SAFE PATIENT HANDLING AND MOVEMENT

SAFE PATIENT HANDLING AND



MOVEMENT

Learning Outline









1. Safe patient handling and movement



a. Positioning of patients


i. Types



ii. Technique


b. Lifting and moving of patients


i. Types



ii. Technique


c. Devices used in handling patient

Safe patient handling and movement









Ergonomics – the science of fitting the job to the worker and



practice of designing equipment and work tasks to match the


capability of the worker.

Ergonomic approaches




are used to:


















1) Design tasks to fit each person



2) Understand the limits of the individual



3) Evaluate the work environment, taking into account that when job


demands exceed the physical ability of workers, problems likely exist.

Ergonomic Risk Factors




Observed in Patient



Care Occupations













• Forceful and Heavy Exertions


• High Frequency/Repetitive Tasks


• Awkward Postures


• Work Duration



• Uneven work floors


• Unpredictable patients


• Dependence level of patients

To control an Ergonomically Safe


Environment include:



















1) Change and enforce rules and procedures



2) Rotating workers through jobs that are physically tiring



3) Training workers to learn techniques for reducing the stress and strain


while performing their work tasks.

To control an Ergonomically Safe


Environment include:



















4) Maintain a clutter-free environment



5) Encourage no-lift of low-lift policies


6) Supervisor encouragement of early reporting of injuries.

Why Ergonomics




Matters






• Mismatching the physical requirements of a job and

the physical capacity of a worker can result in a
Work-Related Injury.

***BEWARE***





















Some lifting task are so stressful to the body that even when


proper body mechanics and ergonomics are used, injuries



can still occur.

Manual • 98% of nurses use the • Nelson, A., Baptiste,

manual lifting technique A. (September 30,
Lifting? known as “Hook and 2004). "Evidence-Based


Toss” even though it Practices for Safe


was deemed unsafe Patient Handling and

since 1981 Movement". Online

Journal of Issues in
• Why? Because nurse

instructors teach them! Nursing. Vol. 9 No. 3,
Manuscript 3.

Preparing for Safe Patient



Handling










• Know what equipment is available and how it

works


• Assess the patient and the environment



• Gather appropriate equipment and staff needed


• Coach Patient

When and Why






Use Lifts

Patient Benefits










• Patient comfort


• Respects a patient’s sense of dignity



• Promotes patient independence and

rehabilitation

Economic Benefits












Decreases occupational injuries and indirect costs

including employee replacement, additional

training, loss of productivity, and liability

Increase in • *The number of U.S. • *“Hospital Employees
Learn How to Handle
patients hospitalized for
Obesity obesity more than doubled Heavier Patients” Dean

Olsen,
from 1994 to 2004
• 797,000 to 1.7 million BeHealthySpringfield.com

• 2/3 of all U.S. adults are

obese or overweight

• For most patient-lifting tasks – max weight limit

is 35 pounds.


• Patient Characteristics that add risk


➢Height

When to Use ➢Weight




a Lift ➢Body Shape

➢Dependency






Waters, Thomas R. PhD. (2007). When Is It Safe to Manually
Lift a Patient?. AJN, Vol. 107, No. 8. 53-59.

Know Know the characteristics of an unsafe lift











Know the help that is available – both
Know coworkers and equipment

Your




Responsibility



Know Know your employer’s lift policies












If unsure about the safety of a lift, ask
Ask
your instructor/director

Positioning of










Patients

ASSISTING IN POSITIONING AND TURNING




















IF THE PATIENT IS



UNABLE TO CHANGE PATIENTS NEED TO BE



POSITION TURNED EVERY TWO


INDEPENDENTLY , YOU HOURS.



WILL NEED TO ASSIST .

BASIC BODY


POSITIONS

The spine is kept straight.








Fowler’s



position is a The head is supported with a




semi-sitting small pillow.




position








The arms are supported with


pillows.

The bed is flat.


The supine




(dorsal



recumbent) The head and shoulders are




position is the supported on a pillow.




back-lying




position


Arms and hands are at the


sides.

Prone position Lateral position (side-lying)






• The person lies on the • A pillow is under the head

abdomen with the head and neck.


turned to one side. • The upper leg, ankle, and



• The bed is flat. thigh are supported with


• Small pillows are placed pillows.


under the head, abdomen, • A pillow is positioned against


and lower legs. the person’s back.


• Arms are flexed at the • A small pillow is under the


elbows with the hands near upper arm and hand.


the head.

ORTHOPNEIC

POSITION



















• Frequently used by patients with respiratory problems



• Helps expand the chest and lungs to allow more oxygen to

enter

• Protect the skin when moving the

person.


• Friction is the rubbing of one surface
MOVING against another.


• Shearing is when the skin sticks to a

PERSONS IN surface while muscles slide in the

direction the body is moving.


BED • 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.

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

RAISING THE




PATIENT'S





SHOULDERS

RAISING THE




SHOULDERS




WITH TWO





HELPERS

TURNING A





PATIENT

PROPER




POSITIONING




FOR LATERAL





POSITION



Lifting and Moving of










Patients

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

Assisting A Patient


To Move Up In


Bed



• One caregiver

• One caregiver



• Points to remember:


Assisting A ➢Properly adjust the height of the bed

according to your own height

Patient To ➢Ask the resident to flex the knee, to look at


his feet and finally to push on his foot.
Move Up In ➢This will increase the resident’s cooperation




Bed ➢During the transfer, switch your own weight

from one side to the other, while keeping a

straight back.

Assisting A Patient To Move Up In Bed

























•Two caregivers

• Two caregivers


• Points to remember:



Assisting A ➢Ask the patient to place his hands on top of
the bed and to pull on the top of the bed


Patient To during the transfer when pushing on his feet

➢During patient lifting, use leg and hip

Move Up In muscles instead of using the upper body


muscles, first bend and then slowly straight
Bed the knees while lifting the patient



➢Movements of both caregivers should be

synchronised while carrying out the patient

transfer. Communication is very important.

MOVING A PATIENT

TO THE SIDE OF THE


BED









• The person is moved in
segments

Move a patient side-to-side in the bed









• One caregiver

• One caregiver



• Points to remember:

➢Properly adjust the height of the bed


Move a according to your own height

➢Split the transfer in three parts: legs,

patient side- middle, shoulder



➢Pull over the patient’s weight while using
to-side in the your own weight. Use leg and hip muscles




bed instead of using the upper body muscles

➢Ask the resident to look at his feet. This will

increase abdominal muscular tension

leading to more cooperation.

Move a patient side-to-side in the bed






Two caregivers

• Two caregivers


• Points to remember:
Move a ➢Properly adjust the height of the bed




patient side- according to your own height

➢Both counterbalance the patient’s weight

to-side in the with your own weight


➢Movements of both caregivers should be
bed synchronised while carrying out the patient



transfer. Communication between both

caregivers is very important.

Bed - (Wheel) chair transfer









• One caregiver

One caregiver


• Points to remember:


➢Place the bed and the (wheel)chair close

together

➢Ensure that the (wheel)chair wheels are locked
Bed - (Wheel) in place




chair transfer ➢Remove any obstacles (armrests, footrests,
footboards)

➢Properly adjust the height of the bed according


to your own height

➢Ask the resident to look at his feet. This will

increase abdominal muscular tension leading to

more cooperation

One caregiver


• Points to remember:

➢Ask the patient to lean forward and push on his

legs during the transfer. This will ease lifting the

patient from sitting to standing position


Bed - (Wheel) ➢Use leg and hip muscles during patient lifting

instead of using the upper body muscles.

chair transfer ➢Firstly, bend and then slowly straight the knees

while lifting the patient


➢Counterbalance the patient’s weight with your

own weight


➢If necessary, hold the knee of the resident

between your own legs/ knees to guide the
movement.

Bed - (Wheel) chair transfer









• Two caregivers

Two caregivers


• Points to remember:

➢Place the bed and the (wheel)chair close together

➢Ensure that the (wheel)chair wheels are locked in

place


Bed - (Wheel) ➢Remove any obstacles (armrests, footrests,
footboards)


chair transfer ➢Properly adjust the height of the bed according to
your height

➢Use leg and hip muscles during patient lifting instead

of using the upper body muscles

➢Movements of both caregivers should be

synchronised while carrying out the patient transfer.

Communication between both caregivers is very
important.

Move a patient up in the chair







One caregiver

• One caregiver



• Points to remember:


➢Before starting, make sure that the patient’s

feet are as close as possible to the chair
Move a ➢Ask the patient to lean forward as far as




patient up in possible, helping him by putting his arms

around your middle

the chair ➢Ask the patient to lean forward and push on


his legs during the transfer. This will ease


lifting

➢Use leg and hip muscles instead of using the


upper body muscles.

Move a patient up in





the chair













• Two caregivers