POSITIONING, TURNING, MOVING,AND TRANSFERING PATIENTS

INTRODUCTION

RESPONSIBILITY OF HEALTH CARE WORKER

IF PROCEDURES DONE CORRECTLY, PROVIDE PATIENT WITH OPTIMUM COMFORT AND CARE

ALSO HELP WORKER PREVENT INJURY TO SELF

CORRECT BODY MECHANICS ESSENTIAL FOR ANY OF THE PROCEDURES

IF YOU ARE UNABLE TO MOVE OR TURN A PATIENT BY YOURSELF, ALWAYS GET HELP

ALIGNMENT

DEFINED AS POSITIONING BODY PARTS IN RELATION TO EACH OTHER TO MAINTAIN CORRECT BODY POSTURE

DIRECT PATIENT CARE TOWARD MAINTAINING NORMAL BODY ALIGNMENT

CORRECT ALIGNMENT HELPS PATIENT FEEL MORE COMFORTABLE AND PREVENTS FATIQUE

HELPS PREVENT DECUBITIS ULCERS

DECUBITUS ULCERS

ALSO CALLED PRESSURE SORES OR BEDSORES

CAUSED BY PRESSURE ON AN AREA THAT INTERFERES WITH CIRCULATION

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

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

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

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

KEEP LINEN DRY AND FREE FROM WRINKLES

OBSERVE SKIN CAREFULLY DURING BATHING AND TURNING

REPORT PALE OR REDDENED AREAS IMMEDIATELY

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

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

RANGE OF MOTION EXERCISES ALSO HELP PREVENT CONTRACTURES

RANGE OF MOTION IS ABBREVIATED ROM

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

REASONS FOR TURNING FREQUENTLY PROVIDES EXERCISE FOR

MUSCLES STIMULATES CIRCULATION HELPS PREVENT DECUBITIS

ULCERS AND CONTRACTURES PROVIDES COMFORT TO THE

PATIENT

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

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

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

OTHER OBSERVATIONS TO BE MADE CHECK RESPIRATORY RATE CHECK BALANCE AND NOTE

VERTIGO OR DIZZINESS NOTE AMOUNT OF PERSIPRATION

AND COLOR

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

TRANSFERS

PATIENTS TRANSFERRED TO WHEELCHAIRS, CHAIRS, AND STRETCHERS

CORRECT PROCEDURES MUST BE FOLLOWED TO PREVENT INJURY TO BOTH PATIENT AND WORKER

IMPLEMENTATION

PLACE BED IN LOW POSITION RAISE HEAD OF BED ASSIST PATIENT TO DANGLE

MANY DIFFERENT MODELS OF WHEELCHAIRS AND STRETCHERS AVAILABLE

IF NO INSTRUCTIONS ARE AVAILABLE, ASK IMMEDIATE SUPERVISOR TO DEMONSTRATE CORRECT OPERATION

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

REASSURE FRIGHTENED PATIENTS THAT LIFT IS SAFE

MOVE UNNECESSARY FURNITURE OUT OF THE WAY DURING TRANSFERS

PARTICULARLY INPORTANT IN HOME CARE SITUATIONS