Safely Moving the Person


Chapter 18

Safely Moving the Person





Key Abbreviation







ID Identification

You will move persons often. You assist with bed mobility. The Centers for Medicare & Medicaid Services (CMS) defines bed mobility as how a person moves to and from a lying position, turns from side to side, and re-positions in a bed or other furniture. You also position persons in chairs and wheelchairs. You must work carefully to protect yourself and the person from injury.


See Focus on Communication: Safely Moving the Person.


See Promoting Safety and Comfort: Safely Moving the Person.






Preventing Work-Related Injuries


Moving procedures involve lifting, awkward postures, and repeated motions. These place you at increased risk for injury. You must prevent work-related injuries during moving procedures. See Chapter 17.


Good body mechanics alone will not prevent injury. The Occupational Safety and Health Administration (OSHA) recommends:



Each person is different. Careful planning is needed to move the person safely. You must know:



The person’s functional status. Functional status is the person’s ability to perform the activities of daily living (ADL) required to meet basic needs and required for health and well-being. Some persons move without help. Others depend on the staff. Know the person’s functional status before you move a person. See Box 18-1. Tell the nurse about changes in the person’s abilities.



The number of staff needed. This depends on the person’s height, weight, cognitive function, and functional status. Some persons need no help. Or they just need reminders or help with devices or equipment. Others need help from 1, 2, 3, or more staff.


What procedure to use. The nurse and care plan tell you what procedure to use.


The equipment needed. Assist equipment and devices are presented throughout this chapter. The nurse and care plan tell you what to use. Always follow the manufacturer’s instructions. Ask for training to use the equipment and devices safely.


See Focus on Children and Older Persons: Preventing Work-Related Injuries.


See Teamwork and Time Management: Preventing Work-Related Injuries, p. 264.


See Delegation Guidelines: Preventing Work-Related Injuries, p. 264.


See Promoting Safety and Comfort: Preventing Work-Related Injuries, p. 264.



Focus on Children and Older Persons


Preventing Work-Related Injuries






Older Persons


Persons with dementia may not understand what you are doing. They may resist your efforts. The person may shout, grab you, or try to hit you. Always have a co-worker help you. Do not force the person. The person’s care plan has measures for safe care. For example:



Tell the nurse at once if you have problems moving the person.




Teamwork and Time Management


Preventing Work-Related Injuries



Patients and residents are moved, turned, and re-positioned often. These procedures are best done by at least 2 staff members.


Friendships are common among co-workers. And some working relationships are better than others. Do not ask for help just from friends or those with whom you work well. Include all co-workers. Do not help just your friends or those with whom you work well. Assist anyone who asks. This includes new staff and those from other units.





Protecting the Skin


Protect the person’s skin during moving procedures. Friction and shearing injure the skin. Both cause infection and pressure ulcers (Chapter 37).



Friction is the rubbing of 1 surface against another. When moved in bed, the person’s skin rubs against the sheet.


Shearing is when the skin sticks to a surface while muscles slide in the direction the body is moving (Fig. 18-1). It occurs when the person slides down in bed or is moved in bed.



To reduce friction and shearing when moving the person in bed:



Roll the person.


Use friction-reducing devices. Such devices include a lift sheet (turning sheet). Drawsheets (Chapter 21) serve as lift sheets (turning sheets). Turning pads (Fig. 18-2), large re-usable waterproof under-pads (Chapter 21), and slide sheets (p. 269) are other friction-reducing devices.


image

FIGURE 18-2 Turning pad.

See Focus on Children and Older Persons: Protecting the Skin.


See Focus on Surveys: Protecting the Skin.



Focus on Children and Older Persons


Protecting the Skin






Older Persons


Older persons are at great risk for shearing. Their fragile skin is easily torn. Protect the skin from injury.


Ask a co-worker to help you move older persons. Use a friction-reducing device. Move older persons carefully and gently.


Persons with dementia may try to resist your efforts. Do not force the person. Work slowly. Use a calm voice. Divert the person’s attention if necessary.



Focus on Surveys


Protecting the Skin



Shearing and friction can easily damage the skin. Surveyors will observe the measures taken by staff to prevent or reduce shearing and friction when moving and re-positioning persons.



Moving Persons in Bed


Some persons can move and turn in bed. Others need help from at least 1 person. Those who are weak, unconscious, paralyzed, or in casts need help. Sometimes 2 or 3 people or a mechanical lift (Chapter 19) is needed. Follow the guidelines in Box 18-2 when lifting or moving persons in bed.



See Focus on Communication: Moving Persons in Bed.


See Delegation Guidelines: Moving Persons in Bed, p. 266.






image Raising the Person’s Head and Shoulders


Sometimes you raise the person’s head and shoulders to give care. Simply turning or removing a pillow requires this procedure. You can raise the person’s head and shoulders easily and safely by locking arms with the person. Do not pull on the person’s arm or shoulder. Have help with older persons and with those who are heavy or hard to move. This protects the person and you from injury.


See procedure: Raising the Person’s Head and Shoulders.



image Raising the Person’s Head and Shoulders





Procedure



8. Have your co-worker stand on the other side of the bed. Lower the bed rails if up.


9. Ask the person to put the near arm under your near arm and behind your shoulder. His or her hand rests on top of your shoulder. If you are standing on the right side, the person’s right hand rests on your right shoulder (Fig. 18-3, A). The person does the same with your co-worker. The person’s left hand rests on your co-worker’s left shoulder (Fig. 18-4, A).




10. Put your arm nearest to the person under his or her arm. Your hand is on the person’s shoulder. Your co-worker does the same.


11. Put your free arm under the person’s neck and shoulders (Fig. 18-3, B). Your co-worker does the same (Fig. 18-4, B). Support the neck.


12. Help the person rise to a sitting or semi-sitting position on the “count of 3” (Figs. 18-3, C and 18-4, C).


13. Use the arm and hand that supported the person’s neck and shoulders to give care (Fig. 18-3, D). Your co-worker supports the person (Fig. 18-4, D).


14. Help the person lie down. Provide support with your locked arm. Support the person’s neck and shoulders with your other arm. Your co-worker does the same.




image Moving the Person Up in Bed


When the head of the bed is raised, it is easy to slide down toward the middle and foot of the bed (Fig. 18-5). You move the person up in bed for good alignment and comfort.



You can sometimes move light-weight adults up in bed alone if they assist using a trapeze. However, it is best done with help and an assist device (p. 269). For heavy, weak, and older persons, 2 or more staff members are needed. Always protect the person and yourself from injury.


See Promoting Safety and Comfort: Moving the Person Up in Bed, p. 268.


See procedure: Moving the Person Up in Bed, p. 268.



Promoting Safety and Comfort


Moving the Person Up in Bed






Safety


This procedure is best done with at least 2 staff members. Work from the side of the bed. Do not pull the person from the head of the bed. Use assist devices as directed by the nurse and the care plan. Ask any questions before you begin the procedure.


Perform the procedure alone only if:




image Moving the Person Up in Bed image




Apr 13, 2017 | Posted by in NURSING | Comments Off on Safely Moving the Person
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