1. Copyright © 2008 Delmar Learning. All rights reserved. Unit 15 Patient Safety and Positioning

2. Copyright © 2008 Delmar Learning. All rights reserved. Objectives Spell and define terms. Identify patients who are at risk for having incidents. List alternatives to the use of physical restraints.

3. Copyright © 2008 Delmar Learning. All rights reserved. Objectives Describe the guidelines for the use of restraints. Demonstrate the correct application of restraints.

4. Copyright © 2008 Delmar Learning. All rights reserved. Objectives Describe two measures for preventing these types of incidents: –Accidental poisoning, thermal injuries, skin injuries, and choking List the elements that are common to all procedures.

5. Copyright © 2008 Delmar Learning. All rights reserved. Objectives Describe correct body alignment for the patient. List the purposes of repositioning patients.

6. Copyright © 2008 Delmar Learning. All rights reserved. Objectives Demonstrate these positions using the correct supportive devices: –Supine, semisupine, prone, semiprone, lateral, Fowler’s, and orthopneic

7. Copyright © 2008 Delmar Learning. All rights reserved. Objectives Demonstrate the following procedures: –Procedure 14 Turning the Patient Toward You –Procedure 15 Turning the Patient Away from You

8. Copyright © 2008 Delmar Learning. All rights reserved. Objectives Demonstrate the following procedures: –Procedure 16 Moving a Patient to the Head of the Bed –Procedure 17 Logrolling the Patient

9. Copyright © 2008 Delmar Learning. All rights reserved. Patient Safety In Unit 14 –You learned how to maintain a safe environment and avoid personal injuries –The prevention of patient injuries is another very important part of your job as a nursing assistant

10. Copyright © 2008 Delmar Learning. All rights reserved. Use of Physical Restraints In the past –Restraints were often used routinely as a preventive measure to avoid falls

11. Copyright © 2008 Delmar Learning. All rights reserved. Use of Physical Restraints Research has shown that side rails and other restraints do not necessarily accomplish this purpose –Restraints may be used for other preventive measures

12. Copyright © 2008 Delmar Learning. All rights reserved.

13. Alternatives to the Use of Restraints Alternatives to restraints should be tried before restraints are applied Restraints are used only as a last resort in situations in which a patient may harm himself or herself or others

14. Copyright © 2008 Delmar Learning. All rights reserved. Alternatives to the Use of Restraints Nursing assistants can take a number of actions to help reduce the need for restraints

15. Copyright © 2008 Delmar Learning. All rights reserved. Potential for Side Rail Injury Mattresses are sometimes replaced –Replacement may not be as large as the original mattress

16. Copyright © 2008 Delmar Learning. All rights reserved. Potential for Side Rail Injury Gaps between the mattress and bed frame or rails –Can be caused by movement or compression of the mattress due to patient weight, movement, or bed position Refer to Figures 15-10A and 15-10B

17. Copyright © 2008 Delmar Learning. All rights reserved. Potential for Side Rail Injury If you observe a gap that is wide enough to entrap a patient’s head or body part –Inform the nurse promptly

18. Copyright © 2008 Delmar Learning. All rights reserved. Potential for Side Rail Injury

19. Copyright © 2008 Delmar Learning. All rights reserved. Prevention of Other Incidents Many situations can result in an incident that may harm a patient Incidents can be prevented when all staff members are aware of appropriate preventive measures

20. Copyright © 2008 Delmar Learning. All rights reserved. Prevention of Other Incidents Some incidents that can be prevented are: –Accidental poisoning –Thermal injuries –Skin injuries –Choking

21. Copyright © 2008 Delmar Learning. All rights reserved. Introduction to Procedures Caring for patients safely means that you must faithfully and carefully carry out specific routines The normal manner of carrying out a task is called a procedure

22. Copyright © 2008 Delmar Learning. All rights reserved. Body Mechanics for the Patient Body mechanics for the patient –Similar to those for the health care team Although the patient probably will not be doing any lifting –Good posture habits should not be neglected

23. Copyright © 2008 Delmar Learning. All rights reserved. Body Alignment and Positioning Body alignment –Means maintaining a person in a position in which the body can properly function

24. Copyright © 2008 Delmar Learning. All rights reserved. Complications of Incorrect Positioning Complications can occur when body alignment is not maintained –Or when the patient’s position is not changed often enough

25. Copyright © 2008 Delmar Learning. All rights reserved. Basic Body Positions There are four basic positions, each with variations: –Prone –Supine –Lateral –Fowler’s position

26. Copyright © 2008 Delmar Learning. All rights reserved.

30. Positioning the Patient After you have turned and moved the patient into proper body alignment –Place pillows and other supportive devices to help the patient maintain the position –Instructions are provided in the textbook for the four basic positions and their variations

31. Copyright © 2008 Delmar Learning. All rights reserved. Chair Positioning Proper chair positioning begins with the feet Feet should be supported on the floor or wheelchair footrests Support the patient in the 90-90-90 position while sitting in the chair Refer to Figure 15-40B

32. Copyright © 2008 Delmar Learning. All rights reserved. Chair Positioning Remember that repositioning and pressure relief are needed when the patient is up in the chair

33. Copyright © 2008 Delmar Learning. All rights reserved. Chair Positioning

34. Copyright © 2008 Delmar Learning. All rights reserved. Chair Positioning Refer to file entitled “pre-post procedure” –For a review of beginning procedure actions and procedure completion actions