The document discusses various patient safety and comfort devices. It provides instructions on applying cotton rings, foot boards, pillows, air rings, bed cradles, adjusting bed side rails, applying sand bags, and applying splints. The purposes, indications, equipment needed, and procedures for applying each device are described in detail in 3-4 steps. Maintaining patient safety, comfort, and proper positioning are the overall goals of using these mechanical devices.

1. CHAPTER FOUR
Managing patient safety and comfort
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2. General objective: -
At the end of the chapter the leaner will be able to
 Identify condition needs utilization of comfort and
safety device
 Demonstrate how to apply sandbag, cotton and air
ring, splint and bed cradles
 Apply safety precaution when applying sandbag,
cotton and air ring, splint and bed cradle
2

3. SAFETY AND COMFORT DEVICES
Safety: - It is to protect oneself from harm,
e.g. mechanical injury.
 Safety is responsibility of everyone but this may
not be applicable in the health care environment
because of different reasons such as
 Altered level of consciousness
 Loss of ability to move
 Loss of ability to think clearly
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4. Comfort:-Comfort is a feeling of physical and mental
well being freedom from worry, fears or pain.
 Are the mechanical devices to promote comfort to
the patient
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5. Causes of discomfort:-
1. Pain
2. Restriction of movements due to weakness
3. Wrinkled, soiled and wet sheet
4. Delayed or inadequate attention to meet the personal
needs.
5. Lack of exercise
6. Temperature extremes
7. Too bright lights and glares
8. Fear and anxiety due to illness
9. Insecurity feeling
10. Lack of sleep
11. uncomfortable position
12. indigestion and irregular bowl movements
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6. PURPOSE OF PATIENT SAFETY AND COMFORT:-
To relieve pain and worry
To provide position of comfort and ease
To place patient in comfortable bed.
To provide proper atmosphere to increase the moral of
patient during illness.
To adjust bed and other apparatus in the proper manner
To give maximum rest and sleep during illness
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7. 4.1. Applying cotton rings
Objectives: - At the end of this lesson, you will be able to:-
 Define cotton rings
 List the Purpose of cotton rings application
 Describe the indications of cotton rings application
 Demonstrate application of cotton rings
Definition: - Cotton rings are small circle of cotton rolled with
bandage or gauze with a hole in the middle.
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8. Purpose of cotton ring
 Used to lift the hip from bed to prevent bed sores or
pressure sore.
 To relieve pressure from small bony prominent areas
such as heel, elbow, occipital.
 Improves the circulation.
Indication
 Bed ridden patients
 Unconscious patients.
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9. CONT’D…
Size: - Based on the body areas we are going
to apply. The size differs from small to
medium size of bony prominent areas.
Equipments
1. Cotton
2. Bandage
3. Chart showing human body prominent
areas
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10. Procedure
1. Explain the procedure to the patient
2. Wash hands
3. Assemble the necessary equipment
4. Prepare cotton ring based on the size of body to be
applied.
5. Place cotton ring under the bony prominence such
as elbow and heel
6. Wash hands
7. Document procedure
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11. 4.2. Applying foot – board
Objectives: - At the end of this lesson, U will be able to:-
1. Explain Foot board
2. List the purpose of foot board application
3. State the indications of foot board application
4. Perform application of foot board
Definition: - A footboard is a flat plane often made of wood
or plastic placed at the foot of the bed.
11

12. CONT…
Purpose
 To provide support for the client’s feet and maintain a
natural foot position.
 To keep the top bed covers of the client’s felt relieving
pressure.
 To make the foot comfortable/prevent foot drop
 To prevent sagging of patient in to bed.
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13. CONT’D…FOOT BOARD
Indication
 Unconscious patients
 Patient with fracture
 Bedridden patients
Types of foot board:
 Foot boards are often made in an L shaped – so that the
base of L fits under foot of the mattress.
 Some foot boards can moved along the mattress to
adjust to the clients foot drop from their normal right
angle.
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14. Foot drop:-is a condition of plantar flexions or a
muscular which occurs from poor foot or leg
alignment.
Cause –when patient in bed for long time when the
top sheet and blanket are tightly tucked.
14

15. CONT…
Equipments
1. A firm pillow
2. Box of board
3. Cotton/sheet of cotton
4. Bandage
15

16.  Procedure
 1. Explain the procedure to the patient
 2. Wash hands
 3. Prepare the equipment
 4. Move the patient up in the bed to allow room for the
footboard.
 5. Loosen the top linens at the foot of the bed, and then
fold them back over the patient to expose his feet.
 6. Lift the mattress at the foot of the bed, and place the
lip of the footboard between the mattress and the
bedsprings. Alternatively, secure the footboard under
both sides of the mattress.
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17.  7. Adjust the footboard so that the patient's feet rest
comfortably against it. If the footboard isn't adjustable,
tuck a folded bath blanket between the board and the
patient's feet.
 8. Unless the footboard has side supports, place a
sandbag, a folded bath blanket, or a pillow alongside
each foot to maintain 90-degree foot alignment.
 9. Fold the top linens over the footboard, tuck them
under the mattress, and miter the corners.
 10. Wash hands
 11. Document
17

18. 4.3. Applying pillows
Definition:-Pillows are used to give comfort, support and to
position patient properly.
Pillows are placed:
 Under the head
 Under the back
 Between the knees
 At the foot of the bed
 Under the arm
18

19. CONT…
Purpose:
 To elevate body part
 To support patient on side
 To prevent pressure on the skin
 To increase comfort
Necessary equipments
 Pillows
 Pillows case
19

20. 4.4. Applying air rings
Objectives:- at the end of this lesson leaner will be able
to:-
1. Explain air rings
2. Describe the purpose of air rings
3. State the indications of air ring application
4. Perform application of air ring
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21. CONT’D…AIR RING
Definition:
 Air rings are used to relieve pressure from the buttock
and other bony prominent areas.
 For application they should be filled with air and covered
with pillow case
Purpose
Used to lift the hip from bed to prevent bed sores or
pressure sore or decubitus ulcer.
To relieve pressure from small bony prominent areas
such as heel, elbow, occipital.
Improves the circulation.
21

22. CONT…
Indication
 Bed ridden patients
 Unconscious patients
Equipments:
1. Plastic air rings
2. Covering towel or pillow case
3. Chart showing body’s prominent areas
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23. CONT…
Procedure
1. Explain the procedure to the patient
2. Wash hands
3. Assemble the necessary equipment.
4. Support the appropriate site
5. Applying air ring to body prominent area.
6. Observe patient comfort status
7. Wash hands.
8. Document
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24. 4.5. Applying bed cradle
Definition: Bed cradle is sometimes called an
Anderson frame. It is a device designed to keep
the top bed clothes off the feet, leg, abdomen and
chest of a client
Types: there are several types of bed cradles; the
most commonly used is curved metal rod.
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25. Purpose
 To keep top linen off the injured part of the body.
 To prevent the weight of the bedding from resting on
some part of the body.
 To apply heat in case of drying plaster casts.
 In case of electronic bed cradles are used to supply the
desired warm in the case of shock.
Indication
 Client with fracture or soft tissue injury.
 Client with burn
 Client with some skin lesions
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26. CONT…
Equipments:
1. Bed cradle
2. Roll gauze/bandage
3. Small size blanket
Procedure:
1. Explain the procedure to the patient
2. Wash hands
3. Assemble the necessary equipment.
4. Loosen and remove top linen.
5. However the cradle on to patients bed.
6. Secure it in place.
7. Wrap gauze roll around both sides of the cradle.
8. Cover the cradle with top linen
9. Wash hands.
10. Document
26

27. 4.6. ADJUSTING SIDE RAILS OF THE BED
Definition: Adjustable full or half side rails are used on
Hospital beds and stretchers to prevent accidents
Types: they can be of various shapes and sizes usually
made of metal
Position: side rails have two or three positions.
 These are high, intermediate and low.
 The down or low positions are employed when a side rail is not
needed.
 The up or high side rail position is used when a client is in bed
and requires protection.
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28. CONT…
Purpose
 Help weak patient turn independently
 Protects patient from falling out of bed
Indication:
 For unconscious patient.
 For weak and unable to control his/her body movement.
 For small children.
 For elderly patients
 Patient with seizure disorder
 Post operatively until the patient awake from anesthesia ·
 When changing position.
 When making certain procedure
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29. CONT’D..
Equipment: bed with side rails
Procedure
Explain the procedure to the patient
Wash hands
Assemble the necessary equipment.
Position the side rail to the needed height
Secure lock and it should be far from reaching by the
patient
Wash hands.
Document
29

30. 4.7. APPLYING SAND BAG
Definition: Sand bags are canvas, rubber or plastic bags
filled with sand and sewed.
Purpose
To relive discomfort
Sand bags are used for supporting or immobilizing limbs
Used to support as in fracture bone
They should be covered with towel and placed on either
side of the limb
To prevent foot drop or wrist drop
To prevent contracture
30

31. CONT’D… SAND BAG
Indication
 Fractured limb
 Amputated limb.
Equipments:
 Bag
 Rope
 Sand
 Covering towel
 Weight scale
 Adhesive plaster for labeling
31

32. CONT…
Procedure
1.Explain the procedure to the patient
2.Wash hands
3. Assemble the necessary equipment.
4. Positioning the patient
5. Apply the sand bags on the side of the area to be
supported.
6. Wash hands.
7. Document and report
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33. 4.8. Applying splint
Definition:
 splints are devices applied to the arms, legs, or trunk to
immobilize the injured part of the body when it is needed.
Purpose
To prevent movement of injured part of the body.
To prevent further damage when transporting injured
patient.
To provide complete rest for injured part.
To relieve pain and discomfort and encourage healing.
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34. CON’T…SPLINT
Types:-There are many varieties of splints available and they
can also be made locally from different material.
1. Wooden: straight pieces of woods of varying length and
width.
2. Metal: Splints made of a tin end of aluminum which are
molded to fit with natural curvature of the body part
3. Wire: It can be quickly cut to required length and easily bent
to support a limb in desired position
4. Plaster (P.O.P):-Often used by surgeon
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35. Nursing consideration
 There are a number of important points to remember.
1. Choice:-The splint chosen should be sufficiently strong and of
suitable length and width.
2. Padding:-The splint should be covered with cotton wool to prevent
discomfort or damage.
3. Molding:-Choose one which is most suitable mould to fit the natural
curvature of the limb.
4. Fixation:-Splints must be fixed to the insured fracture limbs by
bandage placed above and below the injured part. Do not apply
bandage directly on the injured part.
Equipment
 Splints (wooden,metallic)
 Dressing material (if there is open wound)
 Glove
 Padding for splint (rolled bandage to cover the splint)
 Elastic bandage or roll bandage (to hold the splint in place)
35

36. PROCEDURE
1.Explain the procedure to the patient
2.Wash hands
3. Assemble the necessary equipment.
4. Positioning the patient
5. First tie the bandage above the injured part
6. Joints must be immobilized above and below the location of
injury.
7. Wash hands.
8. Document and report
Follow up phase:-
Observation:-Look for the following condition
Presence of adequate circulation
Presence of adequate pulsation
Presence of any color change
Presence of numbness and tingling
N.B:- Rings, bracelets and watch should be removed
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37. 4.9. APPLING FRACTURE BOARD
Purpose
 To maintain good body alignment
 To prevent bed from sagging.
 To support the injured part when the patient has fractured
spine, hips, lower limps.
37

38. CONT…
Equipment
1. Fracture board
2. Thin foam mattress
Procedure
1. Explain the procedure to the patient
2. Wash hands
3. Assemble the necessary equipment.
4. Positioning the patient
5. First tie the bandage above the injured part
6. Joints must be immobilized above and below the location of
injury.
7. Wash hands.
8. Document and report
38

39. 4.10. Applying back rest
 Back rest is used for elevating and supporting the head
and back of the patient
 When back rest is used for the patient is liable to slip
down to the foot of the bed, therefore a foot board might
be used.
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40. THE END!!
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