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Unit 15

Unit 15. Patient Safety and Positioning. Objectives. Spell and define terms. Identify patients who are at risk for having incidents. List alternatives to the use of physical restraints. Objectives. Describe the guidelines for the use of restraints.

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Unit 15

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  1. Unit 15 Patient Safety and Positioning

  2. Objectives • Spell and define terms. • Identify patients who are at risk for having incidents. • List alternatives to the use of physical restraints.

  3. Objectives • Describe the guidelines for the use of restraints. • Demonstrate the correct application of restraints.

  4. Objectives • Describe two measures for preventing these types of incidents: • Accidental poisoning, thermal injuries, skin injuries, and choking • List the elements that are common to all procedures.

  5. Objectives • Describe correct body alignment for the patient. • List the purposes of repositioning patients.

  6. Objectives • Demonstrate these positions using the correct supportive devices: • Supine, semisupine, prone, semiprone, lateral, Fowler’s, and orthopneic

  7. Objectives • Demonstrate the following procedures: • Procedure 14 Turning the Patient Toward You • Procedure 15 Turning the Patient Away from You

  8. Objectives • Demonstrate the following procedures: • Procedure 16 Moving a Patient to the Head of the Bed • Procedure 17 Logrolling the Patient

  9. Patient Safety • In Unit 14 • You learned how to maintain a safe environment and avoid personal injuries • The prevention of patient injuries is another very important part of your job as a nursing assistant

  10. Use of Physical Restraints • In the past • Restraints were often used routinely as a preventive measure to avoid falls

  11. Use of Physical Restraints • Research has shown that side rails and other restraints do not necessarily accomplish this purpose • Restraints may be used for other preventive measures

  12. Alternatives to the Use of Restraints • Alternatives to restraints should be tried before restraints are applied • Restraints are used only as a last resort in situations in which a patient may harm himself or herself or others

  13. Alternatives to the Use of Restraints • Nursing assistants can take a number of actions to help reduce the need for restraints

  14. Potential for Side Rail Injury • Mattresses are sometimes replaced • Replacement may not be as large as the original mattress

  15. Potential for Side Rail Injury • Gaps between the mattress and bed frame or rails • Can be caused by movement or compression of the mattress due to patient weight, movement, or bed position • Refer to Figures 15-10A and 15-10B

  16. Potential for Side Rail Injury • If you observe a gap that is wide enough to entrap a patient’s head or body part • Inform the nurse promptly

  17. Potential for Side Rail Injury

  18. Prevention of Other Incidents • Many situations can result in an incident that may harm a patient • Incidents can be prevented when all staff members are aware of appropriate preventive measures

  19. Prevention of Other Incidents • Some incidents that can be prevented are: • Accidental poisoning • Thermal injuries • Skin injuries • Choking

  20. Introduction to Procedures • Caring for patients safely means that you must faithfully and carefully carry out specific routines • The normal manner of carrying out a task is called a procedure

  21. Body Mechanics for the Patient • Body mechanics for the patient • Similar to those for the health care team • Although the patient probably will not be doing any lifting • Good posture habits should not be neglected

  22. Body Alignmentand Positioning • Body alignment • Means maintaining a person in a position in which the body can properly function

  23. Complications of Incorrect Positioning • Complications can occur when body alignment is not maintained • Or when the patient’s position is not changed often enough

  24. Basic Body Positions • There are four basic positions, each with variations: • Prone • Supine • Lateral • Fowler’s position

  25. Lateral position

  26. Fowlers Position HOB 90 degrees

  27. Semi-Fowlers Position HOB 45 degrees

  28. Positioning the Patient • After you have turned and moved the patient into proper body alignment • Place pillows and other supportive devices to help the patient maintain the position • Instructions are provided in the textbook for the four basic positions and their variations

  29. Chair Positioning • Proper chair positioning begins with the feet • Feet should be supported on the floor or wheelchair footrests • Support the patient in the 90-90-90 position while sitting in the chair • Refer to Figure 15-40B

  30. Chair Positioning • Remember that repositioning and pressure relief are needed when the patient is up in the chair

  31. Chair Positioning

  32. Chair Positioning • Refer to file entitled “pre-post procedure” • For a review of beginning procedure actions and procedure completion actions

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