Chapter - 014 Student Handouts

Wilk: Sorrentino's Canadian Textbook for the Support Worker, 5th Edition
Chapter 14: Body Mechanics
Chapter 14
Body Mechanics
Copyright © 2022 Elsevier, Inc. All Rights Reserved. 1
Helping to Prevent Personal Injuries
 It is important to use your body correctly to

avoid injuries during moving, positioning. and
transferring activities.
 Practising and performing 10 warm-up
exercises prior to initiating any moving,
positioning, or transferring activities will
reduce the risk of injury.
 Seek immediate medical attention for injuries.
 See textbook box: Think About Safety: Warming
Up and Stretching Exercises

Slide 2
Body Mechanics (1 of 4)
 Proper body mechanics means moving the
body in an efficient and careful way.
 It involves good posture, balance, and using your
strongest and largest muscles for work.
 Good body mechanics reduces the risk of
injury.
 Fatigue, muscle strain, and injury can result
from improper use and positioning of the
body.
Copyright © 2022 Elsevier, Inc. All rights reserved. 1

 Body alignment (posture) is the way the
head, trunk, arms, and legs are aligned with
one another.
 Good alignment lets the body move and function
with strength and efficiency.
 Body balance is achieved when a relatively low
centre of gravity is balanced over a wide, stable
base of support.
 Base of support is the area on which an
object rests.
 Feet are about shoulder-width apart
 Toes are pointing forward
 Lunge (stride) stance is with one foot slightly
forward
 Use your strongest and largest muscles in the
shoulders, upper arms, hips, and thighs to
handle and move persons and heavy objects.

Slide 5
 Bend your knees and squat to lift a heavy
object.
 Do not bend from your waist.
 Hold items close to your body and base of
support.
• This involves upper arm and shoulder
muscles
 All activities require good body mechanics.
 See textbook box: Think About Safety: Guidelines
for Good Body Mechanics

Comfort and Safety Measures
(1 of 4)
 Protecting the skin:
 Protect the client’s skin during handling,
moving, and transfer procedures.
 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.

(2 of 4)
 Reduce friction and shearing when moving
the person in bed by:
 Rolling or lifting the client
 Using friction-reducing devices (e.g., turning pad,
slider board)
 Check with your supervisor or care plan
about limits or restrictions in positioning or
moving.

Slide 8

(3 of 4)
 Decide how to move the client and how much
help you need.
 Ask for help—arrange a time.
 Communicate:
 Decide before moving client who will count
and who will be the leader.

(4 of 4)
 Provide privacy—move the client in small
increments.
 Protect tubes or drainage containers.
 Position the client in good body alignment
after moving.
 Leave the client in a wrinkle-free
environment.

Slide 10
Assistive Devices
 Assistive devices:
 Turning pad
 Mechanical lift
 Two to three workers
 “No-lift policy” indicates which clients must

use a mechanical lift
 You need to check with your supervisor or the
care plan
 See textbook box: Supporting Mrs. Quouong:
Understanding the No-Lift Policy
Moving the Client Up in Bed

 The client is moved up in bed for good
alignment and comfort.
 Check agency caregiving lifting programs and
know the policy for moving clients.
 Client may have a trapeze to aid with moving.
 Having someone help you protects you and
the client from injury.
 See textbook Figure 14.8: A person is moved up
in bed by two support workers.

Turning Pads and Sliders (1 of 4)

Slide 13

Slide 14

Slide 15

 Turning pad—is also known as sliding pad,
turning sheet, transfer sheet, lift pad, and
(inaccurately) a draw-sheet.
 Sliders have replaced turning pads in many
facilities.
 Sliders are used to move and reposition
clients.
Rolling Versus Log-Rolling a

Client
 Log-rolling
 Clients with back or spinal surgery often need to
keep their spinal column in straight alignment to
prevent further injuries. Client needs to be rolled
as one unit.
 Rolling
 Clients who do not have severe neck, back or
spinal injury may be turned (rolled).
• See textbook procedure: Log-Rolling the Client (Note:
This Procedure Requires Three Team Members)

Slide 17
Turning the Client

 Clients are turned onto their sides:
• To help prevent complications from bed rest
• For certain procedures and care measures
 The client is turned toward you or away from you.
• The direction depends on the client’s condition and the
situation.
 After the client is turned, position the person in
good alignment.
• Use pillows for support, as needed.

Moving the Client From a Bed to
a Stretcher (1 of 2)
 Stretchers are used to transport clients who:
 Cannot sit up
 Must stay in a lying position
 Are seriously ill
 Are waiting for or returning from surgery
 The stretcher is covered with a folded flat

sheet.
 A slider board is generally used.
 At least three staff members are needed for a
safe transfer.
Moving the Client From a Bed to

a Stretcher (2 of 2)
 Safety straps are used.
 The stretcher side rails are kept up during the
transport of the client.
 The stretcher is moved feet first. The staff
member at the head of the stretcher can
watch the client’s breathing and colour.
 Never leave the client unattended on a
stretcher.
Moving the Client to the

Side of the Bed (1 of 3)
 The client is moved to the side of the bed:
 For repositioning and care procedures
 Before turning
 To limit the need to reach over the client
 To dangle the legs
 Because getting out of bed too fast can make a
client dizzy or faint; the client needs to sit for 1 to 5
minutes first

Moving the Client to the Side of
the Bed (2 of 3)
 Follow these guidelines to safely position a
client:
 Use good body mechanics.
 Ask a co-worker to help you, if needed.
 Explain the procedure to the client.
 Be gentle when moving the client.
 Provide for client privacy.
Moving the Client to the Side of

the Bed (3 of 3)
 Use pillows as directed by the nurse for support
and alignment.
 Provide for comfort after positioning.
 Place the call bell within reach after positioning.
 Complete a safety check before leaving the room.

Slide 23
Sitting on the Side of the Bed

(Dangling the Legs)
 While dangling the legs, the client:
 Coughs and deep-breathes
 Moves the legs back and forth in circles
 Two staff members may be needed
 Clients with balance and coordination problems
need support.
 If dizziness or fainting occurs, lay the client down.
 Report observations, pulse, respirations, skin
colour, complaints of dizziness, light-headedness,
difficulty breathing, how well the activity was
tolerated, amount of help needed, and length of
time the client’s legs dangled.

Positioning the Client
 A client must be properly positioned at all times.
 Regular position changes and good alignment:
 Promote comfort and well-being
 Make breathing easier
 Promote circulation
 Help prevent complications (e.g., pressure ulcers
and contractures)
 Some clients need a reminder to change their
own positioning; others depend entirely on the
health care team for position changes.

 Whether in bed or chair, the client is
repositioned at least every 2 hours.
 Follow your supervisor’s instructions and the care
plan.
 Physician may order certain positions or limits.
 Always leave client in good body alignment.
 Observe client’s skin for signs of redness,
paleness, or discoloration; report immediately if
present.
Types of Positions
 Fowler’s position:
 High Fowler’s: a semi-sitting position
• The head of the bed is raised to 45–90 degrees
• The knees may be slightly elevated
 Semi-Fowler’s
• Head of bed is at 30–45 degrees
 Low-Fowler’s:
• Head of bed is at 15–30 degrees
 Clients confined to bed use these three positions for eating,

visiting, watching TV, reading.
 Use pillows for support.
 Maintain good body alignment.
 Encourage the client to reposition.

Types of Positions (1 of 7)

 Sitting Position:
 Clients who sit in chairs must hold their upper
bodies and heads erect.
• Feet are flat on the floor or on wheelchair footplates.
• Backs of the knees and calves are slightly away from the edge
of the seat.
• The nurse may ask you to put a small pillow between the
client’s lower back and the chair.
• A pillow is not used behind the back if restraints are used.
 Some clients require postural supports if they
cannot keep their upper bodies erect—they may
consider these to be restraints.
• Support paralyzed (affected) arms on pillows

Repositioning the Client in a Chair

or Wheelchair
 For good alignment and safety, the client’s back
and buttocks must be against the back of the
chair.
 Follow the nurse’s directions and the care plan
for the best way to reposition a client in a chair or
wheelchair:
 Lock wheelchair wheels
 Block client’s feet with your knees and feet
 Use transfer belt for a secure hold on client
 If no transfer belt, put your arms under the client’s arms and
place your hands around the client’s shoulder blades
 Encourage the client to push, if possible, to assist with
repositioning
Transferring the Client (1 of 4)

 Transfer—a method used to move a client
who can weight-bear from one place to
another
 Lift—used for a client who cannot weight-
bear and must be manually lifted
 Most often, a mechanical lift will be used to reduce
the risk for serious back injury to the support
worker.
 See textbook box: Think About Safety: The
Difference Between a Lift and a Transfer

 If your client cannot help with the transfer, do
not transfer without assistance.
 Ensure the area is clear for a safe transfer.
 Always move the unaffected side first.
 Transfers from bed to chair or wheelchair:
 Help the client out of bed on their unaffected side:
• In transferring, the unaffected side moves first
• Client should wear non-skid footwear
• May use transfer boards

Slide 37

• Stand and pivot transfers are used if:
 The client’s legs are strong enough to bear some
or all of their own weight
 The client is cooperative and can follow directions
 The client can assist with the transfer
• Chair- or wheelchair-to-bed transfers have the

same rules as bed-to-chair transfers.
• You should always check the care plan to see
what equipment and how many people are
required to transfer a specific client.
 After transferring a client, report and record

the following:
 Client’s pulse rate (if it is to be measured, as
directed) before and after the transfer
 Client complaints of light-headedness, pain,
discomfort, difficulty breathing, weakness, or
fatigue
 The amount of help needed to transfer the client
 How the client helped with the transfer

Slide 39

Applying Transfer Belts (1 of 2)
 Transfer belts are used to transfer unsteady
clients and those with disabilities.
 Prevents falls and other injuries
 Be aware of your agency’s policies around
use of transfer belts.

Slide 40
Applying Transfer Belts (2 of 2)

Slide 41
Other Transfers
 The basic transfer from bed to chair,
commode chair, or wheelchair can be
modified for other situations.
 Lifts are used to physically move clients from
one place to another—into chairs, stretchers,
tubs, toilets, vehicles, etc.
 Most agencies no longer allow staff to
manually lift client, due to risk of back injury
for workers.

Slide 42

Manual Lifts
 Manual lifts
 When working in the home care sector, you might
be responsible for manual lifts (physically picking
up a client who cannot weight-bear).
 This should be done with the assistance of a
family member.
 Ensure you know your agency’s polices regarding
lifts.

Slide 43
Mechanically Lifting a Client

(1 of 2)
 There are many different kinds of mechanical
or electric lifts.
 Knowing one type of lift does not mean that
you know how the others work.
 It is your responsibility to ask your supervisor
to show you how to use a lift, if you are
unsure.
Mechanically Lifting a Client

(2 of 2)
 Mechanical lifts are used to transfer clients
who:
 Cannot help themselves
 Are too heavy for the staff to transfer
• Employers usually provide special training for
the use of mechanical lifts.

Before Using a Mechanical Lift
 You must be trained in its use.
 Make sure it works properly.
 The client’s weight must not exceed the lift’s
capacity.
 At least two staff members are needed.
 Always follow the manufacturer’s instructions.
 See textbook procedure: Using a Mechanical Lift to

Move a Client
Sit-to-Stand Mechanical Lift

 Allows for client transfers from one seated
position to another:
 From bed to chair
 For toileting, perineal care, or changing
incontinent briefs
 This type of lift is good for:
 Clients who are cognitively aware enough to
cooperate with instructions
 Client should have some muscle tone in at least
one leg and some upper body muscle tone
• See textbook procedure: Using Sit-to-Stand Mechanical
Lift
Slide 47

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Wilk: Sorrentino's Canadian Textbook for the Support Worker, 5th Edition

Chapter 14: Body Mechanics

Copyright © 2022 Elsevier, Inc. All Rights Reserved. 1

Helping to Prevent Personal Injuries

 It is important to use your body correctly to

Copyright © 2022 Elsevier, Inc. All Rights Reserved. 2

Copyright © 2022 Elsevier, Inc. All Rights Reserved. 3

Copyright © 2022 Elsevier, Inc. All rights reserved. 1

Copyright © 2022 Elsevier, Inc. All Rights Reserved. 4

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Comfort and Safety Measures

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Comfort and Safety Measures

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 “No-lift policy” indicates which clients must

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Moving the Client Up in Bed

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Turning Pads and Sliders (2 of 4)

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Turning Pads and Sliders (3 of 4)

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Rolling Versus Log-Rolling a

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Turning the Client

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 The stretcher is covered with a folded flat

 At least three staff members are needed for a

Moving the Client From a Bed to

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Moving the Client to the

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Moving the Client to the Side of

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Sitting on the Side of the Bed

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Comfort and Safety Measures

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 Clients confined to bed use these three positions for eating,

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Repositioning the Client in a Chair