Unit 15 Patient Safety and Positioning
Objectives • Spell and define terms. • Identify patients who are at risk for having incidents. • List alternatives to the use of physical restraints.
Objectives • Describe the guidelines for the use of restraints. • Demonstrate the correct application of restraints.
Objectives • Describe two measures for preventing these types of incidents: • Accidental poisoning, thermal injuries, skin injuries, and choking • List the elements that are common to all procedures.
Objectives • Describe correct body alignment for the patient. • List the purposes of repositioning patients.
Objectives • Demonstrate these positions using the correct supportive devices: • Supine, semisupine, prone, semiprone, lateral, Fowler’s, and orthopneic
Objectives • Demonstrate the following procedures: • Procedure 14 Turning the Patient Toward You • Procedure 15 Turning the Patient Away from You
Objectives • Demonstrate the following procedures: • Procedure 16 Moving a Patient to the Head of the Bed • Procedure 17 Logrolling the Patient
Patient Safety • In Unit 14 • You learned how to maintain a safe environment and avoid personal injuries • The prevention of patient injuries is another very important part of your job as a nursing assistant
Use of Physical Restraints • In the past • Restraints were often used routinely as a preventive measure to avoid falls
Use of Physical Restraints • Research has shown that side rails and other restraints do not necessarily accomplish this purpose • Restraints may be used for other preventive measures
Alternatives to the Use of Restraints • Alternatives to restraints should be tried before restraints are applied • Restraints are used only as a last resort in situations in which a patient may harm himself or herself or others
Alternatives to the Use of Restraints • Nursing assistants can take a number of actions to help reduce the need for restraints
Potential for Side Rail Injury • Mattresses are sometimes replaced • Replacement may not be as large as the original mattress
Potential for Side Rail Injury • Gaps between the mattress and bed frame or rails • Can be caused by movement or compression of the mattress due to patient weight, movement, or bed position • Refer to Figures 15-10A and 15-10B
Potential for Side Rail Injury • If you observe a gap that is wide enough to entrap a patient’s head or body part • Inform the nurse promptly
Prevention of Other Incidents • Many situations can result in an incident that may harm a patient • Incidents can be prevented when all staff members are aware of appropriate preventive measures
Prevention of Other Incidents • Some incidents that can be prevented are: • Accidental poisoning • Thermal injuries • Skin injuries • Choking
Introduction to Procedures • Caring for patients safely means that you must faithfully and carefully carry out specific routines • The normal manner of carrying out a task is called a procedure
Body Mechanics for the Patient • Body mechanics for the patient • Similar to those for the health care team • Although the patient probably will not be doing any lifting • Good posture habits should not be neglected
Body Alignmentand Positioning • Body alignment • Means maintaining a person in a position in which the body can properly function
Complications of Incorrect Positioning • Complications can occur when body alignment is not maintained • Or when the patient’s position is not changed often enough
Basic Body Positions • There are four basic positions, each with variations: • Prone • Supine • Lateral • Fowler’s position
Positioning the Patient • After you have turned and moved the patient into proper body alignment • Place pillows and other supportive devices to help the patient maintain the position • Instructions are provided in the textbook for the four basic positions and their variations
Chair Positioning • Proper chair positioning begins with the feet • Feet should be supported on the floor or wheelchair footrests • Support the patient in the 90-90-90 position while sitting in the chair • Refer to Figure 15-40B
Chair Positioning • Remember that repositioning and pressure relief are needed when the patient is up in the chair
Chair Positioning • Refer to file entitled “pre-post procedure” • For a review of beginning procedure actions and procedure completion actions