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Lifting, Transferring And Positioning Patients Essay, Research Paper

Lifting, Transferring and PositioningABSTRACTLifting, transferring and positioning of patients is frequently undertakenby nurses on each working day. This is necessary for patient comfort,medical reasons and completion of self care needs. Lifting can be done innumerous ways. As well as the nurse physically lifting or moving patients,a number of devices are also available to assist in the transfer ofpatients. These range from straps that are attached to or placed under thepatients, to mechanical hoists and lifters. Any assistance the nurse has isbeneficial for both the patient and the health care worker, as patient’sweights are generally heavier than the nurses physical capabilities. This,combined with incorrect lifting techniques, can result in muscle strain, ormore seriously, spinal injury for the nurse, and discomfort, muscle strainor further injury for the patient. INTRODUCTIONWhen lifting, transferring or positioning patients, the most importantconsideration is safety. Any of these procedures need to be undertaken withit in mind. This safety is inclusive of both the patient and the healthcare worker. Communication is an important part of the lifting process asthe nurse should elicit information from the client to find out how and whenthey prefer to be moved. This allows the patient to be involved in thedecision making process and be fully aware of what is occurring. Bycommunicating with the client, the nurse is also aware of whether or not thepatient is experiencing any discomfort during or after the lift. The actions of lifting, transferring or positioning need to be completed fornumerous reasons, including relief of pressure points. Due to the patientbeing in one position continuously, they are prone to the development ofpressure areas. In terms of patient needs, being in the same positionconstantly is physically uncomfortable. However, mentally, a change in theimmediate surroundings is also beneficial for the patient. It is alsonecessary for the patient to be moved for completion of their self careneeds. This includes their hygiene needs, which include, bathing orshowering, elimination, hair, oral and nail care. {PAGE BREAK}METHODWhen lifting, transferring or positioning patients manually, safety is themost important factor. This safety is for the nurse themselves as well asfor the patient. One aspect of safety is for the nurse to utilise “goodbody mechanics” (Kozier et al 1995, p.879). This refers to the nurse havingbalance, which can be achieved with the feet being spread approximatelyshoulder 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) balanceis also achieved by correct body alignment and good posture. The use ofcorrect body alignment reduces the strain on muscles and joints, and makeslifting the clients much easier. When lifting clients, the first thing the nurse should do is explain to thepatient what they are doing and ask the patient if there is any particularway they would prefer to be moved. This allows the patient to have someopinion about what is being done to them. The next thing that should be done when moving a patient is a routineassessment. The nurse may assess the situation by firstly observing thepatient and reading the nursing care plan. The nurse needs to be aware ofthe patients capabilities to see how much they can do or if they can assistin any way. Another important part of assessment is observing thesurrounding environment, to be sure there is no obstructions or otherhazards which may be injurious to the nurse or patient before, during orafter the move. The next phase is that of planning the move. The nurse decides how thepatient will be moved from their current position to where they are going. This may involve the nurse getting assistance for the lift, either fromother health care workers or by mechanical devices, such as a lifter orhoist. When moving or lifting the client, wherever possible the nurseshould have assistance. This assistance is necessary for both nurse andclient safety. This is supported by Kozier (1995 p.910), who says, whereverpossible,”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 canbe used. When moving a client up in bed, the client should be encouraged tohelp if possible. The nurse can ask the patient to bend their knees, sothat when the nurse is ready, the patient can assist by pushing backwardswhen the nurse says. Two nurses stand on opposite sides of the bed facingeach other. With knees bent and legs shoulder width apart, the nurses lockforearms underneath the patient’s thighs and shoulders. The nurses, on thecount 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 thepatient is going to be moved. When moving a client from a lateral lying position to sitting at the side ofthe bed, the first thing that the nurse should do after assessment, is toget the patient in a side lying position. This is done by the nurse placingone hand on the client’s hips and one hand on the client’s shoulder. Thenurse then transfers their weight onto the back foot while at the same timerolling the client towards them. The next step is the nurse places one armunderneath the patient’s shoulders and one arm underneath the knees. Thenurse then turns on the balls of the feet while at the same time pulling theclient’s legs down on the floor. The next move is transferring a client from the bed to a chair. Once theclient is sitting on the edge of the bed, the nurse can easily move thepatient to a chair. This procedure therefore follows on from the procedureof sitting a client up in bed. This can be done by the use of a “transfer

belt” (Kozier 1995 p.924). Before commencing the lift,

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