o INCREASES MUSCLE STRENGTH
o MAINTAINS BODY FLEXIBILITY
o IMPROVES RESPIRATORY FUNCTION
o PREVENTS POOLING OF FLUID IN THE LUNGS
o IMPROVES CIRCULATION
o HELPS MAINTAIN HEALTHY SKIN
o PROMOTES EFFECTIVE ELIMINATION
o AIDS DIGESTION
o RELIEVES STRESS
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
ATROPHY
ATROPHY – A DECREASE IN SIZE
OR A WASTING AWAY OF MUSCLE
TISSUE.
CAUSED BY LACK OF USE
DECUBITUS ULCER
A BREAKDOWN IN SKIN TISSUE THAT OCCURS WHEN
BLOODFLOW TO AN AREA IS INTERRUPTED
MORE DECUBITI
o USING THE BODY IN AN EFFICIENT AND CAREFUL
WAY.
o USING GOOD POSTURE AND BALANCE
o USING THE STRONGEST AND LARGEST MUSCLES FOR
WORK
BASE OF SUPPORT
THE AREA ON WHICH AN
OBJECT RESTS
A GOOD BASE OF
SUPPORT IS NEEDED FOR
BALANCE WHEN LIFTING
YOUR FEET ARE YOUR
BASE OF SUPPORT
STAND WITH YOUR FEET
APART FOR A WIDER
BASE OF SUPPORT AND
MORE BALANCE
BEND YOUR KNEES AND SQUAT TO LIFT A HEAVY
OBJECT
DO NOT BEND FROM YOUR WAIST
WEARING A BACK
SUPPORT WILL HELP
YOU TO USE GOOD
BODY MECHANICS
WHEN LIFTING
HEAVY PATIENTS.
• For good body mechanics:
–
–
–
–
–
–
Bend your knees and squat to lift a heavy object.
Hold items close to your body and base of support.
Have a wide base of support.
Use your larger and stronger muscles.
Avoid unnecessary bending and reaching.
Face your work area.
– Push, slide, or pull heavy objects when you can.
– Turn your whole body when changing direction of
movement.
– Work with smooth and even movements.
– Do not lean over a person to give care.
– Bend your hips and knees to lift heavy objects
from the floor.
– Do not lift objects higher than chest level.
– Get help from a co-worker if the person cannot
assist with turning or moving.
– Use assist equipment and devices when possible.
THE TRUNK OF THE PERSON SHOULD BE IN A STRAIGHT
LINE WHEN THE PATIENT IS LYING DOWN
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 FEET
SHOULD EITHER
REST ON THE
FLOOR OR ON A
STOOL
HIS LOWER BACK
SHOULD REST
AGAINST THE
BACK OF THE
CHAIR
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
FOOT BOARD
KEEP THE FOOT IN A NATURAL POSITION TO PREVENT
FOOT DROP (PLANTER FLEXION)
FOOT DROP BOOT
HELPS PREVENT FOOTDROP
HAND ROLL
PERMITS THE HAND TO FLEX SLIGHTLY AND
PREVENTS CONTRACTURES OF THE FINGERS
o IF THE PATIENT IS UNABLE TO CHANGE
POSITION INDEPENDENTLY , YOU WILL NEED
TO ASSIST .
o PATIENTS NEED TO BE TURNED EVERY TWO
HOURS.
Lateral position
• 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.
• 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.
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
• 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.
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
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
MOVING UP IN BED
IF THE PATIENT HAS A
TRAPEZE ON THE BED
HAVE THE PATIENT GRASP
THE TRAPEZE AND BEND
AT THE KNEES
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
THE PERSON IS MOVED IN SEGMENTS
PROPER POSITIONING FOR LATERAL POSITION
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.
DANGLING
REFERS TO
SITTING
ON THE
SIDE OF
THE BED
WITH THE
FEET
HANGING
DOWN
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
• DO NOT ALLOW THE PERSON TO PUT HIS ARMS AROUND YOUR NECK
• MAKE SURE YOU LOCK THE WHEELS ON THE BED AND WHEELCHAIR
o APPLY THE BELT AROUND THE PERSON’S WAIST, OVER THE CLOTHING.
o 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.
o PLACE THE BUCKLE SLIGHTLY OFF CENTER IN THE FRONT.
o DO NOT USE WITH PATIENTS WITH FRACTURED RIBS, ABDOMINAL
SURGERY, OR HAVING BREATHING DIFFICULTIES
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
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
MANY FACILITIES
HAVE “NO LIFT”
POLICIES.
A SPECIAL LIFT IS
USED TO STAND AND
MOVE RESIDENTS IF
YOUR FACILITY HAS
THIS RESTRICTION.
PARALYZED PERSONS USE A TRANSFER
BOARD FOR TRANSFER FROM
WHEELCHAIR TO BED
THE
WHEELCHAIR IS
PLACED AT A
RIGHT ANGLE TO
THE TOLIET
TAKES 4 OR MORE STAFF
USE A LIFT SHEET OR
SLED TO PULL PATIENT
OVER ONTO CART
REPOSITIONING A
RESIDENT IN A
WHEELCHAIR
o LOCK THE WHEELS
AND MOVE THE
FOOTRESTS OUT OF
THE WAY
o DO NOT PULL THE
RESIDENT UP BY THE
ARMS
o TO AVOID INJURY
TO THE RESIDENT
USE TWO STAFF
MEMBERS
o ALWAYS LOCK THE BRAKES
WHEN TRANSFERRING
o CLEAN THE WHEELCHAIR ON
A REGULAR BASIS
o MOVE THE FOOTRESTS OUT
OF THE WAY WHEN
TRANSFERRING
CARDIAC CHAIR
GERI-CHAIR
BACK DOWN A RAMP WITH A
WHEELCHAIR
BACK INTO THE
ELEVATOR SO THE
PATIENT FACES THE
FRONT
TRANSFER THE PATIENT
FEET FIRST DOWN A RAMP
ENTER THE ELEVATOR
HEAD FIRST