Wk 1 Bed Making, Body Mechanics, Therpeutic Positioning fall 23 - Tagged.pdf

Bedmaking, Body Mechanics and Therapeutic Positioning NURS 1090  Bedmaking, Body Mechanics and Therapeutic Positioning Unit Outcomes: Demonstrate ability to make unoccupied and occupied beds Demonstrate principles of safe patient transfer and positioning techniques including Therapeuti...

Bedmaking, Body Mechanics and Therapeutic Positioning NURS 1090  Bedmaking, Body Mechanics and Therapeutic Positioning Unit Outcomes: Demonstrate ability to make unoccupied and occupied beds Demonstrate principles of safe patient transfer and positioning techniques including Therapeutic positions Bed to chair (Week 4) Bed to cart (Week 4) Identify principles of proper body mechanics to prevent nurse injury.  Hospital Bed Features and Nurse Call System Hospital Bed Features Nurse Call System Side Rails Wheels/Bed Lock Patient control Elevation: system ◦Head up/down ◦Foot up/down ◦Nurse Call System ◦Entire bed up/down ◦TV controller Bed Exit Alarm Bed Weight CPR Function Hospital Bed Operation https://www.youtube.com/watch?v=yF2GMLADcT4  Bedmaking General Principles Presents the opportunity to assess and meet the patient’s needs Keep linen clean, dry and free Follow principles of Medical Asepsis of wrinkles Clean linen is not to be placed on Promotes patient comfort another patient’s bed or on the floor Keep soiled linen away from uniform Helps prevent skin breakdown Do not put soiled linen on overbed table or floor Do not shake soiled linen If in doubt, wear gloves  Bed Making Supplies Linen bag Bottom sheet (flat or fitted) Top sheet Bedspread (optional) Waterproof pads (optional) Pillowcases Blanket (optional) Drawsheet (optional) Bath Blanket (optional)  “Types” of Bed Making Unoccupied Bed: patient is not Occupied Bed: patient is physically physically in the bed in the bed Open bed: the patient is assigned the Must change linen with patient in bed, but is not physically in the bed now bed (bedrest)  Once the bed is made, the sheets are pulled down to allow patient easy Provide for privacy access Safety Closed bed: after discharge. Bed is not Get help if necessary assigned to a patient Once bed is made, the sheets cover Log roll: method to turn patient the entire mattress until a new patient side to side is admitted  Gather clean linens Place bed in comfortable working height Remove soiled linens Wipe mattress with disinfectant if soiled Making an Apply bottom sheet, top sheet and waterproof pad or draw sheet if needed Occupied Miter (fold) bottom corners of bed linens – Assists Bed in preventing wrinkles and holds linen securely Make one side of the bed before moving to the other side Cuff top of sheet over bed spread Apply clean pillowcase Mitered Corner  Making an Unoccupied Bed: Video Kaplan Nursing: Kaptest.com Clinical resources Clinical Skills Watch Clinical Skills in Action Making an Unoccupied Bed  Making an Occupied Bed 1. Remove top bedding a. Cover patient with bath blanket 2. Change bottom linen a. Log roll patient – b. Fan fold dirty linen toward center of bed – c. Place new bottom sheet and pad; fan fold 3. Assist patient to roll over to side of bed on to clean linen 4. Remove used linen; complete linen change 5. Reposition patient to center of bed 6. Apply or complete top bedding  Making an Occupied Bed: Video Kaplan Nursing: Kaptest.com  Clinical Resources Clinical Skills Watch Clinical Skills in Action Making an Occupied Bed  Bed Positions Pearson Vol. 3 pp._401-404 1. Flat: entire bed frame horizontally parallel with floor 2. Semi- Fowler: Head of bed raised to 30⁰ angle 3. Fowler: Head of bed elevated 45- 60 degree angle (semi- sitting) a. High-Fowler: 60- 90 degree angle  Bed Positions Orthopneic position: Head of bed at 90⁰ Patient leans forward to allow chest expansion May use over bed table Why is this position used to assist with breathing?  Bed Positions Trendelenburg Position: Head of bed lowered and foot raised Used to promote venous circulation Emergencies only Will not use as a student  Patient Positioning To increase patient comfort and maintain body alignment Nursing judgment Physician/HCP order Assess need for help** ◦ – Turn sheet ◦ – Mechanical lift ◦ – Other healthcare personnel  Body Mechanics Definition: Techniques used to prevent musculoskeletal injuries, especially back injuries Principles: ◦Encourage patient to help if possible ◦Use wide base of support with both feet flat on the floor, one foot in front of the other ◦Slightly bent at the knees ◦Tighten abdominal muscles and tuck buttocks in so that spine is in alignment ◦Hold head erect and secure firm stance ◦Maintain weight to be lifted as close to your body as possible ◦Use arms/legs when lifting; not back. Avoid twisting.  Positioning a Patient Pearson, Volume 3, pp. 403-416 Supine Position: back lying position Prone Position: lying face down; head to side Lateral Position: side lying ◦ Top arm and leg flexed ◦ Use pillow to protect bony prominences Dorsal Recumbent: back lying with legs flexed Sims: ¾ way over on side Positioning aids: ◦ Enemas, colonoscopy Pillows, trochanter roll, ◦ Prevents pressure on greater trochanter positioning boots Positioning Boot  Repositioning a Patient: Moving a Patient up in Bed – Assess need for help – Determine if assistive devices are needed (pull and/or turn sheet) – Note if any tubes or drains are present (IV, urinary catheter) – Have patient to flex the hips and knees and position the feet so they can be used for pushing (if possible) – Nurse uses legs/arms/own body weight and rocking motion – Use pull sheet or pad ◦ Lift enough to prevent friction ◦ “1-2-3”