Body Mechanics and Safety

1. Body Mechanics and Safety Fundamentals Unit 4

2. Body Mechanics and Safety • Describe what “base of support” means… • Area of the body that comes into contact with the surface upon which it rests • Describe what “center of gravity” means… • Point of the body at which mass is centered • Describe what “line of gravity” means… • Imaginary vertical line that passes through the center of gravity

3. Body Mechanics and Safety • Good posture and our anatomy • The vertebrae • The discs • The nerves • The large muscle groups

4. Body Mechanics and Safety • Moving and lifting principles • Bend the knees and keep back straight • Get as close to the work as possible • Use ladders or stepstools • Carry objects close to the body • Avoid twisting with a load • Avoid sudden jerking movements • Slide, roll, or pivot to avoid lifting • Use your body weight to help push or pull • Face the work to be done • DON’T BE AFRAID TO ASK FOR HELP

5. Body Mechanics and Safety • How do we use proper body mechanics when… • We are standing? • We are sitting? • We are bending and lifting? • We are reaching for an object? • We are adjusting the bed to a comfortable work level? • We are adjusting an overbed table? • We are using a turning sheet? • We are logrolling a patient? • Logrolling video • We are assisting a patient to dangle? • We are transferring a patient to a chair or wheelchair? • We are assisting a patient that cannot bear weight or help?

6. Body Mechanics and Safety • Ambulating a patient • Dangle first • Support the patient on the weak side • Do not allow to become fatigued • Walkers and canes • A cane is held on the strongest side • Crutches • Measuring • There are nerves in the axilla, watch out for brachial paralysis • Crutch gaits • Steps

7. Body Mechanics and Safety • What safety measures are used with crutches? • Rubber tips • Do not rest on axilla to avoid brachial paralysis • Watch out for loose rugs • Good shoes • Do not hold on to the crutches for the patient • Proper pt. body alignment

8. Body Mechanics and Safety • Devices used to transfer the patient- transfer belt, hoyer lift, transfer board, draw sheet • How shall I assist a falling patient?- pull patient back against hip/thigh and ease to floor • Transferring a patient to a stretcher- use slideboard or draw sheet • Using different types of mechanical lifts- Hoyer, Sit to stand

9. Body Mechanics and Safety Actions which ensure a Patient’s Safety • To prevent falls I will… • To prevent burns I will… • To prevent asphyxiation I will… • To prevent poisoning I will… • To prevent misidentification I will… • To prevent pathogen spread I will… • Who is at risk for falls? • We can’t say enough about FALL PREVENTION!

10. Body Mechanics and Safety • There are many types of safety devices… • We should limit our use of restraints to specific indications: • Fall prevention • Maintenance of necessary medical equipment • Patient protection • Protection of others We must focus on protection and prevention of injury. Alternatives must be considered first.

11. Body Mechanics and Safety • Search for possible problems • Try to discover the cause of agitation • Try to discover the cause of confusion • Consider the need for more movement • Identify the risk for falls • Alternatives to restraints are… • Calming measures • Eliminating confusion • Provide the maximum amount of movement • Institute fall prevention measures

12. Body Mechanics and Safety Safety Devices • How are we going to plan for safety devices? • Have a doctor’s order • Obtain family consent • Use the least restrictive type • Give a complete explanation why device is to be used • Remove as soon as possible

13. Body Mechanics and Safety Safety Devices • How should we implement safety devices correctly? • Place pt. in proper body alignment • Use extreme care while pt. is positioned on the back • Do not fasten too tightly • Pad bony prominences • No two skin surfaces may touch • Do adequate circulation and respiratory checks

14. Body Mechanics and Safety • How should we implement safety devices correctly? • Tie to the bedframe, not the siderails • Tie that the device may be loosened quickly • Provide food and fluids • Offer toileting and ROM at frequent intervals • Loosen the device at least every two hours • Provide circulatory checks every two hours • Document all actions, with assessment of skin

15. Body Mechanics and Safety • What is included in circulatory checks? • Color • Temperature • Sensation – pain, numbness, or tingling • Movement • Pulses • Capillary refill • Swelling

16. Body Mechanics and Safety Safety Devices • Applying Safety Devices • Limbs • Mittens • Belts • Vest or jackets • Crotch

17. Wrist Restraints Mitten Restraints

18. Vest Restraint Belt Restraint

19. Body Mechanics and Safety • Handling an incident. • We will need to fill out an incident report… • Let’s practice.

20. Body Mechanics and Safety • 6 Benefits To Exercise • Cardiovascular • Respiratory • Gastrointestinal • Musculoskeletal • Skin and nerves • Psychological

21. Body Mechanics and Safety • Factors restricting mobility are… • Temporary • Permanent • Degrees of mobility • The 3 categories of immobility are… • Therapeutic • Unavoidable • Voluntary

22. Body Mechanics and Safety There are problems related to immobility • Cardiovascular-venous stasis or pooling of the blood within the veins • Respiratory-pooling of secretions and decreased lung expansion • Gastrointestinal-slows down, affecting elimination and metabolism • Musculoskeletal-muscle and joint function loss • Integumentary- skin breakdown • Urinary-urine pool in the bladder (UTI) • Psychological-sleep, depression, anger, decreased coping

23. Body Mechanics and Safety Here are some nursing interventions to prevent or decrease the effects of immobility… • Range of Motion- maintain muscle and joint function • Positioning- prevents pooling of body fluids • Therapeutic devices- aid in care of the immobile • Environmental stimulation- talking with and listening to the patient, encourage visitors • Patient and family teaching- stress the importance of interventions Lets practice ROM!

24. Body Mechanics and Safety

25. Body Mechanics and Safety Therapeutic devices used Anti-embolism Stockings

26. Body Mechanics and Safety Skin Breakdown • Let’s make a list of risk factors in skin breakdown… • Moisture- urine, feces, perspiration, wounds • Poor Nutrition- body lacks necessary nutrients • Anemia- less oxygen to tissues • Body Heat- increased perspiration, higher oxygen and nutrient demands • Friction and Shear- Friction: rubbing action ovet the surface of the skin/Shear: friction and pressure occurring when two layers of tissue slide together • Irritating Substances- wrinkles in linens, crumbs • Mental Status- unable or unwilling to cooperate • Mobility- patients ability to move

27. Body Mechanics and Safety Areas of skin breakdown are…

28. Body Mechanics and Safety Skin Breakdown • Methods to prevent skin breakdown are… • Frequent turning and repositioning • Thorough skin care • ROM • Therapeutic devices • Attention to bedmaking • Avoid friction and shear • Adequate nutrition • Thorough skin assessment

29. Body Mechanics and Safety • There are several stages of skin breakdown. • Positioning for comfort • All positions require good body alignment • Joints must be well supported • Joints are in a position of function • What are some positions for patient comfort? • Supine • Prone • Lateral • Sim’s • Fowler’s

30. Body Mechanics and Safety Supine

31. Body Mechanics and Safety Prone

32. Body Mechanics and Safety

33. Body Mechanics and Safety

34. Body Mechanics and Safety Fowler’s

35. Body Mechanics and Safety

36. Body Mechanics and Safety • Decubitis Ulcers: Stage I:Reddness to the skin that does not fade when pressure is removed

37. Body Mechanics and Safety • Decubitis Ulcers: Stage II:Reddness with edema or a blistered area

38. Body Mechanics and Safety • Decubitis Ulcers: Stage III: Involves a break in the skin with subcutaneous tissue exposed

39. Body Mechanics and Safety • Decubitis Ulcers: Stage IV: Involves all layers of the skin and may involve bone.