Chapter 18 Safely Moving the Person Copyright 2017

Chapter 18 Safely Moving the Person Copyright © 2017, Elsevier, Inc. All rights reserved.

Safely Moving Persons During these and other tasks, you must use your body correctly. Turning and repositioning persons Ø Moving persons in bed Ø Copyright © 2017, Elsevier, Inc. All rights reserved. 2

Preventing Work. Related Injuries You must prevent work-related injuries when moving patients and residents. The Occupational Safety and Health Administration (OSHA) recommends: Minimizing manual lifting in all cases Ø Eliminating manual lifting when possible Ø Copyright © 2017, Elsevier, Inc. All rights reserved. 3

Preventing Work. Related Injuries (Cont. ) To safely move the person, the nurse and health team determine: The person’s dependence level Ø The amount of assistance needed Ø What procedure to use Ø The equipment needed Ø Copyright © 2017, Elsevier, Inc. All rights reserved. 4

Moving Persons in Bed Those who are weak, unconscious, paralyzed, or in casts need help moving in bed. Code 4: Total Dependence—mechanical lift or friction-reducing device and at least two staff members Ø Code 3: Extensive Assistance—mechanical lift or friction-reducing device and at least two staff members • The person weighs less than 200 pounds—two to three Ø staff members and a friction-reducing device • The person weighs more than 200 pounds—at least three staff members and a friction-reducing device Copyright © 2017, Elsevier, Inc. All rights reserved. 5

Moving Persons in Bed (Cont. ) Protecting the skin Ø Protect the person’s skin during moving and transfer procedures. • Friction is the rubbing of one surface against another. • Shearing is when the skin sticks to a surface while muscles slide in the direction the body is moving. Ø Reduce friction and shearing when moving the person in bed by: • Rolling the person • Using friction-reducing devices Copyright © 2017, Elsevier, Inc. All rights reserved. 6

Moving Persons in Bed (Cont. ) Raising the person’s head and shoulders You can raise the person’s head and shoulders easily and safely by locking arms with the person. • Do not pull on the person’s arm or shoulder. Ø It is best to have help with older persons and with those who are heavy or hard to move. Ø Copyright © 2017, Elsevier, Inc. All rights reserved. 7

Moving Persons in Bed (Cont. ) Moving the person up in bed The person is moved up in bed for good alignment and comfort. Ø You can sometimes move lightweight adults up in bed alone if they can assist using a trapeze. • It is best to have help and to use an assist device. Ø Two or more staff members are needed to move heavy, weak, and very old persons up in bed. Ø Always protect the person and yourself from injury. Ø Copyright © 2017, Elsevier, Inc. All rights reserved. 8

Moving Persons in Bed (Cont. ) Moving the person up in bed with an assist device The person is moved more evenly. Ø Shearing and friction are reduced. Ø At least two staff members are needed. Ø This procedure is used for: • Most patients and residents • Persons recovering from spinal cord surgery or spinal Ø cord injuries • Older persons Copyright © 2017, Elsevier, Inc. All rights reserved. 9

Moving Persons in Bed (Cont. ) Moving the person to the side of the bed Ø The person is moved to the side of the bed: • For repositioning and care procedures • Before turning • To limit the need to reach over the person One method involves moving the person in segments. Ø With at least one co-worker, use a mechanical lift or an assist device: Ø • • Following guidelines For older persons For persons with arthritis For persons recovering from spinal cord injuries or spinal cord surgery Copyright © 2017, Elsevier, Inc. All rights reserved. 10

Turning Persons are turned onto their sides: To help prevent complications from bed rest Ø For certain procedures and care measures Ø The person is turned toward you or away from you. Ø The direction depends on the person’s condition and the situation. After turning the person, position him or her in good alignment. Ø Use pillows to support the person in the side-lying position. Copyright © 2017, Elsevier, Inc. All rights reserved. 11

Turning Persons (Cont. ) Logrolling is turning the person as a unit, in alignment, with one motion. The spine is kept straight. Ø The procedure is used to turn: • Older persons with arthritic spines or knees • Persons recovering from hip fractures • Persons with spinal cord injuries • Persons recovering from spinal surgery Ø Copyright © 2017, Elsevier, Inc. All rights reserved. 12

Sitting on the Side of the Bed (Dangling) Patients and residents sit on the side of the bed (dangle) for many reasons. While dangling the legs, the person: Coughs and deep breathes Ø Moves the legs back and forth in circles Ø Two staff members may be needed. Persons with balance and coordination problems need support. Ø If dizziness or fainting occurs, lay the person down. Ø Copyright © 2017, Elsevier, Inc. All rights reserved. 13

Re-Positioning in a Chair or Wheelchair For good alignment and safety, the person’s back and buttocks must be against the back of the chair. Follow the nurse’s directions and the care plan for the best way to re-position a person in a chair or wheelchair. Ø Do not pull the person from behind the chair or wheelchair. Copyright © 2017, Elsevier, Inc. All rights reserved. 14