Bed mobility and transfers activity (chap 8)

Question 1

objectives

Following the lectures and labs, the student will be able to:

Syllabus objectives: 3, 11, 13, 14, 15 and 23

Answer 1

fyi

Question 2

The safe movement of a person fro one surface or location to another or from one position to another

Answer 2

transfer

Question 3

what are the Various levels of assistance?

Answer 3

1. Independent
2. assisted
3. standby assist
4. contact guarding
5. modified independent
6. Max ass 75%
7. Mod ass 50%-75%
8. Min ass 25% - 50%

Question 4

what are you Documenting?

Answer 4

1. type of transfer performed
2. info on the amount or type of assistance the pt requires to perform transfers
3. amount of time required to complete the transfer
4. the level of safety demonstrated
5. precautions for transfers
6. level of consistency of the performance
7. equipment of devices used

Question 5

precautions for tranfers (pg 170)

Answer 5

• spinal
• total knee
• replacement
• total hip replacement

Question 6

How can you be organized with a transger?

Answer 6

• Inform the patient about what will take place
• Tell them how they are expected to assist
• Consider demonstration
• Make sure to have enough assistance or appropriate equipment

Question 7

How can you prepared for transfers?

Answer 7

Make sure the environment is well-prepared.

• Consider the environment, yourself, and others who will assist you and the equipment needed

Question 8

what are some consederations for planning the transfers?

Answer 8

• Consider how the patient is transferring now
• What are their limitations
• How much assistance do you need
• What are the precautions

Question 9

What are some of the pts physical abilities that need to be considered?

Answer 9

Strength
Balance
Flexibility
Endurance
Sitting and standing tolerance
Motor control

Question 10

what is some equipment used for transfers?

Answer 10

• Hydraulic lift or mechanical lift (Fig. 8-35)
• Transfer board (Fig. 8-19)
• Bedrail
• Trapeze

Make sure any equipment that you choose to use it secured properly

Question 11

how can you inform and instruct the pt?

Answer 11

1. Always make sure you have their informed consent to perform the activity
2. Make sure they are properly dressed
3. Be especially careful of shoes

Question 12

Who can you explain the transfer to the pt?

Answer 12

• You may have to break it down into component parts
• Give instructions and ask them to repeat back

Question 13

What can make the the tranfers safer? as far as where they hold to push themselves up.

Answer 13

• Under all circumstances make sure it is a safe transfer
• Use safety belt and the patient’s knees, pelvis, upper thorax for stabilization
• Do Not use the patient arms or clothing
• Fig. 8-33– Eeeks! Not the preferred procedure, as this may result on the patient straining the PTs neck and/or shoulders.
  
  • What can you do instead?

Question 14

What should you consider with giving instructions to the pt?

Answer 14

1. Be brief
2. Provide enough information without being overwhelming
3. Remember that they are probably fatigue and not feeling particularly well and will process slowly
4. Encourage the patient to participate at their maximum level
5. Determine the best position to protect the patient
6. Generally it will be in front and slightly to the side of the patient
7. Your body mechanics may be somewhat compromised, the patient’s safety is your first priority

Question 15

What are some precauitons for transfers? this is another slide

Answer 15

• The patient should be wearing appropriate shoes
• The patient should ALWAYS be wearing a safety belt
• Anticipate an unusual event
• Make sure anything attached to the patient including bandages, casts, drainage catheters are appropriately protected

Question 16

What is consideration is appropriate after the transfer to protect the pt?

Answer 16

1. Bedrails
2. Center the patient on the bed
3. Using lap belt if appropriate
4. Do Not leave the Patient Unattended without Adequate Protection

Question 17

What are mobility acitvities - pre-transfers?

Answer 17

• Activities used to adjust a recumbent patient’s body or to assist patient in prep for transfers
• May be performed independently or with assistance
• Assist in turning from supine to side-lying or from supine to prone, moving upward or downward or side to side in the bed
• P176-181

Question 18

Equipment to be used may include with mobility activities

Answer 18

1. Bedrails
2. Overhead frame
3. Loops
4. Matt or mattresses
5. Linen (dry sheet)

Question 19

why do we educate on mobility activities?

Answer 19

• These are taught to patients to improve independence and assist in preventing development of skin problems
• Patient must become independent in all phases of bed mobility to become independent sitting or standing transfers

Question 20

A patient who had a recent R hip replacement is getting out of bed with therapy for the first time. To what side of the bed should the patient transfer out?

Answer 20

The good side. so the right side. to give more confidence

Question 21

A patient who had a recent R hip replacement is getting out of bed with therapy for the first time. To what side of the bed should the patient transfer out?

Answer 21

• Check the height of the bed
• Instruct and assist the patient to the side of the bed
• Can the patient barrel roll? If so, this will assist with decreasing potential back strain.
• Typically, legs first and arms follow. Instruct the patient to push through their arms
• Once sitting, is the patient leaning?
• Patient should have feel flat on the floor.
• Allow some time for the patient to adjust to the new position.
• Instruct your patient to breathe (yes, you do need to inform people to breathe…remember, breathing is the key to life.)

Question 22

Your patient is in a semi-reclined position in bed because he/she cannot tolerate lying flat. When moving to a seated position, what should you do with the top part of the bed once the patient has his/her legs close to or over the edge?

Answer 22

lower the top of the bed and take it to a flat position.

Question 23

• As discussed before, move individual body segments to reduce effort and stress on your body
• Remember….. You want the patient to complete as much as he/she can.

what should you Encourage ?

Answer 23

his/her participation!

Question 24

Bed mobility-Side to Side( talk about it).

Answer 24

• Segmental
• Arms supporting under upper back (arm can support head) and middle of the back/ arms under low trunk and distal to pelvis/ arms under thighs and legs
• Assist by sliding; DO NOT LIFT
• Remember your body mechanics… bend, squat, lower COG

Question 25

bed mobility- upward (talk about it)

Answer 25

• Have patient assist with flexed hips and knees (within any precautions)
• Support head and upper trunk of patient with your arms and lift until scapulae clear the bed or mat
• Slide patient up- short distance. If more is needed, reposition patient and do it again.
  
  • We will demo this in lab. There is more than one way to do this.

Question 26

bed mobility - downward (talk about it)

Answer 26

• Patient should flex at hips and knees
• Cradle and lift the pelvis slightly before sliding downward

Up or down is often easier with the assist of two people (one on each side) and use of a fabric towel or draw sheet (Fig. 8-2)

Question 27

bed mobility - Rolling (talk about it)

Rolling to get to supine to prone or prone to supine

Answer 27

• Rolling tactile landmarks- pelvis and scapulae
• Patient should always be rolling toward you. If rolling away, bed rail or another person should be “meeting” patient on the other side
• Moving to prone, the arm to which the patient will roll should be close to his/her side, ER, palm up and slightly tucked under the pelvis

Question 28

start at Slide #34