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Moving and Transferring Clients On Bed

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47 views38 pages

Moving and Transferring Clients On Bed

Uploaded by

milescoduco
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Moving and turning

clients in bed
Moving Clients Up in Bed
 Ill
people have difficulty moving,
even in bed
 Assistance require depends on their

own (ill people) ability to move and


their health status
 Nurses should be sensitive to the

need of people to function


independently, and their need for
assistance to move.
 Thenurse assists a person to move,
correct body mechanics needs to be
employed to avoid injury.
 Theclient must be maintained in
correct body alignment so that
undue stress is not placed on the
musculoskeletal system
Moving and lifting clients
Moving and lifting clients
 1. Before moving a client assess:
 the degree of exertion permitted,
 the client’s physical abilities (e.g.,

muscle strength, presence of


paralysis),
 ability to assist with the move,
 ability to understand instructions,
 Degree of comfort or discomfort

when moving
 Client’s weight
 Presence of orthostatic hypotension
 Nurses’ strength and ability to move

the client
Moving and lifting clients
(cont’d)
 2. If indicated, use pain relief
modalities or medication prior to
moving the client.
 3. Prepare any needed assistive

devices and supportive equipment


(e.g., pillows, trochanter roll).
Moving and lifting clients
(cont’d)
 4. Plan around encumbrances to
movement such as IV or heavy cast
 5. Be alert to the effects of any

medications the client takes that


may impair alertness, balance,
strength, or mobility.
Moving and lifting clients
(cont’d)
 6. Obtained required assistance from
other persons.
 7. Explain the procedure to the client

and listen to any suggestions the


client or support people have.
 8. Provide privacy
 9. Wash hands.
 10. Raise the height of the bed to

bring the client close to your center


of gravity.
 11. Lock the wheels on the bed, and

raise the rail on the side of the bed


opposite you to ensure client’s safety
Moving and lifting clients
(cont’d)
 12. Face in the direction of the
movement to prevent spinal twisting.
 13. Assume a broad stance to

increase stability and provide


balance
 14. Lean your trunk forward, and flex

your hips, knees, ankles, to lower


your center of gravity, increase
stability, and ensure use of large
muscle groups during movements.
Moving and lifting clients
(cont’d)
 15. Tighten your gluteal, abdominal,
leg, and arm muscles to prepare
them for action and prevent injury
 16. Rock from the front leg to the

back leg when pulling or from the


back leg to the front leg when
pushing to overcome inertia,
counteract the client’s weight, and
help attain a balanced, smooth
motion
17. After moving the client, determine
and document:
 the client’s comfort (presence of anxiety,

dizziness, or pain),
 body alignment,
 tolerance of activity (check pulse rate, BP)
 ability to assist,
 use of support devices
 safety precautions required (e.g., side

rails)
 Read skills on moving and turning
clients in bed and helping them to sit
up on the edge of the bed. (Skills 44-
1 through 44-4)
 Log rolling
Logrolling
 Logrolling is a technique used to turn a
patient whose body must at all times be
kept in a straight alignment (like a log).
 Used for the patient who has a spinal

injury.
 Used for the patient who must be turned

in one movement, without twisting.


 Requires two people, or if the patient is

large, three people.


Technique: Logrolling
 1. Wash your hands.
 2. Approach and identify the patient

(by checking the identification band)


and explain the procedure (using
simple terms and pointing out the
benefits).
 3. Provide privacy.
 4.Position the bed.
a. The bed should be in the flat position at
a comfortable working height.
b. Lower the side rail on the side of the
body at which you are working.
 5. Position yourself with your feet apart and
your knees flexed close to the side of the
bed.
 6. Fold the patient's arms across his chest.
 7. Place your arms under the patient so

that a major portion of the patient's weight


is centered between your arms. The arm of
one nurse should support the patient's
head and neck.
 8. On the count of three, move the patient
to the side of the bed, rocking backward
on your heels and keeping the patient's
body in correct alignment.
 9. Raise the side rail on that side of the

bed.
 10. Move to the other side of the bed.
 11. Place a pillow under the patient's head

and another between his legs.


 12. Position the patient's near arm toward
you.
 13. Grasp the far side of the patient's body

with your hands evenly distributed from


the shoulder to the thigh.
 14. On the count of three, roll the patient

to a lateral position, rocking backward


onto your heels.
 15. Place pillows in front of and behind the
patient's trunk to support his alignment in
the lateral position.
 16. Provide for the patient's comfort and

safety.
◦1 Position the call bell.
◦2 Place personal items within reach.
◦3 Be sure the side rails are up and
secure.
 17. Report and record as appropriate.
Transferring clients
between bed and wheel
chair and
vice versa
Transferring Clients
 The nurse must determine the
client’s physical and mental
capabilities to participate in the
transfer technique
 The nurse must analyze and organize

the activity
General guidelines for transfer
techniques
 1. Plan what to do and how to do it.
* determine the space in which the transfer
is maneuvered (e.g., bathrooms are
usually cramped);
* determine the number of assistants
needed to accomplish the transfer safely
* the skills and strength of the nurse(s), and
* client’s capabilities
General guidelines (cont’d)
 2. Obtain essential equipment before starting
(e.g., wheelchair, transfer belt), and check
its function
 3. Remove obstacles from the area used for
the transfer.
 4. Explain the transfer to the client, including
what the client should do
 5. Explain the transfer to the nursing
personnel who are helping; specify who
will give directions (one person needs to be in
charge
General guidelines (cont’d)
 6. Always support or hold the client
rather than the equipment and ensure
the client’s safety and dignity.
 7. During transfer, explain step by step

what the client should do, for example,


“Move your right foot forward”
 8. Make a written plan of the transfer,

including the client’s tolerance (e.g.,


pulse and respiratory rates)
Clinical Alert
 Wheelchair and stretchers are unstable,
they can predispose the client to falls and
injury.
 Transfer (walking) belts provide the greatest

safety
 The nurse grasps the belt to control

movement of the client during transfer


Guidelines for the safe use of
wheelchairs
 Always lock the brakes on both wheels
of the wheelchair when the client transfer in
or out of it.
 Raise the footplates before

transferring the client into the wheelchair


 Lower the footplates after the transfer

and place the client’s feet on them.


 Ensure that client is positioned well

back in the seat of the wheelchair


Safe use of wheelchairs (cont’d)
 Use seat belts that fasten behind the
wheelchair to protect confused clients from
falls.
Note: seat belts are a form of restraint and
must be used in accordance with policies
and procedures that apply to the use of
restraints.
 Back the wheelchair into or out of an

elevator, rear large wheels first.


 Place your body between the wheelchair

and the bottom of an incline


Safe use of Stretchers
 Lock the wheels of the bed and stretcher
before the client transfers in or out of them
 Fasten safety straps across the client on a

stretcher and raise the side rails.


 Never leave the client unattended on a

stretcher unless the wheels are locked, and


the side rails are raised on both sides and/or
the safety straps are securely fastened
across the client
Safe use of Stretchers
(cont’d)
 Always push a stretcher from the end where
the client’s head is positioned. This position
protects the client’s head in the event of a
collision (clash or crash).
 If the stretcher has two swivel wheels and
two stationary wheels:
a. Always positioned the client’s head at the
end of the stationary wheels and
b. Push the stretcher from the end with the
stationary wheels. The stretcher is
maneuvered more easily when push from this
end
Safe use of Stretchers
(cont’d)
 Maneuver the stretcher when entering the
elevator so that the client’s head goes in
first.
End of Presentation
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