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 TRANSFERSBefore 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 chairLogrolling

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