1. Fundamentals Of Nursing
Moving the client in & out of bed 
Presented by:
MS. AHDAB FAISAL ESKANDAR

3. OBJECTIVES Differentiate between manual and assistive technique .
Enumerate the common purposes for moving client.
Assess client`s status needs and environment .
Mention required equipment.
Demonstrate the steps of each procedure .

4. OUTLINE: Introduction Purpose of moving client Needed assessment
Required equipment
Types of transfer
Procedure transfer
Conclusion
Reffrance

5. Introduction
*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.

6. Purpose Maintains body alignment
Maintains skin integrity and facilitates pressure distribution
prevent friction and shear on tissue
Promote comfort
Promote optimal lung expansion
Prevent injury and deformities of musculoskeletal system
Position clients for a variety of clinical procedures

7. 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.

8. 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

9. EQUIPMENTS: Support devices required by clients(e.g.
Draw sheet
Sliding sheet
Foot board
Sandbags
Hand rolls
Foam wedges
Pillows for head ,extra pillows
Gloves

10. Slide sheet ( made from low friction material )
Bed pole (trapeze) and leader
Transfer ( walking) belt
Wedges

11. Lifting machine

12. Types of transfer 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.
DEPENDENT TRANSFERS

13. 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.

14. PROCEDURE

15. 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

16. Moving client up in bed Equipment :pull sheet or sliding bar.
Purposes: clients slide down or being pulled by traction
Preparation :determine(assistive device-attached IV or heavy cast-medications-assisted personal)

17. 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

18. 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 :-
Grasp the head of the bed with both hands and pull during move or
Raise upper part of body on elbows and push with hands and forearm during the move

19. 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

21. Other methods for moving 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.

22. 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

23. 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

25. 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

26. 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

27. 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

31. 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 .

33. 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)

34. 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.

36. 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

37. 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

38. 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

39. Conclusion

40. ?
Any question

41. 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

42. Thank you