Body Mechanics, Patient Mobility and Safety - PowerPoint PPT Presentation

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Body Mechanics, Patient Mobility and Safety

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  1. Body Mechanics, Patient Mobility and Safety PN 103

  2. Body Mechanics Body Mechanics -field of physiology that studies the muscular action and the function of muscles in maintaining the posture of the body

  3. Body Mechanics The musculoskeletal system must be protected to prevent injury to the patient and the nurse -maintain a wide base of support -bend the knees and hips rather than the back -stand in front of the object -adjust the working live to comfort -carry objects close to the midline of the body

  4. Positioning Patients There are many positions to use to prevent patients from developing complications Dorsal (supine) -lying horizontal on the back

  5. Positioning Patients Dorsal recumbent -supine position with the patient lying on back, head, and shoulders, with extremities moderately flexed, legs my be extended

  6. Positioning Patients Fowlers -Head of the bed is raised 45-60 degrees Semi-Fowlers Head of the be is raised 30 degrees

  7. Positioning Patients Orthopnic -Sitting up in bed at 90 degree angle, sometimes resting forward supported by pillows on an overbed table Sims -lying on side and the knees and thighs drawn upward toward the chest

  8. Positioning Patients Prone position -horizontal position when lying face down Lithotomy -lying supine with hips and knees flexed and thighs abducted and rotated externally

  9. Positioning Patients Trendelenberg -head low and body and legs elevated on an incline

  10. Mobility vs. Immobility Mobility - a person’s ability to move around freely in his/her environment Serves many purposes -express emotion -self-defense -attain basic needs -preform recreational activities -preform activities of daily living (ADLs) -maintain the body’s normal physiological activities

  11. Mobility vs. Immobility Immobility -Inability to move freely Complications of immobility -muscle and bone atrophy -contractures, pressure ulcers -constipation, urinary tract infections -disuse osteoporosis, kidney stones -pneumonia, pulmonary embolism, postural hypotension -anorexia, insomnia -asthenia -disorientation

  12. Moving the Patient -lifting the patient up into the bed -to the side of the bed -to the tub -into the car -turning, dangling -assisting the patient in and out of the bed for ambulation

  13. Moving the Patient Mechanic equipment for lifting patients -Hydraulic lift (Hoyer) -Roller board -Gurney lift

  14. Moving the Patient Lift TWICE -once mentally -once physically Be certain to have sufficient assistance Assess the patient’s ability to assist with moving If moving is painful for the patient, the patient needs to be medicated for pain BEFORE the activity

  15. Moving the Patient

  16. Using a Lift for Moving Patients Hydraulic lift with a Hoyer sling -moves patients safely -protects the nurses back -provide full weight lifting of patients who can’t assist

  17. Ambulation Ask the patient to sit on the side of the bed with legs dangling until they are accustomed to the upright position Be prepared to take any equipment needed (O2, IV) BE SAFE!! Get assistance if the patient is unsteady -non-skid footwear -glasses/hearing aide -use gait belt as needed

  18. Ambulation Documentation -length of ambulation (distance and time) -patient’s response to ambulation/exercise

  19. Gait Belts Added safety feature in transferring/ ambulating patients -apply gait belt securely around the patient’s waist -walk to the weaker side of the patient when ambulating -one arm around the patient’s waist and hand on the belt -the patient can support him/herself by leaning or holding onto the nurse’s arm - the nurse should walk with his/her closest leg just behind the patient’s knee -walk with knees and hips flexed

  20. Safe Environment Freedom from injury -preventing falls -electrical injuries -fires/burns -poisonings The nurse must be aware of potential safety problems and must know how to report and respond when safety is threatened

  21. Safe Environment Who is responsible to maintain a safe environment? -the patient -visitors -members of the health care team Protection and education are primary nursing responsibilities

  22. Safe Environment Left handed patient -a typical hospital room is set up to accommodate the right handed person -left handed patients may struggle and strain to cope by contorting the body, which creates a “risk for injury” situation -document in the chart that the patient is left handed

  23. Safe Environment Left handed patient -place bathing articles at the patient’s left -allow the patient to turn right during back care -place the drainage bag for the indwelling catheter to the patient’s left -when ambulating walk of the patient’s left side -use the patient’s right hand/arm for IVs/injections -allow patients more time to master skills -adjust the patient’s environment by placing the bed stand, table, and call light to the patient’s left

  24. Falls Majority of falls happen during transfers either to a bedside commode or wheelchair High risk -the very old -patients over 65 years old -individuals who are ill or injured Unfamiliar environments and various signs and symptoms associated with the patient’s diagnosis may put the patient at risk

  25. Safe Environment Infants and Children -Ensuring the safety of the environment of infants and children requires protection of the child and education of the parents -Most accidents are preventable -parents/caregivers need to be aware of the specific dangers at each stage of development

  26. Safe Environment Older Adults -Changes associated with aging significantly affect the ability of older adults to protect themselves from injury -unsteadiness in gait can cause falls -vision changes may affect the ability to see the height of stairs -vertigo may occur due to disease and/or medications

  27. Hospital/Health Care Environment The hospital environment is a source of potential safety hazards for health care workers -Biological, chemical, and physical hazards -Laser -Blood/body fluids -Contaminated needles -Radiation -Vaccine-preventable diseases

  28. Hospital/Health Care Environment National Institute of Occupational Safety and Health (NIOSH) -Focuses on safety and issues related to health Hazard Communication Act of the Occupational Safety and Health Administration (OSHA) -National organization that provides guidelines to help reduce safety hazards in the workplace -Requires hospitals to inform employees about the presence of or potential for harmful exposure and how to reduce the risk of exposure

  29. Hospital/Health Care Environment Centers for Disease Control and Prevention (CDC) -Federal agency that provides facilities and services for the investigation, identification, prevention, and control of disease -Provides guidelines for working with infected patients

  30. Fire Safety -Fire in the health care facilities are often related to smoking in bed or faulty electrical equipment -An established fire safety program is mandatory for all health care facilities -Fire prevention includes good housekeeping, maintenance, and employee discipline

  31. Fire Safety -All employees should know the telephone number and procedure for reporting a fire, as well as the location of the firefighting equipment -Health care workers must know their role in the overall evacuation plan

  32. Fire Safety Type of fire extinguishers -Type A -paper, wood or cloth fires -Type B -flammable liquid fires (grease, anesthetics) -Type C -electrical -Type ABC any type of fire

  33. Fire Safety Patients in immediate danger should be rescued, and then the facility’s procedure should be followed for activating the fire alarm and reporting the location and extent of the fire Measures should then be take to contain or extinguish the fire if there is no immediate threat to safety -close doors and windows, turn off the oxygen and electrical equipment, and use appropriate fire extinguisher

  34. Fire Safety Use the mnemonic RACE to set priorities in care of fire R -Rescue and remove all patients in immediate danger A -Activate the alarm C -Confine the fire E –Extinguish the fire using an extinguisher

  35. Fire Safety Using a fire extinguisher P Pull the pin A Aim at the base of the fire S Squeeze the handle S Sweep the fire side to side

  36. Disaster Planning Disaster situation -an uncontrolled, unexpected, psychologically shocking event -earthquakes, hurricanes, floods, tornados, bombings, arson, riots and hostage-taking -healthcare facilities are expected to receive victims and survivors and to assist rescuers

  37. Disaster Planning External and Internal Disaster -external disaster originates outside the health care facility and results in an influx of casualties brought to the facility -internal disaster represents an extraordinary situation that is brought about by events within the health care facility

  38. Disaster Planning Disaster planning represents the means by which health care facilities and personnel meet the responsibilities associated with managing the disaster Disaster Manual -specifies departmental responsibilities: chain of command, callback procedures, assignment procedure, patient evacuation procedure and routes procedures for the receipt and management of casualties, and policies related to the overall management of supplies and equipment

  39. Accidental Poisoning Childhood poisoning is one of the major causes of death in children under 5 years of age The older adult is also at risk -changes associated with aging interfere with the individual’s ability to absorb or excrete drugs -the older adult may share drugs with friends -changes in eyesight may lead to an accidental ingestion

  40. Accidental Poisoning Hospitalized patients and those in other types of health care facilities can be at risk for accidental poisoning because there are many poisonous substances in the environment -cleaning solutions -disinfectants -drugs

  41. Accidental Poisoning Preventing Poisoning -remove toxic agents from areas where poisoning could occur -toxic or poisonous substance should not be remove from their original containers -poisonous substances should be labeled conspicuously and stored appropriately Poison control centers are a valuable source of information when poisoning is suspected or does occur.