Patient Positioning & Transfer Flashcards
What does transferring mean in
medical terms?
- The taking or moving of something from one place to another.
- The moving of a patient from one surface to another, Patients can be taught to transfer safely either independently or with minimal assistance if they can balance in a sitting position.
Levels of transfer
- Independent transfers
- Assisted transfers
- Dependent transfers
What is the patient transfer?
- A transfer is the safe movement of the patient from one place to another, like from bed to wheelchair and by the used of assistive devices.
- In doing so, the health care workers must teach patient and ask for his or her participation for successful results. There are many methods of transfer.
Independent transfers
◦The patient consistently performs all aspects of the transfer, including setup, in a safe manner and without assistance
Assisted transfers
◦The patient actively participates, but also requires assistance by a clinician(s).
Dependent transfers
◦The patient does not participate actively, or only very minimally and the clinician(s)perform all aspects of the transfer
Types of Transport
- Intrahospital
- Interhospital
- Scene run
Intrahospital
transport of a patient from one location to another within the hospital
Interhospital
transport of a patient between hospitals
Scene run
transport of a patient from a non-medical site to
the nearest available or designated hospital
Transfer assist devices
- Draw and slider sheets
- Transfer belts
- Slide/transfer boards
- Smaller slide/transfer boards
- Turning discs
Principles of moving or
turning patients in bed
- See that you are in correct position
- Always keep your back straight
- Keep elbows close to your body to decrease strain on back muscles
- Slide the patient on bed instead of lifting whenever possible
- Ask for help if the patient is too heavy
- Give signal ready to patient and helpers when
working in a team. - Always explain to patient what you are going to
do - Maintain body alignment of the patient at all times
and protect him from injury. - Support the patient’s muscles and joints well and
properly - Know that most strains and fatigue caused by
lifting are due to using the wrong group of muscles
Steps of Moving a patient in bed
Consider the patient’s body is divided into three segments
A) from head and neck to west
b) From west to thighs.
c) From thighs to heals.
Move each segment separately.
Objectives of Moving a patient in bed
o To promote comfort.
o To make an occupied bed.
Objectives of Turning a patient in bed
- To change patient’s position.
- To make an occupied bed.
- To provide back care and/ or back massage.
Steps of Turning a patient away
from you
Move the patient toward you.
Flex the patient’s near knee.
Put the pt’s near hand across his\her chest.
Push the far arm under his/her buttock.
Put your palms: One over patient’s shoulder, The other over the buttock.
Turn the patient away from you.
Steps of Turning a patient toward
you
Move the patient away from you.
Flex the patient’s far knee.
Put the pt’s far hand across his\her chest.
Push the near arm under his/her buttock.
Put your hands: One over patient’s shoulder, The other over the thigh.
Turn the patient toward you.
Objectives of Moving a patient up in bed
- To promote pt’s comfort.
- To maintain good body alignment.
Steps of Moving a patient up in bed
- If the pt conscious
- If the pt unconscious
Moving a patient up in bed if consciouss
- Remove the pillow.
- Ask the pt. to flex his knees, hold the bar of the bed, slide your hands under his/her head and thigh, with signal ready; move.
Moving a patient up in bed if unconsiouss
- Get an assistant.
- Flex the pt’s knees.
- Cross pt’s arms.
- With locked hands between you and your helper
under pt’s west and thighs, give signal ready, and
move.
Objectives of Raising the patient’s
shoulder
- To arrange the pillow.
- To help the patient to change his gown.
- To assist the patient to assume a sitting position.
Objective of Moving the patient to a
stretcher
To transfer the patient to any department in
the hospital (e.g. operating room-X ray-lab.) and vice versa.
Steps of Raising the patient’s
shoulder
- Stand in correct position.
- With locked shoulders, non dominant hand under
pt’s neck, raise the pt. to sitting position.
- Positioning a client in good body alignment and changing the position regularly (every 2 hours) and systematically are essential aspects of nursing practice.
..
Objectives of Transferring a patient to
wheelchair
- To help the pt. to a sitting position.
- To transfer patient from a place to another place
- Clients who can move easily automatically reposition themselves for comfort, Such people generally require minimal positioning assistance from nurses, other than guidance about ways to maintain body alignment and to exercise their joints.
..
However, people who are weak, frail, in pain, paralyzed, or unconscious rely on nurses to provide or assist with position changes.
..
For all clients, it is important to assess the skin and provide skin care before and after a position change.
..
Common sites of bed sores in supine position
- Some bed boards are hinged across the middle so that they will bend as the head of the bed is raised. It is particularly important in the home setting to inspect the mattress for support.
…..
Common sites of bed sores in Side-Lying position
Common sites of bed sores in Prone position
When positioning clients in bed, the health care provider can do a number of things to ensure proper alignment and promote client comfort and safety:
- Make sure the mattress is firm and support natural body curvatures
- Ensure that the bed is clean and dry.
- place support devices in specified areas according to the patient position and condition
- Plan a systematic 24 hour schedule for position changes
- Protecting the Nurse’s back.
- A sagging mattress, a mattress that is too soft, or an under filled waterbed used over a prolonged period can ……
contribute to the development of hip flexion contractures and low back strain and pain.
- Bed boards made of plywood and placed beneath a sagging mattress are increasingly
recommended for clients who have …….
back problems or are prone to them.
- Wrinkled or damp sheets …… the risk of pressure ulcer formation.
- Make sure extremities can move freely whenever
possible, For example, the top bedclothes need to be loose enough for clients to move their feet.
increase
- Use only those support devices needed to maintain T alignment and to prevent stress on the client’s muscles and joints. If the client is capable of movement, too many devices ……..
and ……… for muscle weakness and atrophy
limit mobility, increase potential
Frequent position changes are essential to
prevent pressure ulcers in immobilized clients.
…
- Healthcare workers providing direct patient care rank ….. in the number of work-related musculoskeletal injuries. Nurses are at risk for
………. as a result of manual
moving and repositioning of patients.
fifth, back and shoulder injury
what are assisstive devices used for proper using?
- Pillow
- Mattresses
- Foot Board
- Suspension or heel guard boot
- Hand roll
- Hand , wrist splint
- Heel, elbow protectors
- Abduction pillow
- Side rails
- Trapeze bar
- Bed cradle
- Bed board
- Trochanter roll
- Sand bag
- Slide sheet
Refer to Original Lecture for uses (VIP)
Function of Abduction pillow
Maintain hip abduction after
hip surgery.
Function of Side rails
- Help week patient turn independently
- protect patient from falling out of bed
Function of Trapeze bar
- allow patient help in transfer&position
changes - strengthen upper arms through exercises
Function of Bed cradle
- hold bedding up off the toes and feet, allowing for free movement.
Function of Bed board
- provide additional support to mattress
- improve vertebral alignment
Function of Slide sheet
- Help reposition patient
- can be secured to side rail to support patient in side lying position
Patient Positions
- Fowler’s
- Lateral
- prone
- Sim’s
- Supine
Description of Fowler’s Position
Indications of Fowler’s Position
Potential Complications & Corrective measures of Fowler’s Position
Description of Lateral Position
Indications of Lateral Position
Potential complications & Corrective Measures of Lateral Position
Indications of Prone Position
Description of Prone Position
Potential Complecations & Corrective Measures of Prone Position
Descrption of Sim’s Position
Indications of Sim’s Position
Potential Complications & Corrective Measures of Sim’s Position
Description of Supine Position
Indications of Supine Position
Potential Diagnosis & Corrective Measures of Supine Position