Methods of Patient Care1 Unit 2 Chapter 13 & 14 Transfer and Immobilization Techniques.
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Transcript of Methods of Patient Care1 Unit 2 Chapter 13 & 14 Transfer and Immobilization Techniques.
Methods of Patient Care 1
Unit 2 Chapter 13 & 14
Transfer and Immobilization
Techniques
Methods of Patient Care 2
Transfer TechniquesChapter 13
Methods of Patient Care 3
Radiographer Responsibilities
Put the patient at ease Decrease level of embarrassment Set the tone for the patient’s experience Respect the patient’s right to privacy Protect patient and staff from injury Use necessary restraints safely Adhere to rules of radiation safety, fire safety,
and use and disposal of hazardous chemicals
Methods of Patient Care 4
Care of Patient’s Belongings
Describe to patient what clothing/items must be removed for exam
Show the patient where he/she may change, and how to put on hospital gown
Show patient where he/she may keep belongings (locker, belongings bag)
Methods of Patient Care 5
Care of Patient’s Belongings
Understand patient’s concern about leaving items behind
Place small items (rings, necklaces, earrings) in container marked with patient’s identification data
Document items removed/returned Every item is of value, respect patient’s
property
Methods of Patient Care 6
Body Mechanics
Back injuries from moving & lifting patients are the leading cause of injury to health care workers
Biomechanics- branch of science that applies the law of physics to living creatures.– Understanding can help prevent injury
Methods of Patient Care 7
Base of Support Base of Support is the
foundation on which a body rests.– IE. The feet and the space
between the feet when standing– Wide=Stable (BEST)– Narrow=Unstable
Good posture Body is in alignment, with all parts
in balance Permits bones & joints to work at
maximum efficiency with a minimal amount of strain on joints, tendons, ligaments, & muscles
Aids body systems to work efficiently
Methods of Patient Care 8
Center of Gravity
Center of Gravity – the hypothetical point at which all mass appears to be concentrated.
Stability can be achieved when the center of gravity is over the base of support.
Methods of Patient Care 9
Mobility vs. Stability Muscles
Mobility muscles – located in limbs– In transfer used
for lifting Stability muscles
– located in torso– In transfer used
for support
Methods of Patient Care 10
Body Mechanics Guidelines for picking up or lifting heavy
objects (patients) Let the patient do as much as possible Check chart for precautions/patient assessment Widen base of support Bend from the knees, not from the waist Pull rather than push Balance the weight over both feet; stand close to
the patient when bending knees Don’t twist body; change foot position instead Make sure floor area is clear of objects Never move a patient without enough assistance
to prevent injury to yourself & the patient
Methods of Patient Care 11
Moving & Transferring Patients
Establish the correct identity of the patient
Request pertinent information regarding the patient’s ability to follow directions
Request information concerning the patient’s ability to ambulate & any precautions to be taken concerning the patient’s mobility
Methods of Patient Care 12
Assessing the Patient’s Mobility Must use critical
thinking & problem solving to plan most effective manner of moving patient Expected outcome –
move patient without causing additional pain or injury to the patient or to yourself
Use interviewing & assessment skills
Methods of Patient Care 13
Assessing the Patient’s Mobility Patient’s general condition Range of motion & weight-bearing
ability Patient’s strength & endurance Patient’s ability to maintain balance Patient’s ability to understand what is
expected during the transfer Patient’s acceptance of the move Patient’s medication history
Methods of Patient Care 14
Moving & Transferring Patients Greet & identify patient
and provide an explanation of what is to occur
Move the patient to the department according to the necessary restrictions
Upon returning, notify nurse that patient has returned
Ask for assistance if needed
Methods of Patient Care 15
Moving & Transferring Patients
Assist the patient to bed Always lock wheels Assist patient from wheelchair Place patient’s bed in lowest position Side rails raised Put call button within reach
Methods of Patient Care 16
Assessing the Patient’s Mobility Rules for moving patients
Give only the assistance that the patient needs for comfort & safety
Always transfer a patient across the shortest distance
Lock all wheels on beds, carts & wheelchairs before the move begins
Generally, it is better to move a patient toward his or her stronger side while assisting on the patient’s weaker side
Methods of Patient Care 17
Methods of Moving Patients
Cart (aka. Stretcher or gurney)
Wheelchair
Ambulation (walking)
Methods of Patient Care 18
Wheelchair Transfers
1. Standby assist
2. Assisted standing pivot
3. Two-person lift
4. Hydraulic lift
Methods of Patient Care 19
Wheelchair Never allow a patient to get off a table
or onto a wheelchair without some assistance Patient may not be as strong as they think Sudden movement may cause dizziness
Orthostatic hypotension
Always transfer towards the strong side
Methods of Patient Care 20
Wheelchair – standby assist From supine position
Have patient turn to the side towards you with knees flexed
Place yourself in front of patient with one arm under shoulder and other across the knees
If patient can assist, have him push with upper arm when told to do so
On count of three, move or help patient to sitting position
Allow patient to sit on edge to get sense of balance
Methods of Patient Care 21
Wheelchair Stand at the patient’s side and take the
patient’s arm to help Put table or bed at lowest position Provide step stool Position wheelchair at a 45-degree angle
to the table. Move foot rests out of the way. Place locked wheelchair close enough so
that patient can be seated in the chair with one pivot
Methods of Patient Care 22
Wheelchair – 2-person lift
Stronger person lifts the patient’s torso– Directs the lift
Other person lifts patient’s feet. Lock wheelchair; Remove arm and leg
rests and if possible Have patient cross arms across chest
Methods of Patient Care 23
Wheelchair – Hydraulic lifts
Used for heavy patients
Requires use of a sling
Methods of Patient Care 24
Cart (Stretcher, gurney)
Bed to Cart; Cart to table Position cart alongside bed/table Patient’s strong (or less affected side)
towards the direction of the transfer Lock the wheels in place Let patient assist if possible Use moving devices as available
Methods of Patient Care 25
Cart (Stretcher, gurney) Moving devices include:
– Draw sheets or bed sheets*– Sheets of plastic*– Canvas or plastic over
rollers*– Slide board*
Reducing Friction* Requires 3 or more
“lifters”*– Mechanical lifts
Methods of Patient Care 26
Cart (Stretcher, gurney) Sheet transfer
To place sheet• Fold sheet in half lengthwise• Turn patient onto his side
away from you, place sheet under patient with fold against patient’s back
• Turn patient towards you, have an assistant unfold sheet beneath patient
• Return patient to a supine position
Methods of Patient Care 27
Cart (Stretcher, gurney)
To transfer 3 – 4 people are
needed 1 person needed to
support head Roll sheet at the side of
the patient so hands can easily grasp it
Transfer patient in unison
Methods of Patient Care 28
Cart (Stretcher, gurney)
Sliding board transfer < 150 #s - 2 people 150 – 375 #s – 4 375 – 500#s – 6 500 #s – requires
mechanical lift
Methods of Patient Care 29
Cart (Stretcher, gurney)
Sliding board transfer Move the patient to the edge of the bed Move the cart up against bed, lock the
wheels Assist the patient to turn onto his or her
side, away from the cart, and place slider board under the sheet
Place the sheet over the board, and allow the patient to roll back onto the board
Methods of Patient Care 30
Cart (Stretcher, gurney)
Slide patient with slide board onto cart Assist patient to roll after from the bed,
remove slide board Place sheet under patient, allow patient to
lie flat again
Methods of Patient Care 31
Log Roll
Necessary to turn a patient without flexing his or her neck or back
Requires 5 people Two assist with maintaining alignment of the torso Two assist with the feet One immobilizes head & neck Roll patient in one unit in unison
Methods of Patient Care 32
Mechanical Lift Several different types of lifts available Decreases number of work-related back
injuries Should be used as much as possible Needs a minimum of 2 people when
moving patients Must be used for patients > 500 #s Takes time to set up and move patient,
but prevents injuries
Methods of Patient Care 33
Mechanical Lift
Methods of Patient Care 34
Immobilization Techniques
Chapter 14
Methods of Patient Care 35
Use of Immobilizers & Restraints Immobilization - A method or device used to
minimize movement or assist in positioning a patient accurately– Reduces motion/improves radiographic quality– Reduces radiation exposure by reducing repeats– Keeps patient safe.
Simple vs complex methods/devices Examples of simple:
– positioning sponges– Sandbags
Examples of complex:– Backboard– Pigg-o-stat
Methods of Patient Care 36
Use of Immobilizers Examples of simple:
– positioning sponges– Velcro straps– Tape– Sandbags– Head clamps
Examples of complex:– Backboard– cervical collars– Splints– Sheets/mummy– Pigg-o-stat
Methods of Patient Care 37
Use of Immobilizers & Restraints Restraints – a device which restricts the
freedom of patient movement– Used to restrict movement– Used to protect the patient– Can only be ordered by a physician
Examples:– Straps– Posies– Velcro straps
Methods of Patient Care 38
Use of Immobilizers & Restraints Effective communication –
most effective method of avoiding the need to restrain/immobilize an adult patient
Reasons for application of immobilizers To control movement Remind a patient who is
sedated or confused to remain in a particular position
To prevent patient injury
Methods of Patient Care 39
Use of Immobilizers & Restraints
Never leave immobilized/restrained patients alone
Reassure patients that restraints are not a punishment.
Restraints (not immobilizers) can only be ordered by a physician.
Methods of Patient Care 40
Use of Restraints
Rules for application for restraints Patient must be allowed as much mobility
as safely possible Areas of the body where immobilizers are
applied must be padded to prevent injury to the skin beneath the device
Normal anatomic position must be maintained
Methods of Patient Care 41
Use of Restraints Restraints must be easy to remove
quickly if necessary Neither circulation nor respiration must
be impaired by the restraint Restraints must be removed every 2
hours After removal, the joints affected by the
immobilizer must be put through range of motion
Methods of Patient Care 42
Use of Restraints
Any use of restraints requires documentation of: – the type of used, – the time is was applied and removed, – the reason for its application, and – an assessment of the patient at each stage
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Methods of Patient Care 43