Body Mechanics, Positioning and Bed Making

1. Body Mechanics, Positioning and Bed Making PN 1 Nursing Skill Labs

2. Physiology of movement • involves skeletal system, muscular system and nervous system • body mechanics is the efficient use of the body as a machine and a means of locomotion • concept of body mechanics includes body alignment or posture, balance, coordinated body movement and postural balance

3. General principles…………... • develop good posture • use the longest and strongest muscles of the arms and legs • use the internal girdle and a long midriff when stooping, reaching, lifting or pulling • work as closely as possible to object • use weight of body as a force for pulling or pushing

4. Before you ambulate the pt………. • assess pt capabilities • administer pain med if needed • plan what you are going to do and make sure you have the right number of helpers, the right equipment etc. • explain to patient what is going to happen and what their role is

5. make sure the area is free of obstacles • elevate bed, lock wheels etc. • watch body mechanics of both you and your patient • protect patient from harm if dependent • avoid friction on patients skin • move smoothly using a rhythmic motion

6. use mechanical devices as indicated but make sure you know how to use them safely !!!! • be realistic about what you can do safely and without injury • dangle patient prior to standing to avoid incidents related to postural hypotension

7. Bed making guidelines • usually only changed as needed ($) or scheduled • consider body mechanics - put bed at proper height for you • tidy room • keep soiled linen away from uniform • don’t put sheets on floor - bring laundry hamper with you if possible

8. check linen for personal belongings!! • dispose of linen in proper containers • make one side then the other • leave bed at safe height • call bell reattached, side rails up PRN • ensure patient is comfortable and safe when you leave room!!!!

9. Making an occupied bed……. • only do this when needed • movement good for pt. so get pt up if possible • make 1/2 the bed, then the other • use side rails for safety • may work side to side or top to bottom depending on patient ability to help

10. Moving the patient up in bed - 1 nurse……. • many patients can assist by using over bed bars, pushing with their feet, using the side rails etc. • Assess the patient’s capabilities before beginning • Be clear when instructing the patient about the move • on count of 3, move with patients help

11. Moving the patient up in bed - 2 nurses…... • explain what you’re doing to patient • raise bed to comfortable position • remove pillow and place at head of bed • place lift sheet under patient • have patient flex knees if able to assist • place pts arms across chest and flex neck

12. stand at pt center point, knee on bed • roll draw sheet in towards pt and grasp firmly • shift your weight as you move patient upwards on count of three • position pt comfortably and leave in safe manner (side rails, call bell etc.)

13. Positioning the head of the bed • Low or semi Fowler’s - 30º head of bed elevation • Fowler’s - semi sitting, 45º -60º • High Fowler’s - 90º head of bed elevation • buttocks bear the main weight of the body so need to be assessed frequently

14. Positioning Patients • prone position: on abdomen, flat on bed, head to side • orthopneic: 90º head, arms rest on overbed table • supine: on back, legs together, sight bend in knee • Sim’s position: S shape, side lying, lower arm behind body, knees bent, upper knee bent more • side lying: lower arm forward

15. Supportive equipment…….. • pillows: support prevent pressure, elevate parts, splints • mattresses: spring, foam, air, pressure, kevlar, water • adjustable beds: heads, height, knee gatch • trapeze bar attached to frame, moving, exercises

16. Supportive equipment…….. • foot boards: prevent plantar flexion or footdrop • cradles: keep weight of sheets off legs • sandbags: prevent external rotation, immobilize a part • trochanter rolls: to support hips from rotating externally