POSITIONING, TURNING, MOVING,AND TRANSFERING PATIENTS

1. POSITIONING, TURNING, MOVING,AND TRANSFERING PATIENTS

2. INTRODUCTION • RESPONSIBILITY OF HEALTH CARE WORKER • IF PROCEDURES DONE CORRECTLY, PROVIDE PATIENT WITH OPTIMUM COMFORT AND CARE • ALSO HELP WORKER PREVENT INJURY TO SELF

3. CORRECT BODY MECHANICS ESSENTIAL FOR ANY OF THE PROCEDURES • IF YOU ARE UNABLE TO MOVE OR TURN A PATIENT BY YOURSELF, ALWAYS GET HELP

4. ALIGNMENT • DEFINED AS POSITIONING BODY PARTS IN RELATION TO EACH OTHER TO MAINTAIN CORRECT BODY POSTURE • DIRECT PATIENT CARE TOWARD MAINTAINING NORMAL BODY ALIGNMENT

5. CORRECT ALIGNMENT HELPS PATIENT FEEL MORE COMFORTABLE AND PREVENTS FATIQUE • HELPS PREVENT DECUBITIS ULCERS

6. DECUBITUS ULCERS • ALSO CALLED PRESSURE SORES OR BEDSORES • CAUSED BY PRESSURE ON AN AREA THAT INTERFERES WITH CIRCULATION

7. COMMON IN AREAS WHERE BONES ARE CLOSE TO SKIN, SUCH AS TAILBONE OR COCCYGEAL AREA, HIPS, KNEES, AND ELBOWS

12. DEVELOPMENT OF DECUBITIS ULCERS • FIRST SIGN IS PALE OR REDDENED AREA ON THE SKIN • VESICLE OR BLISTER MAY FORM AT THE SITE • AS CELLS DIE, SKIN BREAKS DOWN AND AN ULCER OR OPEN SORE DEVELOPS

13. EASIER TO PREVENT DECUBITIS ULCERS THAN IT IS TO TREAT THEM • PROVIDE GOOD SKIN CARE • CLEAN URINE AND FECES FROM SKIN PROMPTLY • MASSAGE IN A CIRCULAR MOTION AROUND A REDDENED AREA

14. APPLY A LIGHT DUSTING OF POWDER TO AREAS WHERE SKIN TOUCHES SKIN TO AVOID FRICTION • TURN PATIENT FREQUENTLY TO CHANGE POSITION • POSITION TO AVOID PRESSURE ON IRRITATED AREAS

15. KEEP LINEN DRY AND FREE FROM WRINKLES • OBSERVE SKIN CAREFULLY DURING BATHING AND TURNING • REPORT PALE OR REDDENED AREAS IMMEDIATELY

16. HELPS PREVENT CONTRACTURES • TIGTHENING OR SHORTING OF A MUSCLE DUE TO LACK OF MOVEMENT OR USAGE OF A MUSCLE • FOOT DROP IS A COMMON CONTRACTURE

17. PREVENT IN PART BY KEEPING FOOT AT RIGHT ANGLES TO THE LEG • USE FOOTBOARDS AND HIGH-TOP TENNIS SHOES TO KEEP FOOT IN THIS POSITION

18. RANGE OF MOTION EXERCISES ALSO HELP PREVENT CONTRACTURES • RANGE OF MOTION IS ABBREVIATED ROM

19. MOVES AND TURNS • PATIENTS WHO ARE CONFINED TO BED MUST BE TURNED FREQUENTLY • POSITION SHOULD BE CHANGED AT LEAST EVERY TWO HOURS IF PERMITTED BY DOCTOR

20. REASONS FOR TURNING FREQUENTLY • PROVIDES EXERCISE FOR MUSCLES • STIMULATES CIRCULATION • HELPS PREVENT DECUBITIS ULCERS AND CONTRACTURES • PROVIDES COMFORT TO THE PATIENT

21. DANGLING • DANGLING MEANS SITTING PATIENT WITH LEGS HANGING DOWN OVER THE SIDE OF THE BED • PATIENT FREQUENTLY PLACED IN THIS POSITION PRIOR TO BEING TRANSFERRED FROM BED IF CONFINED FOR A PERIOD OF TIME

22. PULSE IS CHECKED THREE TIMES DURING PROCEDURE • TAKEN JUST BEFORE PATIENT MOVED TO SERVE AS RESTING OR CONTROL RATE • TAKEN IMMEDIATELY AFTER POSITIONING PATIENT IN DANGLING POSITION • TAKEN AFTER PATIENT HAS RETURNED TO LYING POSITION

23. BY NOTING CHANGES IN PULSE RATE YOU CAN DETERMINE HOW WELL PATIENT TOLERATES PROCEDURE

24. OTHER OBSERVATIONS TO BE MADE • CHECK RESPIRATORY RATE • CHECK BALANCE AND NOTE VERTIGO OR DIZZINESS • NOTE AMOUNT OF PERSIPRATION AND COLOR

25. RETURN PATIENT IMMEDIATELY TO SUPINE IF • EXCESSIVE INCREASE IN PULSE RATE OR WEAK PULSE • SIGNS OF LABORED RESPIRATIONS • COLOR BECOMES PALE OR INCREASED PERSPIRATION NOTED • PATIENT GETS DIZZY OR WEAK

26. TRANSFERS • PATIENTS TRANSFERRED TO WHEELCHAIRS, CHAIRS, AND STRETCHERS • CORRECT PROCEDURES MUST BE FOLLOWED TO PREVENT INJURY TO BOTH PATIENT AND WORKER

28. IMPLEMENTATION • PLACE BED IN LOW POSITION • RAISE HEAD OF BED • ASSIST PATIENT TO DANGLE

29. MANY DIFFERENT MODELS OF WHEELCHAIRS AND STRETCHERS AVAILABLE • IF NO INSTRUCTIONS ARE AVAILABLE, ASK IMMEDIATE SUPERVISOR TO DEMONSTRATE CORRECT OPERATION

30. MECHANICAL LIFTS • FREQUENTLY USED TO TRANSER WEAK OR PARALYZED PATIENTS • READ INSTRUCTIONS PROVIDED • CHECK STRAPS, CLASPS, AND SLING FOR ANY DEFECTS • USE SMOOTH EVEN MOVEMENTS WHILE OPERATING LIFT

31. REASSURE FRIGHTENED PATIENTS THAT LIFT IS SAFE • MOVE UNNECESSARY FURNITURE OUT OF THE WAY DURING TRANSFERS • PARTICULARLY INPORTANT IN HOME CARE SITUATIONS