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MOVING THE CLIENT IN & OUT OF BED
PRESENTED BY:
MS. AHDAB FAISAL ESKANDAR
Fundamentals Of Nursing
OBJECTIVES
1. Differentiate between manual and assistive technique .
2. Enumerate the common purposes for moving client.
3. Assess client`s status needs and environment .
4. Mention required equipment.5. Demonstrate the steps of each procedure .
OUTLINE:
IntroductionPurpose of moving clientNeeded assessmentRequired equipmentTypes of transferProcedure transferConclusionReffrance
*ill people usually have difficulty moving in bed. How much assistance clients required depends on?
*Nurse should be sensitive to both the need of people to function independtly and their need for assistance to move.
Introduction
1. Maintains body alignment2. Maintains skin integrity and facilitates
pressure distribution3. prevent friction and shear on tissue4. Promote comfort5. Promote optimal lung expansion6. Prevent injury and deformities of
musculoskeletal system7. Position clients for a variety of clinical
procedures
Purpose
Before moving a client assess the following :
Clients weight, age and medical diagnosis.
Client physical abilities (e.g. muscle strength ,presence of paralysis).
Clients ability to understand instructions.
Assessments cont:
Integumentary and musculoskeletal assessment.
Doctor orders for specific restrictions in positioning client
surrounding area and attached equipment such as( IV-urinary catheter-drain etc)
Nurse strength and types for assistance
Support devices required by clients(e.g. Draw sheet Sliding sheet Foot board Sandbags Hand rolls Foam wedges
Pillows for head ,extra pillowsGloves
EQUIPMENTS:
Slide sheet( made from low
friction material )Bed pole (trapeze) and leader
WedgesTransfer ( walking) belt
Lifting machine
DEPENDENT TRANSFERS
Before specially adapted equipment for transfers was introduced, hospitals had to rely on dependent manual techniques to get the patient in and out of bed.
Types of transfer
Assisted transfer
Overhead lifts.Manual lifts
Overhead lifts can be used to aid in the transfer of medically fragile patients. Often they are permanently mounted to the ceiling with a secure rail system.
PROCEDURE
Assist client to sit on side
of bed
Assist client to move up in
bed
Transferring between bed
and chair
Logrolling client
Transferring between bed and stretcher
Moving client up in bed
Equipment :pull sheet or sliding bar.Purposes: clients slide down or being pulled
by tractionPreparation :determine(assistive device-
attached IV or heavy cast-medications-assisted personal)
Moving client up in bed
Performance: Explain to the client and listen for his
questions Wash hands and provide privacy Lower head of the bed and raise the bed
to your center of gravity lock the wheels and raise the side rail
opposite to you
Performance cont:
Remove the pillows and place one only against the head of the bed
Ask client to flex hips and knees and position feet so that they can be used for pushing
Ask client to :-A. Grasp the head of the bed with both
hands and pull during move or B. Raise upper part of body on elbows
and push with hands and forearm during the move
Two nurses using a hand interlock
Two people required to move clients who are unable to assist because of their condition or weight.
The second staff member on the opposite side of bed, both of you interlock your forearm under clients thighs and shoulders and lift client up in bed
Upper extremities: Flex hips and knees Arms across chest Flex neck during movement Place one arm under clients back and
shoulders and other under clients thigh Shift your weight
two nurses using turn sheet.
Other methods for moving client up in bed
ASSISTING CLIENT TO SIT ON SIDE OF BED
Purpose: before walking, moving to chair, eating or performing other activates
Performance : Assist client to lateral position
facing you Raise head of bed slowly to
highest position
Assisting client to sit on side of bed
Stand beside clients hips and face far corner of bed
Lean your trunk forward and flex your hips , knees and ankles
Move client to sitting position (place one arm around client shoulder and other beneath both clients thigh near knees
Tighten your muscles and lift client thighs slightly
continue
Pivot on balls of your feet in desired direction facing foot of bed while pulling client feet and legs off bed ( prevent twisting of nurse supine)
Support client well ( this movement may cause some clients to faint )
Assess vital signs as indicated by clients health status
Logrolling client
Purpose: to turn client whose body most all times be kept in straight alignment
Performance: Stand on the same side of bed and broad
base of support with on foot ahead of other
Place clients arms across chest Lean your trunk and flex your hips knees
and ankles
Logrolling
Place your arm under client Pull client to the side of the bed Move to the other side and place
supportive devices Roll and position clients in proper
alignment
TRANSFARING BETWEEN BED AND CHAIR
Equipment : appropriate clothes and slipper –transfer belt
Preparation : Plan of what to do and how to do it Obtain equipment and check for function well Remove obstacles from areas
Performance: Place wheelchair parallel to bed as close as
possible and lock the wheels and raise the foot plate .
continue
Assist client to sitting position on side of bed Place transfer belt around the waist of clients Ask client to
move forward and sit on the edge of bed lean forward slightly from hips Place strong foot beneath edge of bed and the other
forward Place client hands on bed surface or on your
shoulders( so they can push while standing ) Mirror the placement of the clients feet (prevent
loss of balance during transfer)
continue
Encircle clients waist with your arms and grasp the belt at client back
Assist the client to stand, and then move together toward the wheelchair
Assist the client to sit.
Transferring from bed to chair
Ask the client to: Back up to the wheelchair and place the legs
against the seat Place the foot of the stronger leg slightly behind
the other Keep the other foot forward Place both hands on the wheelchair arms or on
your shoulders Ask the client to push back into the wheelchair
seat. Lower the footplates, and place the client’s feet on
them
TRANSFERRING BETWEEN BED AND STRETCHER
Performance: Lower the head of the bed Raise the bed slightly higher than the stretcher
(easier for client to move down ) Pull draw sheet out from both sides of bed Place the stretcher parallel to bed and fill the gap
with blankets Roll the sheet against client ,flex hips and pull onto
stretcher Ask client to flex neck and place arms across chest Ensure clients comfort and raise the side rails of
stretcher
Documentation
Document all relevant information:- Time and change of position moved from
and position moved to Any signs of pressure areas Use of support devices Ability of client to assist in moving and
turning Response of client to moving and turning
Conclusion
?ANY QUESTION
References
Fundamentals of nursing concepts ,process and practice,7th edition written by kozier 2005
Nurses guide to clinical procedures 5th edition written by jean smith temple and Joyce young Johnson 2007
http://www.rehabpub.com/features/892005/3.asphttp://www.independentliving.co.uk/manual-handlin
g.html
THANK YOU