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 • Moving persons in bed 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 • Eliminating manual lifting when possible 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 • The amount of assistance needed • What procedure to use • The equipment needed Copyright © 2017, Elsevier, Inc. All rights reserved. 4

Moving Persons in Bed 5 • 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 • 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 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.

Moving Persons in Bed (Cont. ) • Protecting the skin • 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. • 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. • It is best to have help with older persons and with those who are heavy or hard to move. 7

Moving Persons in Bed (Cont. ) Moving the person up in bed • The person is moved up in bed for good alignment and comfort. • 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. • Two or more staff members are needed to move heavy, weak, and very old persons up in bed. • Always protect the person and yourself from injury. 8

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

Moving Persons in Bed (Cont. ) • Moving the person to the side of the bed • 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. • With at least one co-worker, use a mechanical lift or an assist device: • Following guidelines • For older persons • For persons with arthritis • For persons recovering from spinal cord injuries or spinal cord surgery 10

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

Turning Persons (Cont. ) 12 • Logrolling is turning the person as a unit, in alignment, with one motion. • The spine is kept straight. • 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

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 • Moves the legs back and forth in circles • Two staff members may be needed. • Persons with balance and coordination problems need support. • If dizziness or fainting occurs, lay the person down. 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. • Do not pull the person from behind the chair or wheelchair. Copyright © 2017, Elsevier, Inc. All rights reserved. 14