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Positioning Patients - PowerPoint PPT Presentation


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Positioning Patients. THE IMPORTANCE OF ACTIVITY. INCREASES MUSCLE STRENGTH MAINTAINS BODY FLEXIBILITY IMPROVES RESPIRATORY FUNCTION PREVENTS POOLING OF FLUID IN THE LUNGS IMPROVES CIRCULATION HELPS MAINTAIN HEALTHY SKIN PROMOTES EFFECTIVE ELIMINATION AIDS DIGESTION

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Presentation Transcript
slide2

THE IMPORTANCE OF ACTIVITY

  • INCREASES MUSCLE STRENGTH
  • MAINTAINS BODY FLEXIBILITY
  • IMPROVES RESPIRATORY FUNCTION
  • PREVENTS POOLING OF FLUID IN THE LUNGS
  • IMPROVES CIRCULATION
  • HELPS MAINTAIN HEALTHY SKIN
  • PROMOTES EFFECTIVE ELIMINATION
  • AIDS DIGESTION
  • RELIEVES STRESS
slide3

COMPLICATIONS OF BEDREST

EVERY BODY SYSTEM IS AFFECTED

CONTRACTURE

AN ABNORMAL SHORTENING OF THE MUSCLE DUE TO LACK OF USE.

THE MUSCLE IS FIXED INTO POSITION, IS DEFORMED, AND CANNOT STRETCH.

THE PERSON WITH A CONTRACTURE IS PERMANENTLY DISABLED

slide4

ATROPHY

ATROPHY – A DECREASE IN SIZE OR A WASTING AWAY OF MUSCLE TISSUE.

CAUSED BY LACK OF USE

slide5

DECUBITUS ULCER

A BREAKDOWN IN SKIN TISSUE THAT OCCURS WHEN BLOODFLOW TO AN AREA IS INTERRUPTED

slide7

BODY ALIGNMENT

THE TRUNK OF THE PERSON SHOULD BE IN A STRAIGHT LINE WHEN THE PATIENT IS LYING DOWN

slide8

PROPER POSITIONING IN A CHAIR

THE PATIENT IN A CHAIR SHOULD SIT UP STRAIGHT

THE BACKS OF HIS KNEES

SHOULD BE SLIGHTLY AWAY

FROM THE SEAT OF

THE CHAIR

HIS LOWER BACK SHOULD REST AGAINST THE BACK OF THE CHAIR

HIS FEET SHOULD EITHER REST ON THE FLOOR OR ON A STOOL

slide9

RESTORATIVE EQUIPMENT

DESIGNED TO HELP THE PATIENT MAINTAIN CORRECT BODY ALIGNMENT AND PREVENT COMPLICATIONS

BED CRADLE

KEEPS THE WEIGHT OF THE LINENS FROM PRESSING ON THE PATIENT’S BODY

slide10

FOOT BOARD

KEEP THE FOOT IN A NATURAL POSITION TO PREVENT FOOT DROP (PLANTER FLEXION)

slide11

FOOT DROP BOOT

HELPS PREVENT FOOTDROP

slide12

HAND ROLL

PERMITS THE HAND TO FLEX SLIGHTLY AND PREVENTS CONTRACTURES OF THE FINGERS

slide13

ASSISTING IN

POSITIONING AND TURNING

  • IF THE PATIENT IS UNABLE TO CHANGE POSITION INDEPENDENTLY , YOU WILL NEED TO ASSIST .
  • PATIENTS NEED TO BE TURNED EVERY TWO HOURS.
slide14

BASIC BODY POSITIONS

Lateral position

slide15
Fowler’s position is a semi‑sitting position.
    • The spine is kept straight.
    • The head is supported with a small pillow.
    • The arms are supported with pillows.
  • The supine (dorsal recumbent) position is the back‑lying position.
    • The bed is flat.
    • The head and shoulders are supported on a pillow.
    • Arms and hands are at the sides.
slide16
Prone position
    • The person lies on the abdomen with the head turned to one side.
    • The bed is flat.
    • Small pillows are placed under the head, abdomen, and lower legs.
    • Arms are flexed at the elbows with the hands near the head.
  • Lateral position (side-lying)
    • A pillow is under the head and neck.
    • The upper leg, ankle, and thigh are supported with pillows.
    • A pillow is positioned against the person’s back.
    • A small pillow is under the upper arm and hand.
slide17

ORTHOPNEIC POSITION

FREQUENTLY USED BY PATIENTS WITH RESPIRATORY PROBLEMS

HELPS EXPAND THE CHEST AND LUNGS TO ALLOW MORE OXYGEN TO ENTER

moving persons in bed
MOVING PERSONS IN BED
  • Protect the skin when moving the person.
    • Friction is the rubbing of one surface against another.
    • Shearing is when the skin sticks to a surface while muscles slide in the direction the body is moving.
  • To reduce friction and shearing:
    • Roll the person or use assist devices.
    • Use a lift sheet (turning sheet), turning pad, large incontinence product, slide board, or slide sheet.
slide19

SHEARING

THE SKIN STICKS TO THE SURFACE BUT THE INTERNAL STRUCTURES ( BONE AND MUSCLE ) SLIDE IN THE DIRECTION THE BODY IS MOVING

OCCURS WHEN THE PATIENT SLIDES DOWN IN BED

slide20

RAISING THE

PATIENT'S SHOULDERS

slide21

RAISING THE SHOULDERS

WITH TWO HELPERS

slide22

ASSISTING A PATIENT TO MOVE

UP IN BED

IF THE PATIENT CAN ASSIST:

HAVE THE PATIENT GRASP THE HEADBOARD AND BEND HIS KNEES

PLACE YOUR FOREARMS UNDER HIS SHOULDERS AND KNEES

LIFT AT THE COUNT OF THREE

slide23

MOVING UP IN BED

IF THE PATIENT HAS A TRAPEZE ON THE BED HAVE THE PATIENT GRASP THE TRAPEZE AND BEND AT THE KNEES

slide24

USING A LIFT SHEET

A LIFT SHEET MAKES LIFTING EASIER

HELPS PREVENT FRICTION AGAINST THE PATIENT’S SKIN

TAKES TWO WORKERS TO LIFT

IF PATIENT CAN HELP HAVE HIM BEND HIS KNEES

USE FOR PERSONS WHO CAN NOT HELP WITH THE MOVE

slide25

MOVING A PATIENT TO

THE SIDE OF THE BED

THE PERSON IS MOVED IN SEGMENTS

slide28

LOGROLLING

A PATIENT WHO HAS A SPINAL INJURY OR SPINAL SURGERY MUST BE KEPT IN GOOD BODY ALIGNMENT WHEN TURNING.

USING A LIFT SHEET THE PERSON IS TURNED IN ONE MOTION.

IT TAKES 2 OR 3 PERSONS TO SAFELY LOGROLL A PATIENT.

slide29

ASSISTING TO DANGLE

DANGLING REFERS TO SITTING ON THE SIDE OF THE BED WITH THE FEET HANGING DOWN

slide30

DO NOT LEAVE THE PATIENT ALONE WHEN DANGLING.

HAVE THE PATIENT COUGH, DEEP BREATHE, AND EXERCISE THEIR LEG MUSCLES WHEN DANGLING.

IF THE PATIENT BECOMES DIZZY LIE HIM DOWN.

CHECK THE PERSON’S PULSE AND RESPIRATIONS

slide32

DO NOT ALLOW THE PERSON TO PUT HIS ARMS AROUND YOUR NECK

  • MAKE SURE YOU LOCK THE WHEELS ON THE BED AND WHEELCHAIR
slide34

RULES FOR GAIT BELT / TRANSFER BELT

  • APPLY THE BELT AROUND THE PERSON’S WAIST, OVER THE CLOTHING.
  • TIGHTEN THE BELT SO IT IS SNUG. IT SHOULD NOT CAUSE DISCOMFORT OR IMPAIR BREATHING. YOU SHOULD BE ABLE TO SLIDE YOUR OPEN HAND UNDER THE BELT.
  • PLACE THE BUCKLE SLIGHTLY OFF CENTER IN THE FRONT.
  • DO NOT USE WITH PATIENTS WITH FRACTURED RIBS, ABDOMINAL SURGERY, OR HAVING BREATHING DIFFICULTIES
slide36

NOTE THE POSITION OF THE CNA’S HANDS ON THE GAIT BELT

NOTE HIS USE OF PROPER BODY MECHANICS

NOTE THE PLACEMENT OF HIS KNEES AGAINST THE KNEES OF THE PATIENT

slide37

MECHANICAL LIFT

ALSO CALLED

HOYER LIFT

USED TO TRANSFER PATIENTS WHO ARE PARALYZED, VERY HEAVY, OR DIFFICULT TO MOVE

YOU NEED AT LEAST 2 STAFF MEMBERS TO SAFELY USE A MECHANICAL LIFT

slide41

MANY FACILITIES HAVE “NO LIFT” POLICIES.

A SPECIAL LIFT IS USED TO STAND AND MOVE RESIDENTS IF YOUR FACILITY HAS THIS RESTRICTION.

slide44

TRANSFER FROM

BED TO STRETCHER

TAKES 4 OR MORE STAFF

USE A LIFT SHEET OR SLED TO PULL PATIENT OVER ONTO CART

slide46

REPOSITIONING A RESIDENT IN A WHEELCHAIR

  • LOCK THE WHEELS AND MOVE THE FOOTRESTS OUT OF THE WAY
  • DO NOT PULL THE RESIDENT UP BY THE ARMS
  • TO AVOID INJURY TO THE RESIDENT USE TWO STAFF MEMBERS
slide47

SAFETY MEASURES WITH WHEELCHAIRS

  • ALWAYS LOCK THE BRAKES WHEN TRANSFERRING
  • CLEAN THE WHEELCHAIR ON A REGULAR BASIS
  • MOVE THE FOOTRESTS OUT OF THE WAY WHEN TRANSFERRING
slide48

CARDIAC CHAIR

GERI-CHAIR

slide50

TRANSFER THE PATIENT FEET FIRST DOWN A RAMP

ENTER THE ELEVATOR HEAD FIRST