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Nursing: Lifting, Transferring And Positioning Of Patients Essay, Research Paper

Nursing: Lifting, Transferring and Positioning of Patients

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ABSTRACT

Lifting, transferring and positioning of patients is frequently undertaken by

nurses on each working day. This is necessary for patient comfort, medical

reasons and completion of self care needs. Lifting can be done in numerous ways.

As well as the nurse physically lifting or moving patients, a number of devices

are also available to assist in the transfer of patients. These range from

straps that are attached to or placed under the patients, to mechanical hoists

and lifters. Any assistance the nurse has is beneficial for both the patient

and the health care worker, as patient’s weights are generally heavier than the

nurses physical capabilities. This, combined with incorrect lifting techniques,

can result in muscle strain, or more seriously, spinal injury for the nurse, and

discomfort, muscle strain or further injury for the patient.

INTRODUCTION

When lifting, transferring or positioning patients, the most important

consideration is safety. Any of these procedures need to be undertaken with it

in mind. This safety is inclusive of both the patient and the health care

worker. Communication is an important part of the lifting process as the nurse

should elicit information from the client to find out how and when they prefer

to be moved. This allows the patient to be involved in the decision making

process and be fully aware of what is occurring. By communicating with the

client, the nurse is also aware of whether or not the patient is experiencing

any discomfort during or after the lift.

The actions of lifting, transferring or positioning need to be completed for

numerous reasons, including relief of pressure points. Due to the patient being

in one position continuously, they are prone to the development of pressure

areas. In terms of patient needs, being in the same position constantly is

physically uncomfortable. However, mentally, a change in the immediate

surroundings is also beneficial for the patient. It is also necessary for the

patient to be moved for completion of their self care needs. This includes

their hygiene needs, which include, bathing or showering, elimination, hair,

oral and nail care.

METHOD

When lifting, transferring or positioning patients manually, safety is the most

important factor. This safety is for the nurse themselves as well as for the

patient. One aspect of safety is for the nurse to utilise “good body mechanics”

(Kozier et al 1995, p.879). This refers to the nurse having balance, which can

be achieved with the feet being spread approximately shoulder width apart, which

gives stability and a “wide base of support” (Kozier et al 1995, p.888).

According to Kozier et al, (1995 p.879) balance is also achieved by correct body

alignment and good posture. The use of correct body alignment reduces the

strain on muscles and joints, and makes lifting the clients much easier.

When lifting clients, the first thing the nurse should do is explain to the

patient what they are doing and ask the patient if there is any particular way

they would prefer to be moved. This allows the patient to have some opinion

about what is being done to them.

The next thing that should be done when moving a patient is a routine assessment.

The nurse may assess the situation by firstly observing the patient and reading

the nursing care plan. The nurse needs to be aware of the patients capabilities

to see how much they can do or if they can assist in any way. Another important

part of assessment is observing the surrounding environment, to be sure there is

no obstructions or other hazards which may be injurious to the nurse or patient

before, during or after the move.

The next phase is that of planning the move. The nurse decides how the patient

will be moved from their current position to where they are going. This may

involve the nurse getting assistance for the lift, either from other health care

workers or by mechanical devices, such as a lifter or hoist. When moving or

lifting the client, wherever possible the nurse should have assistance. This

assistance is necessary for both nurse and client safety. This is supported by

Kozier (1995 p.910), who says, wherever possible,

“the preferred method is to have two or more nurses move or turn the client”.

When moving clients physically, there are different types of moves that can be

used. When moving a client up in bed, the client should be encouraged to help

if possible. The nurse can ask the patient to bend their knees, so that when

the nurse is ready, the patient can assist by pushing backwards when the nurse

says. Two nurses stand on opposite sides of the bed facing each other. With

knees bent and legs shoulder width apart, the nurses lock forearms underneath

the patient’s thighs and shoulders. The nurses, on the count of three, at the

same time as the patient is pushing backwards, transfer the weight to the legs

that are in the same direction that the patient is going to be moved.

When moving a client from a lateral lying position to sitting at the side of the

bed, the first thing that the nurse should do after assessment, is

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