copyright © 2008 delmar learning. all rights reserved. unit 15 patient safety and positioning

Copyright © 2008 Delmar Learning. All rights reserved.

Unit 15

Patient Safety and Positioning

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Objectives

• Spell and define terms.• Identify patients who are at risk for

having incidents.• List alternatives to the use of physical

restraints.

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Objectives

• Describe the guidelines for the use of restraints.

• Demonstrate the correct application of restraints.

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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.

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Objectives

• Describe correct body alignment for the patient.

• List the purposes of repositioning patients.

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Objectives

• Demonstrate these positions using the correct supportive devices:– Supine, semisupine, prone, semiprone,

lateral, Fowler’s, and orthopneic

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Objectives

• Demonstrate the following procedures:– Procedure 14 Turning the Patient Toward

You – Procedure 15 Turning the Patient Away

from You

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Objectives

• Demonstrate the following procedures:– Procedure 16 Moving a Patient to the Head

of the Bed– Procedure 17 Logrolling the Patient

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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

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Use of Physical Restraints• In the past

– Restraints were often used routinely as a preventive measure to avoid falls

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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

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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

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Alternatives to the Use of Restraints

• Nursing assistants can take a number of actions to help reduce the need for restraints

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Potential for Side Rail Injury

• Mattresses are sometimes replaced– Replacement may not be as large as the

original mattress

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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

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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

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Potential for Side Rail Injury

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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

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Prevention of Other Incidents

• Some incidents that can be prevented are:– Accidental poisoning– Thermal injuries– Skin injuries– Choking

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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

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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

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Body Alignmentand Positioning

• Body alignment – Means maintaining a person in a position

in which the body can properly function

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Complications of Incorrect Positioning

• Complications can occur when body alignment is not maintained– Or when the patient’s position is not

changed often enough

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Basic Body Positions

• There are four basic positions, each with variations: – Prone– Supine– Lateral– Fowler’s position

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Lateral position

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Fowlers Position

HOB 90 degrees

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Semi-Fowlers PositionHOB 45 degrees

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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

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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

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Chair Positioning

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

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Chair Positioning

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Chair Positioning

• Refer to file entitled “pre-post procedure” – For a review of beginning procedure

actions and procedure completion actions