Chapter 13 Assisting with Mobility 395 Copyright Goodheart-Willcox Co., Inc. Safe Patient-Handling Techniques It is vital that you follow safe patient-handling techniques at all times when positioning or moving patients. Some general safety guidelines include the following: • Maintain a wide, stable base with your feet. • Position the bed at the correct height (waist level when you provide care, hip level when moving a patient). • Try to keep the work directly in front of you to avoid rotating your spine. • Keep the patient as close to your body as possible to minimize reaching. • Give skin care to pressure points before and after a change in position. Protect the patient from tubing that may rub his or her skin, if possible. • Provide the most support to the heaviest part of the patient’s body and avoid placing one body part directly on top of another. • Move the patient smoothly. • Always check the bed linens to be sure they are clean, dry, and smooth so that folds in the sheets or food crumbs do not rub the skin and increase the risk of decubitus ulcers. Positioning Guidelines Properly positioning and repositioning patients requires knowledge of the different types of available positions, familiarity with the equipment, and attention to the condition of the patient and the patient’s skin. Always practice safety by using proper body mechanics and asking for assistance from others if the patient is frail, is overweight, or has equipment or devices attached to his body, such as tubes or an intravenous (IV) catheter. Different types of equipment and devices are used for positioning. If you are uncertain about the type of positioning equipment or devices to use, or how to use them, check with the appropriate provider. (Note: some devices can be interpreted as a type of restraint, which is contraindicated.) Examples of positioning equipment and devices you may use include • pillows of various sizes to help protect the skin prop up a limb or support the head, a limb, or the back for comfort • folded or rolled towels and blankets to prop up and support the patient and maintain proper body alignment • trochanter rolls made from rolled towels or blankets placed from the top of the pelvic bone to mid-thigh to prevent external rotation of the hip (Figure 13.29) • a turning sheet, also called a pull sheet, draw sheet, or lift sheet, is used by the healthcare worker to turn the patient • cotton padding to protect skin and bony areas • a foot board, which is a fl at panel used at the end of the bed to prevent foot drop and • a hip abduction wedge, which is usually made of a stiff foam rubber material cut in a wedge to prop up the hip (Figure 13.30). trochanter roll a rolled towel or blanket placed along the hip that prevents the hips from rotating externally Wards Forest Media, LLC Figure 13.29 Trochanter rolls prevent the patient’s hips from externally rotating. Wards Forest Media, LLC Figure 13.30 Hip abduction wedge