Chapter 17 Body Mechanics Copyright 2017 Elsevier Inc

Body Mechanics Body mechanics means using the body in an efficient and careful way. Ø It involves good posture, balance, and using your strongest and largest muscles for work. Good body mechanics reduces the risk of injury. Copyright © 2017, Elsevier, Inc. All rights reserved. 2

Principles of Body Mechanics Body alignment (posture) is the way the head, trunk, arms, and legs are aligned with one another. Ø Base of support is the area on which an object rests. Ø Good alignment lets the body move and function with strength and efficiency. 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. Copyright © 2017, Elsevier, Inc. All rights reserved. 3

Principles of Body Mechanics (Cont. ) For good body mechanics: Bend your knees and squat to lift a heavy object. • Do not bend from your waist. Ø Hold items close to your body and base of support. • This involves upper arm and shoulder muscles. Ø All activities require good body mechanics. Copyright © 2017, Elsevier, Inc. All rights reserved. 4

Ergonomics is the science of designing a job to fit the worker. Ø The goal is to eliminate a serious and disabling work-related musculoskeletal disorder (MSD). MSDs are injuries and disorders of the muscles, tendons, ligaments, joints, and cartilage. They can involve the nervous system. Ø MSDs are caused or made worse by the work setting. Copyright © 2017, Elsevier, Inc. All rights reserved. 5

Ergonomics (Cont. ) The Occupational Safety and Health Administration (OSHA) has identified MSD risk factors for the nursing team. Force—the amount of physical effort needed to perform a task Ø Repeating action—doing the same motion or series of motions continually or frequently Ø Awkward postures—assuming positions that place stress on the body Ø Heavy lifting—manually lifting people who cannot move themselves Ø Copyright © 2017, Elsevier, Inc. All rights reserved. 6

Ergonomics (Cont. ) OSHA requires a safe work setting. The setting must be free of hazards that cause or are likely to cause death or serious physical harm to staff. Ø The employer must make reasonable attempts to prevent or reduce the hazard. Ø Back injuries are major threats. Ø Signs and symptoms include: • Pain when trying to assume a normal posture • Decreased mobility • Pain when standing or rising from a seated position Copyright © 2017, Elsevier, Inc. All rights reserved. 7

Positioning the Person The person must be properly positioned at all times. Regular position changes and good alignment: Promote comfort and well-being. Ø Promote breathing. Ø Promote circulation. Ø Help prevent pressure ulcers and contractures. Ø Copyright © 2017, Elsevier, Inc. All rights reserved. 8

Positioning the Person (Cont. ) Patients and residents may: Move and turn when in bed or a chair without assistance Ø Need reminding to adjust their positions Ø Need help with position changes Ø Depend entirely on the nursing team for position changes Ø Whether in bed or a chair, the person is repositioned at least every 2 hours. Ø Follow the nurse’s instructions and the care plan. Copyright © 2017, Elsevier, Inc. All rights reserved. 9

Positioning the Person (Cont. ) To safely position a person: Use good body mechanics. Ø Ask a co-worker to help you if needed. Ø Explain the procedure to the person. Ø Be gentle when moving the person. Ø Provide for privacy. Ø Use pillows as directed by the nurse for support and alignment. Ø Provide for comfort after positioning. Ø Place the signal light within reach after positioning. Ø Complete a safety check before leaving the room. Ø Copyright © 2017, Elsevier, Inc. All rights reserved. 10

Positioning the Person (Cont. ) Fowler’s position is a semi-sitting position. The head of the bed is raised 45 to 60 degrees. Ø The knees may be slightly elevated. Ø Supine position (dorsal recumbent position) is the back-lying position. Prone position Ø Lateral position (side-lying position) Ø The person lies on the abdomen with the head turned to one side. The person lies on one side or the other. Sims’ position (semi-prone side position) is a left sidelying position. Copyright © 2017, Elsevier, Inc. All rights reserved. 11

Positioning the Person (Cont. ) Chair position Persons who sit in chairs must hold their upper bodies and heads erect. Ø Feet are flat on the floor or wheelchair footplates. Ø Backs of the knees and calves are slightly away from the edge of the seat. Ø The nurse may have you 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. Ø Some people require postural supports if they cannot keep their upper bodies erect. Ø Copyright © 2017, Elsevier, Inc. All rights reserved. 12