Lesson plan on Interventions for Impaired Body Alignment & Immobility Demonstration On Range Of Motion Exercises and Moving, Lifting and Transferring Of Casualty and In-Patient

1. Procedure Check list for Moving, Lifting and Transferring of
Casualty and In-Patient
Procedure No I - Moving the patient up in bed
Steps Done
1. Explain the procedure to the client.
2. Wash hands
3. Raise the bed to a comfortable position.
4. Adjust the bed to a flat position if the client can tolerate it
5. Lower the side rail nearest to you
6. Remove the pillow and place it at the head of the bed.
7. If possible, ask the client to flex the knees with the feet flat on the bed.
8. Fold the client’s arms across the chest.
9. Instruct the client to flex the neck with the chin on the chest.
10. Stand opposite the client’s centre with your feet spread and turned toward the
head of the bed. Position one foot slightly forward
11. Flex your knees and hips. Place one arm under the client’s neck and shoulders,
grasping the far shoulder with your hand. Place your other arm under the
client’s upper thighs. Pull the client close to your side of the bed. Move the
client’s head and legs into alignment.
12. Review the plan of movement with the client.
13. Tighten your abdominal and gluteal muscles. Assume the position to move the
client
14. Shift your weight back and forth from back leg to front leg, and on count of
three, move the client upward in bed. If possible, the client should push with
legs and assist movement upward
15. Assist the client to a comfortable position in the centre of the bed. Reposition
the pillow. Raise the side rail and adjust the bed position, if necessary.
16. Wash your hands.
Procedure No II- Moving patient to one side of the bed
Steps Done
• Explain the procedure to the client.
• Wash hands
• Maintain privacy
• 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 your
arms to the level of bed
• Place the arm of the patient on his/her chest
• Place one arm under the shoulders and neck of the patient and the other hand

2. under the patient’s back
• Shift own body weight from your front foot to back foot as you rock back ward
, bringing the patient towards you to the side of the bed
• Move the middle part of the patient in the same manner by placing one arm
under his back and one arm under his thigh
• Then move the feet and lower legs with the same motion
• Make the patient in comfortable position
• Wash hands
Procedure No III- Transferring a helpless patient from the bed to stretcher and Vice versa
Steps Done
➢ Explain the procedure to the client.
➢ Wash hands
➢ Maintain privacy
➢ Position the stretcher at right angel to head end or foot end of the bed
➢ Call helpers to position them at the bed side along the same side of the bed
➢ Move the patient to the edge of the bed ( As discussed above)
➢ Position yourself (3 Nurses) at the following level
1. Head, shoulder and chest
2. Hips
3. Thighs and ankles
➢ Count 1,2,3,4, &5
1. At count 1, the nurses slide their arms under the patient to support his body
sections.
2. At count 2 , the nurses stand with back erect, holding the patient as near their
body as possible
3. At count 3 ,the nurses take one step backwards and pivot on their heels towards
the stretcher
4. 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 in to stretcher
5. At count 5, the nurses lower the patient to the stretcher in a supine position
➢ Make the patient in comfortable position
➢ Wash hands
Procedure No IV- Transferring a patient from bed to wheel chair/ chair and vice versa
Steps Done
▪ Explain the procedure to the client.
▪ Wash hands
▪ Maintain privacy
▪ Place the chair/ wheel chair at the right side of the bed ,with the back towards
the foot of the bed
▪ The wheels should be locked or placed against the wall or another person

3. ▪ Help the patient to sit on the right side of the bed
▪ Stand in front of the patient , facing him
▪ 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
▪ 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 arm chair/side rails or mattress
▪ Instruct the patient to place his left arm on the far arm of the wheel chair/chair
and pivot on the heel of his/her feet, bringing the buttocks towards the wheel
chair
▪ Instruct the patient to step back to the chair/ wheel chair until he/she touches
the seat and grasp the other arm of the chair with his / her right-hand
▪ Instruct the patient to lean forward and lower his /her buttocks slowly to the
seat by bending knees and elbows
▪ Check for any discomfort , correct posture of the patient
▪ Make the patient in comfortable position
▪ Wash hands
Signature of demonstrator
Signature of Advisor