Fundamentals Of Nursing

1. Fundamentals Of Nursing Moving the client in & out of bed  Presented by: MS. AHDAB FAISAL ESKANDAR

3. OBJECTIVES Differentiate between manual and assistive technique . Enumerate the common purposes for moving client. Assess client`s status needs and environment . Mention required equipment. Demonstrate the steps of each procedure .

4. OUTLINE: Introduction Purpose of moving client Needed assessment Required equipment Types of transfer Procedure transfer Conclusion Reffrance

5. Introduction *ill people usually have difficulty moving in bed. How much assistance clients required depends on? *Nurse should be sensitive to both the need of people to function independtly andtheir need for assistance to move.

6. Purpose Maintains body alignment Maintains skin integrity and facilitates pressure distribution prevent friction and shear on tissue Promote comfort Promote optimal lung expansion Prevent injury and deformities of musculoskeletal system Position clients for a variety of clinical procedures

7. Before moving a client assess the following : • Clients weight, age and medical diagnosis. • Client physical abilities (e.g. muscle strength ,presence of paralysis). • Clients ability to understand instructions.

8. Assessments cont: • Integumentary and musculoskeletal assessment. • Doctor orders for specific restrictions in positioning client • surrounding area and attached equipment such as( IV-urinary catheter-drain etc) • Nurse strength and types for assistance

9. EQUIPMENTS: • Support devices required by clients(e.g. • Draw sheet • Sliding sheet • Foot board • Sandbags • Hand rolls • Foam wedges • Pillows for head ,extra pillows • Gloves

10. Slide sheet ( made from low friction material ) Bed pole (trapeze) and leader Transfer ( walking) belt Wedges

11. Lifting machine

12. Types of transfer DEPENDENT TRANSFERS Before specially adapted equipment for transfers was introduced, hospitals had to rely on dependent manual techniques to get the patient in and out of bed.

13. Assisted transfer • Overhead lifts. • Manual lifts Overhead lifts can be used to aid in the transfer of medically fragile patients. Often they are permanently mounted to the ceiling with a secure rail system.

14. PROCEDURE

16. Moving client up in bed Equipment:pull sheet or sliding bar. Purposes: clients slide down or being pulled by traction Preparation:determine(assistive device-attached IV or heavy cast-medications-assisted personal)

17. Moving client up in bed • Performance: • Explain to the client and listen for his questions • Wash hands and provide privacy • Lower head of the bed and raise the bed to your center of gravity • lock the wheels and raise the side rail opposite to you

18. Performance cont: • Remove the pillows and place one only against the head of the bed • Ask client to flex hips and knees and position feet so that they can be used for pushing • Ask client to :- • Grasp the head of the bed with both hands and pull during move or • Raise upper part of body on elbows and push with hands and forearm during the move

19. Two nurses using a hand interlock Two people required to move clients who are unable to assist because of their condition or weight. The second staff member on the opposite side of bed, both of you interlock your forearm under clients thighs and shoulders and lift client up in bed

21. Other methods for moving client up in bed • Upper extremities: • Flex hips and knees • Arms across chest • Flex neck during movement • Place one arm under clients back and shoulders and other under clients thigh • Shift your weight • two nurses using turn sheet.

22. ASSISTING CLIENT TO SIT ON SIDE OF BED • Purpose:before walking, moving to chair, eating or performing other activates • Performance : • Assist client to lateral position facing you • Raise head of bed slowly to highest position

23. Assisting client to sit on side of bed • Stand beside clients hips and face far corner of bed • Lean your trunk forward and flex your hips , knees and ankles • Move client to sitting position (place one arm around client shoulder and other beneath both clients thigh near knees • Tighten your muscles and lift client thighs slightly

25. continue • Pivot on balls of your feet in desired direction facing foot of bed while pulling client feet and legs off bed ( prevent twisting of nurse supine) • Support client well ( this movement may cause some clients to faint ) • Assess vital signs as indicated by clients health status

26. Logrolling client • Purpose: to turn client whose body most all times be kept in straight alignment • Performance: • Stand on the same side of bed and broad base of support with on foot ahead of other • Place clients arms across chest • Lean your trunk and flex your hips knees and ankles

27. Logrolling • Place your arm under client • Pull client to the side of the bed • Move to the other side and place supportive devices • Roll and position clients in proper alignment

31. TRANSFARING BETWEEN BED AND CHAIR • Equipment : appropriate clothes and slipper –transfer belt • Preparation : • Plan of what to do and how to do it • Obtain equipment and check for function well • Remove obstacles from areas • Performance: • Place wheelchair parallel to bed as close as possible and lock the wheels and raise the foot plate .

33. continue • Assist client to sitting position on side of bed • Place transfer belt around the waist of clients • Ask client to • move forward and sit on the edge of bed • lean forward slightly from hips • Place strong foot beneath edge of bed and the other forward • Place client hands on bed surface or on your shoulders( so they can push while standing ) • Mirror the placement of the clients feet (prevent loss of balance during transfer)

34. continue • Encircle clients waist with your arms and grasp the belt at client back • Assist the client to stand, and then move together toward the wheelchair • Assist the client to sit.

36. Transferring from bed to chair Ask the client to: • Back up to the wheelchair and place the legs against the seat • Place the foot of the stronger leg slightly behind the other • Keep the other foot forward • Place both hands on the wheelchair arms or on your shoulders • Ask the client to push back into the wheelchair seat. • Lower the footplates, and place the client’s feet on them

37. TRANSFERRING BETWEEN BED AND STRETCHER • Performance: • Lower the head of the bed • Raise the bed slightly higher than the stretcher (easier for client to move down ) • Pull draw sheet out from both sides of bed • Place the stretcher parallel to bed and fill the gap with blankets • Roll the sheet against client ,flex hips and pull onto stretcher • Ask client to flex neck and place arms across chest • Ensure clients comfort and raise the side rails of stretcher

38. Documentation Document all relevant information:-  • Time and change of position moved from and position moved to • Any signs of pressure areas • Use of support devices • Ability of client to assist in moving and turning • Response of client to moving and turning

39. Conclusion

40. ? Any question

41. References • Fundamentals of nursing concepts ,process and practice,7th edition written by kozier 2005 • Nurses guide to clinical procedures 5th edition written by jean smith temple and Joyce young Johnson 2007 • http://www.rehabpub.com/features/892005/3.asp • http://www.independentliving.co.uk/manual-handling.html

42. Thank you