o INCREASES MUSCLE STRENGTH

o MAINTAINS BODY FLEXIBILITY

o IMPROVES RESPIRATORY FUNCTION

o PREVENTS POOLING OF FLUID IN THE LUNGS

o IMPROVES CIRCULATION

o HELPS MAINTAIN HEALTHY SKIN

o PROMOTES EFFECTIVE ELIMINATION

o AIDS DIGESTION

o RELIEVES STRESS

EVERY BODY SYSTEM IS AFFECTED

CONTRACTURE

AN ABNORMAL SHORTENING OF THE MUSCLE DUE TO LACK OF USE.

THE MUSCLE IS FIXED INTO POSITION, IS DEFORMED, AND CANNOT STRETCH.

THE PERSON WITH A CONTRACTURE IS PERMANENTLY DISABLED

ATROPHY

ATROPHY – A DECREASE IN SIZE OR A WASTING AWAY OF MUSCLE TISSUE.

CAUSED BY LACK OF USE

DECUBITUS ULCER

A BREAKDOWN IN SKIN TISSUE THAT OCCURS WHEN BLOODFLOW TO AN AREA IS INTERRUPTED

MORE DECUBITI

THE TRUNK OF THE PERSON SHOULD BE IN A STRAIGHT LINE WHEN THE PATIENT IS LYING DOWN

THE PATIENT IN A CHAIR SHOULD SIT UP STRAIGHT

HIS FEET SHOULD EITHER

REST ON THE FLOOR OR ON A

STOOL

HIS LOWER BACK SHOULD REST AGAINST THE BACK OF THE

CHAIR

THE BACKS OF HIS KNEES SHOULD BE SLIGHTLY AWAY

FROM THE SEAT OF THE CHAIR

PROPER POSITIONING IN A CHAIR

DESIGNED TO HELP THE PATIENT MAINTAIN CORRECT BODY ALIGNMENT AND PREVENT COMPLICATIONS

BED CRADLE

KEEPS THE WEIGHT OF THE LINENS FROM PRESSING ON THE PATIENT’S BODY

FOOT BOARD

KEEP THE FOOT IN A NATURAL POSITION TO PREVENT FOOT DROP (PLANTER FLEXION)

FOOT DROP BOOT

HELPS PREVENT FOOTDROP

HAND ROLL

PERMITS THE HAND TO FLEX SLIGHTLY AND PREVENTS CONTRACTURES OF THE FINGERS

o IF THE PATIENT IS UNABLE TO CHANGE POSITION INDEPENDENTLY , YOU WILL NEED TO ASSIST .

o PATIENTS NEED TO BE TURNED EVERY TWO HOURS.

Lateral position

• Fowler’s position is a semi‑sitting position.– The spine is kept straight.– The head is supported with a small pillow.– The arms are supported with pillows.

• The supine (dorsal recumbent) position is the back‑lying position.– The bed is flat.– The head and shoulders are supported on a pillow.– Arms and hands are at the sides.

• Prone position– The person lies on the abdomen with the head

turned to one side.– The bed is flat.– Small pillows are placed under the head, abdomen,

and lower legs.– Arms are flexed at the elbows with the hands near

the head.

• Lateral position (side-lying)– A pillow is under the head and neck.– The upper leg, ankle, and thigh are supported with

pillows.– A pillow is positioned against the person’s back.– A small pillow is under the upper arm and hand.

ORTHOPNEIC POSITION

FREQUENTLY USED BY PATIENTS WITH RESPIRATORY PROBLEMS

HELPS EXPAND THE CHEST AND LUNGS TO ALLOW MORE OXYGEN TO ENTER

MOVING PERSONS IN BED

• Protect the skin when moving the person.– Friction is the rubbing of one surface against

another.– Shearing is when the skin sticks to a surface while

muscles slide in the direction the body is moving.

• To reduce friction and shearing:– Roll the person or use assist devices.– Use a lift sheet (turning sheet), turning pad, large

incontinence product, slide board, or slide sheet.

THE SKIN STICKS TO THE SURFACE BUT THE

INTERNAL STRUCTURES ( BONE AND MUSCLE )

SLIDE IN THE DIRECTION THE BODY

IS MOVING

OCCURS WHEN THE PATIENT SLIDES DOWN

IN BED

IF THE PATIENT CAN ASSIST:

HAVE THE PATIENT GRASP THE

HEADBOARD AND BEND HIS KNEES

PLACE YOUR FOREARMS UNDER HIS

SHOULDERS AND KNEES

LIFT AT THE COUNT OF THREE

IF THE PATIENT HAS A TRAPEZE ON THE BED

HAVE THE PATIENT GRASP THE TRAPEZE AND BEND

AT THE KNEES

MOVING UP IN BED

A LIFT SHEET MAKES LIFTING EASIER

HELPS PREVENT FRICTION AGAINST

THE PATIENT’S SKIN

TAKES TWO WORKERS TO LIFT

IF PATIENT CAN HELP HAVE HIM BEND HIS

KNEES

USE FOR PERSONS WHO CAN NOT HELP

WITH THE MOVE

THE PERSON IS MOVED IN SEGMENTS

PROPER POSITIONING FOR LATERAL POSITION

A PATIENT WHO HAS A SPINAL INJURY OR SPINAL SURGERY MUST BE KEPT IN GOOD BODY ALIGNMENT WHEN TURNING.

USING A LIFT SHEET THE PERSON IS TURNED IN ONE MOTION.

IT TAKES 2 OR 3 PERSONS TO SAFELY LOGROLL A PATIENT.

DANGLING REFERS TO SITTING ON THE SIDE OF THE BED WITH THE FEET HANGING DOWN

DO NOT LEAVE THE PATIENT ALONE WHEN DANGLING.

HAVE THE PATIENT COUGH, DEEP BREATHE, AND EXERCISE THEIR LEG MUSCLES WHEN DANGLING.

IF THE PATIENT BECOMES DIZZY LIE HIM DOWN.

CHECK THE PERSON’S PULSE AND RESPIRATIONS

• DO NOT ALLOW THE PERSON TO PUT HIS ARMS AROUND YOUR NECK• MAKE SURE YOU LOCK THE WHEELS ON THE BED AND WHEELCHAIR

o APPLY THE BELT AROUND THE PERSON’S WAIST, OVER THE CLOTHING.

o TIGHTEN THE BELT SO IT IS SNUG. IT SHOULD NOT CAUSE DISCOMFORT OR IMPAIR BREATHING. YOU SHOULD BE ABLE TO SLIDE YOUR OPEN HAND UNDER THE BELT.

o PLACE THE BUCKLE SLIGHTLY OFF CENTER IN THE FRONT.

o DO NOT USE WITH PATIENTS WITH FRACTURED RIBS, ABDOMINAL SURGERY, OR HAVING BREATHING DIFFICULTIES

NOTE THE POSITION OF THE CNA’S HANDS ON THE GAIT BELT

NOTE HIS USE OF PROPER BODY MECHANICS

NOTE THE PLACEMENT OF HIS KNEES AGAINST THE KNEES OF THE PATIENT

ALSO CALLED

HOYER LIFT

USED TO TRANSFER PATIENTS WHO ARE

PARALYZED, VERY HEAVY, OR DIFFICULT TO MOVE

YOU NEED AT LEAST 2 STAFF MEMBERS TO

SAFELY USE A MECHANICAL LIFT

MANY FACILITIES HAVE “NO LIFT” POLICIES.

A SPECIAL LIFT IS USED TO STAND AND MOVE RESIDENTS IF YOUR FACILITY HAS THIS RESTRICTION.

PARALYZED PERSONS USE A TRANSFER BOARD FOR TRANSFER FROM

WHEELCHAIR TO BED

THE WHEELCHAIR IS

PLACED AT A RIGHT ANGLE

TO THE TOLIET

TAKES 4 OR MORE STAFF

USE A LIFT SHEET OR SLED TO PULL PATIENT OVER ONTO CART

REPOSITIONING A RESIDENT IN A WHEELCHAIR

o LOCK THE WHEELS AND MOVE THE FOOTRESTS OUT OF THE WAY

o DO NOT PULL THE RESIDENT UP BY THE ARMS

o TO AVOID INJURY TO THE RESIDENT USE TWO STAFF MEMBERS

o ALWAYS LOCK THE BRAKES WHEN TRANSFERRING

o CLEAN THE WHEELCHAIR ON A REGULAR BASIS

o MOVE THE FOOTRESTS OUT OF THE WAY WHEN TRANSFERRING

CARDIAC CHAIR GERI-CHAIR

BACK DOWN A RAMP WITH A WHEELCHAIR

BACK INTO THE ELEVATOR SO THE

PATIENT FACES THE FRONT

TRANSFER THE PATIENT FEET FIRST DOWN A RAMP

ENTER THE ELEVATOR HEAD FIRST