1. BODY MECHANICS MS KLUTSEY ELLEN E. SONAM UHAS

2. OBJECTIVES At the end of the presentation, students should be able to: Define body mechanics Outline the importance of body mechanics to both the nurse and the patient Demonstrate the principles of body mechanics during nursing activities Outline the various positions used in nursing clients and the circumstances under which each can be use. Mention the various types of bed used and the indications for their use

3. BODY MECHANICS Body mechanics is the application of mechanical principles and knowledge of human anatomy to the action of the body parts during an activity. It is the coordinated effort of the muscular and nervous system to ensure or maintain balance, posture and body alignment during lifting, bending, moving and performing activities of daily living. It entails adoptions of appropriate ways of moving the body in order to accomplish tasks without stress or injury.

4. BODY MECHANICS Nurses’ implementation of correct body mechanics helps minimize the following: work-related musculoskeletal injuries. Body mechanics helps protect joints and muscles from being pulled or stretched beyond their capacities while allowing them to be used for maximum effectiveness. nurse fatigue Client injury

5. BODY MECHANICS Teaching patients how to move safely especially those with musculoskeletal disorders will contribute to the healing process. The nurse can further promote good body mechanics by such simple measures as placing articles within easy reach of patients so that they do not twist or over-stretch in reaching out to them. Also demonstrating correct techniques for getting in and out of bed can prevent musculoskeletal injuries

6. BODY MECHANICS Some principles of body mechanics are: Maintain the centre of gravity over a broad base of support Use major muscles by bending at the knee or squatting when lifting or reaching out to items lower than your centre of gravity. This is because the broad flat muscles of the back are weakest when stretched and flattened and so are very susceptible to injury when heavy objects are lifted. Avoid twisting this is because it can lead to torsion of the spine lessening its ability to function effectively.

7. BODY MECHANICS Slide (push/pull) instead of lifting. Lifting should be the last option to be considered to be considered. Keep the weight to be lifted as close to the body as possible- this positions the weight of the lifted item/person and the lifter in the same plane and closer to the centre of gravity for proper balance.

8. BODY MECHANICS When moving heavy objects, face the direction of the movement. Work on a level that avoids strain on your body; e.g. raise the bed to a level that you can comfortably bath a patient without bending over. Put on the internal abdominal girdle by tightening the stomach and tucking in the pelvis. Without this, the abdominal muscles can be weakened or torn causing its contents to herniate.

9. BODY MECHANICS Use a counter weight: one’s weight and that of the object or person to be moved may be used to assist movement. Hold your body in a stable position and then rock back using your weight against the weight being lifted rather than simply using your muscular strength as a counter- balance Avoid working against gravity as it demands more force and energy to do so. Reduce friction: friction is a force that opposes motion and can increase the amount of effort required to move an object.

10. BODY MECHANICS Use aids/assistance-ask other for assistance when needed and also use mechanical aids such as the hoist and the hydraulic lifter to avoid strain on the body.

11. BODY MECHANICS Some Concepts in Body Mechanics Body alignment Body alignment : refers to the position of body parts in relation to each other. Also it refers to the position of the joint, tendons, ligaments and muscles while in sitting, standing or lying down. The body is in line with the pull of gravity and contributes with body balance. When the body is in proper alignment it reduces strain on its parts

12. BODY MECHANICS Proper alignment and posture of the client lying in bed is similar to the standing position.

13. BODY MECHANICS Standing alignment Head upright Face forward Shoulders squared Back straight Abdominal muscles tucked in Arms straight at side Legs straight Feet forward

16. BODY MECHANICS Proper alignment when sitting Head is erect Vertebrae are in alignment Body weight is evenly distributed on buttocks and thigh Thighs are parallel and in a horizontal plane Both feet are supported on the floor and ankle are comfortably flexed. Space is maintained between the edge of the sit and posterior aspect of the knee Forearms are supported on arm rest or a table

18. BODY MECHANICS benefits of good alignment and posture Boots confidence prevents contractures promotes client’s comfort Lessens stress on muscle, tendons, nerves, and joints promotes respiration and circulation; Prevents of foot drop (plantar flexion).

19. BODY MECHANICS Body balance: 2. Body balance: it is achieved when the centre of gravity is balanced over a wide and a stable support. This provides support for stability of objects 3.Coordinated body movement: 3.Coordinated body movement: use of the body in coordinated manner when lifting, positioning and turning of patient.

20. B ODY MECHANICS Transferring is a nursing skill that helps the dependent client or client with restricted motility attain positions needed or desired safely. Mobilization plays important role in rehabilitation as physical activity: maintains and improves joint motion Increases strength of the musculoskeletal system Promotes circulation Relieves pressure on skin (pressure points) Improves respiratory function

21. B ODY MECHANICS Equipment needed for transfers include: Transfer belt Slide board Wheelchair Stretcher Lifts e.g. hydraulic lift.

22. B ODY MECHANICS Assisting client to sitting position Manipulate bed to the waist level Place client on his back flat Face head of bed and remove pillows Steady self with feet slightly apart; with feet nearer the bed behind other foot; facing bed at 45-degree angle to the head of the bed Place hand farther from patient under his shoulders, supporting his head and cervical vertebrae Place other hand on the bed surface Raise client to sitting position by shifting weight from front to back leg Push against bed using arm that is placed on the bed surface.

23. B ODY MECHANICS Assisting client to sitting position on side of bed With client in the supine position, raise head of bed to 30 degrees Turn him onto his side to face the nurse and on the side of the bed on which he will be sitting Nurse stands opposite client’s hips; turning diagonally so nurse faces client and corner of foot of the bed Stand with feet apart with foot closer to head of the bed in front of the other foot Place arm nearer head of bed under client’s shoulders, supporting head and neck. Move client’s lower legs and feet over side of bed; pivot toward rear leg, allowing client’s upper legs to swing downward. At the same time, shift weight to rear leg and elevate client.

24. BODY MECHANICS Transferring from Bed to Stretcher clients who are too weak to sit upright, those who are unconscious, or those with injuries that prevents them from maintaining an erect position may have to lie flat during transfers. a stretcher is therefore used to facilitate the transfer of such client. Stretchers have several features, including side rails, safety belts/straps, and locking wheels that ensures safety.

25. BODY MECHANICS 1. Transferring a patient from bed to stretcher with minimal support Inform client about desired purpose and destination. Raise the height of bed to that of Stretchers the and lock brakes of bed. Instruct client to move to side of bed close to stretcher Lower the side rails of both bed and stretcher Stand at outer side of stretcher and push it toward bed. Lock wheels of stretcher

26. BODY MECHANICS Instruct client to move onto stretcher with assistance as needed Cover client with sheet or bath blanket. Elevate side rails on stretcher and secure safety belts over client. Release brakes of stretcher, Stand at head of stretcher to guide it when pushing.

27. BODY MECHANICS Transferring a patient from bed to stretcher with maximum support Inform client about desired purpose and destination. Raise the height of bed to that of Stretchers the and lock brakes of bed. Assess amount of assistance required for transfer, usually two to four staff members are required for the maximum assisted transfer. Lock wheels of bed and stretcher

28. BODY MECHANICS Have one nurse stand close to client’s head Logroll the client and place a lift sheet under the client’s back, trunk, and upper legs. The lift sheet can extend under the head if client lacks head control abilities. If urinary drainage bag is present, empty it and move it to side of bed closest to stretcher Move client to edge of bed near stretcher. Nurse on non stretcher side of bed holds the lift sheet across the client’s chest

30. BODY MECHANICS Secure safety belts and elevate side rails of stretcher move intravenous fluid (IVF) to stretcher after client transfer and empty all drainage bags. Secure drainage system to client’s gown prior to transfer

31. BODY MECHANICS Transferring patient from bed to chair/stretcher

32. BODY MECHANICS Inform client about desired purpose and destination. Assess client’s ability to assist with the transfer and for presence of cognitive or sensory deficits. Lower the bed. Allow client to dangle feet for a few minutes. Bring wheelchair close to the side of the bed, toward the foot of the bed.

33. BODY MECHANICS Lock wheelchair brakes and elevate the foot pedals. Assist client to side of bed until feet touch the floor. Assess client for dizziness. Remain in front of client until dizziness has subsided. Apply gait belt if necessary.

34. BODY MECHANICS Reach under client’s axillae and place hands on client’s scapulae (or grasp gait belt). Assist the client to a standing position and provide support. Pivot client so client’s back is toward the wheelchair Instruct client to place hands on the arm supports of the wheelchair Bend at the knees, easing the client into a sitting position Assist client to maintain proper posture. Secure the safety belt, place client’s feet on feet pedals, and release brakes

35. BODY MECHANICS Logrolling a Client Place a small pillow between client’s knees in the supine position Cross clients arms on his chest Two nurses are positioned on the side the client is to be turned toward and one nurse on the opposite side Fold drawsheet along the side of patient that will be turning At the side of two nurses; one nurse grasps drawsheet at the lower hips and thighs, and the other nurse grabs the drawsheet at patient’s shoulder and lower back Roll the patient as one unit in a smooth, continuous motion at a signal e.g. at the count of three.

36. BODY MECHANICS Nurse on the opposite side tuck pillows along the length of the patient for support Gently lean patient as unit back towards the pillows for support. Assess the client for comfort and proper alignment; e.g. of hands etc. Elevate side rails and lower the bed height. Wash and dry hands. NB: This procedure can be reversed to reposition clients on their backs.

37. BODY MECHANICS Moving an immobile client up in bed using the drawsheet (two nurses) A nurse should be at each side of the patient Place drawsheet under the patient, extending from the shoulders to the thighs Place patient on his back Fold the drawsheet on both sides and hold it near the patient on both side With feet apart in a forward-backward stance, move client to the desired position in the bed.