Universidad De Manila College of Nursing POSITIONING THE CLIENT IN BED

Name: Evaluator: I. ATTITUDE (10%) Date: Done Done with Assistance Score: __________________ Group no: ______ Not Done Remarks

1. Reports on time 2. Wear complete prescribed uniform 3. Neat and well groomed 4. Observe proper decorum 5. Acknowledges criticism/suggestions cheerfully 6. Shows mastery of notivity II. KNOWLEDGE (20%) 1. State objectivity of the activity 2. Uses appropriate terms 3. State steps of the procedure in correct order 4. Explain rationale in every step III. SKILLS (70%) 1. Explain to the client what you are going to do, why it is necessary, and how he can cooperate 2. Wash hands and observe other appropriate infection control procedures

3. Provide privacy for the client 4. Adjust the bed and the clients position Adjust the head of the bed to a flat position, or as low as the client can tolerate Raise the bed to the height of your center of gravity Lock the wheels on the bed, and raise the rail on the side of the bed opposite to you 5. Elicit the clients help to lessen your workload Ask the client to flex the hips and knees and to position the feet so that they can be used effectively for pushing Ask the client to: Grasp the head of the bed with both hands and pull during the move Or: Raise the upper part of the body on the elbows and push with the hands and forearms during the move Or: Grasp the overhead trapeze with both hands and lift and pull during the move 6. Position yourself appropriately, and move the client Face the direction of the movement, and assume a broad stance with the foot nearest the bed

behind the forward foot and weight on the forward foot. Lean your trunk forward from the hips. Flex hips, knees, and ankles Place your near arm under the clients thighs. Push down on the mattress with the far arm Tighten your gluteal, abdominal, leg, and arm muscles, and rock from the back leg to the front leg and back again. Then, shift your weight to the front leg as the client pushes away with the heels and pulls with the arm, so that the client moves toward the head of the bed 7. Ensure clients comfort Elevate the head of the bed and provide appropriate support devices for the clients new position See the sections on positioning the client earlier in this chapter Variation: A Client Who Has Limited Strength of the Upper Extremities Procedure: Assist the client to flex the hips and knees as in step 5 previously. Place the clients arm across the chest. Ask the client to flex the neck during the move and keep his head off the bed surface Position yourself as in step 6, and place one arm under the clients back and shoulders and the other arm under the clients thighs. Shift your weight, as in step 6

Variation: Two Nurses Using a Hand -Forearm Interlock Procedure: Using the technique described in step 6, with the second staff member on the opposite side of the bed, interlock forearms under the clients thighs and shoulders, lift the client up in bed Variation: Two Nurses Using a Turn Sheet Procedure: Place a draw sheet or a full sheet folded in half under the client, extending from the shoulders to the thighs. Each person rolls up or fanfolds the turn sheet close to the clients body on either side Both individuals grasp the sheet close to the shoulders and buttocks of the client. Follow the method of moving client with limited upper extremity strength, as described earlier 8. Document all relevant information Record: Time and change of position moved from and position moved to Any signs of pressure areas Use of support devices Ability of client assist in moving and turning Response of client to moving and turning