps of moving a helpless patient up in bed Preprocedural • Perform hand hygiene • Position yourself and the patient appropriately before performing the move.
Steps of moving a helpless patient up in bed Intraprocedural steps • Stand at the side of the patients bed. Stand with broad stance placing one foot behind the other. • Flex your knees and bring your arms at bed level. Put your arms under the patient. • Supports the body of the patient and helps in easy movement of the patient.
Continue... • Place one arm under the patient’s head and shoulders and one arm under his back. • Supports the body of the patient. • Move forward and shift your weight from forward foot to your back foot with flexed hips. • Encourage the client to reach up and grasp the upper side rails with both hands, bend knees, and push off with the feet and pull up with the arms simultaneously.
Continue... • Flexing the hips and knees keeps the entire lower leg off the bed surface preventing friction during movement, and ensures use of the large muscle groups in the client’s legs when pushing, thus increasing the force of movement. • Instruct patient to push with heels and elevate trunk if possible, moving towards the head end of the bed, to the count of 3. • Move the trunk and legs of the patient in the same manner. • Go to the other side of the bed and repeat the above steps till the patient is positioned satisfactorily.
Steps of turning a patient to one side of the bed Preprocedural • Perform hand hygiene • Prior to performing the procedure, introduce self and verify patient’s identity. • Position yourself and the patient appropriately before performing the move
Steps of turning a patient to one side of the bed Intraprocedural steps • Move the patient to the same side of the bed so as to bring him slightly off the centre of mattress. • If the patient is not moved to the side of the bed,he/she may fall to the ground when he/she is turned on his/her side. • Keep the farthest arm along the side of the head and face,the near arm across the chest and near leg flexed over the farthest leg.
Continue... • Helps to prevent injury and in easy turning of the patient. • Place your arm under the shoulders and hips of the patient and roll him gently away. Make the patient comfortably by placing pillow as in side lying position. • Supports the body and turns the body as a whole.
Transferring a helpless patient from bed to stretcher Preprocedural • Perform hand hygiene • Position yourself and the patient appropriately before performing the move.
Transferring a helpless patient from bed to stretcher Intraprocedural steps • Position the stretcher at right angle to head or foot end of the bed. • Shortens the distance to carry the patient. • Call helpers to position them at the bedside along the same side of the bed. • If the patient is heavy,call for more helpers. • Move the patient to the edge of the bed. • Placing the patient to the edge of the bed prevents over reaching and sustains injury to the back.
Continue... • Position yourself (three nurses) at the: Head,shoulders and chest Hips Thighs and ankles • Facilitates moving of the body as a whole. • Count 1,2,3,4 & 5 At Count 1, the nurses slide their arms under the patient to support his body sections. At Count 2, the nurses stand with back erect, holding the patient as near body as possible.
Continue... At Count 3, the nurses take one step backwards and pivot on their heels towards the stretcher. At Count 4, the nurses move to the side of the stretcher and stand with a wide base and flexed knees ready to lower the patient into the stretcher. At Count 5, the nurses lower the patient to the stretcher in a back lying position. • Helps to bring the patient’s body weight within nurse’s base of support. • A feeling of security to the patient.
Steps of assisting a patient from to chair or wheel chair Preprocedural • Perform hand hygiene • Explain to the patient what you are going to do and how he or she can cooperate. • Position yourself and the patient appropriately before performing the move.
Steps of assisting a patient from to chair or wheel chair Intraprocedural steps • Place the chair/wheel chair at the right side of the bed, with the back towards the foot of the bed. • Helps to reduce energy expenditure. • The wheels should be locked or placed against the wall or another person. • To prevent rolling of the wheel chair during transfer of the patient. • Help the patient to sit on the right side of the bed. • Stand in front of the patient, facing him. • To extend help to the patient, when needed.
Continue... • Slide the patient’s buttocks close to the edge of the bed by shifting his weight alternatively from right to left buttock till his feet are placed on the floor. • Rocking motion lifts weight on alternate buttocks and enhances forward movement. • Instruct the patient to stand on command by simultaneously leaning forward, pushing with the foot placed at the back as he straightens his legs. Balance the patient on the armchair/side rail or mattress. • Do not risk the danger of the patient falling to the floor.
Continue... • Instruct the patient to place his left arm on the far arm of the chair/wheel chair and pivot on the heel of his/her feet,bringing the buttocks towards the wheel chair. • Facilitates sitting in the chair with ease • Instruct the patient to lean forward and lower his/her buttocks slowly to the seat by bending knees and elbows. • Facilitates sitting in the chair with ease
Gait Belts • Gait belts is a safety device used to transfer a patient feom one place to another. They can be used when walking a patient or to transfer a person from wheelchair to bed. It is worn just above the waist. • The purpose for this is to put less strain on the back of the caregiver and to provide support to the client.
Gait Belt Gait Belt with handles
After care • Ensure correct body alignment and comfort of the patient. • Replace pillow and other comfort devices as needed. • Raise the side rails if necessary for the safety of the patient. • Remain with the patient during change of position to prevent his/her falling. • Ensure that the patient is comfortable and safe.
References: • TNAI.Fundamentals of Nursing A procedure manual:Body Mechanics,1st Ed;2005:226-240 • Ghai S.Clinical Nursing Procedures:Body Mechanics.CBS Publishers & Distributor Pvt Ltd.1st Ed;2018.74-79 • Silvestri A L.Comprehensive Review for the NCLEX- RN:Body Mechanics.Reed Elsevier India Private Ltd Publication.2nd Ed;2017.1094-1096