Transcript Health Skills II Unit 204 Ambulation and Assistive Devices Moving Patients  General  know patient diagnosis, abilities and restrictions (physical & cognitive)  mentally and.

Health Skills II
Unit 204
Ambulation and Assistive Devices
Moving Patients
 General
 know patient diagnosis, abilities and
restrictions (physical & cognitive)
 mentally and physically plan your action
 seek help when necessary and available
 explain procedure to patient and assistants
and how they can assist in the move
 remove obstacles to maintain a safe
environment for patient & health care worker
 lock wheels of movable objects
Moving Objects/Patients
 Protect Yourself
 adjust bed height
to safe height for
you. Ideally waist
height
 if bed isn’t
adjustable, bend at
hips & knees (avoid
bending of back,
keep hips lower
than shoulders)
Moving Objects/Patients
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use leg & trunk muscles
for lifting
keep your feet
shoulder’s width apart &
one foot slightly in front
of the other
keep patient close to
your body by bending
your elbows and
keeping them close to
your side
avoid twisting your back
when lifting
Moving Patients
 Protect Your Patient
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good patient communication (keep the
patient informed and instructed as to how
and when they can assist you)
use smooth, rhythmical motions during
movement to avoid skin friction
keep patient in good body alignment
Moving Patient to
Sitting Position
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assist patients, and encourage them to do
as much as they can
instruct patient how and when to assist, be
specific
make moves slowly, and allow patient to
recover and gain balance after each move
Hydraulic Lift
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used for patients who
cannot assist
patients too heavy for
others to safely lift
bed to wheelchair
bed to bath
bed to stretcher
bed to scale
MUST be trained before
using
two caregivers should
operate
Hoyer Lift Device
Dangling Patients
 Dangling position
 defined as sitting on
edge of bed without
the feet touching the
floor
Sequence from Extended Bed
Stay to Dangling Position
 check chart for orders to dangle
 identify yourself and patient
 wash hands and provide privacy
 adjust bed
 elevate head of bed
 lower side rail
 assist patient to sitting position
 monitor patient for balance/dizziness
 document outcome
Devices to Assist with Transfers
and Ambulation
 gait belts
 applied at the waist
snugly
 always gripped from
underneath
 NOT used on patient
when:
 pregnant
 history of recent
abdominal surgery
 history of abdominal
aortic aneurysm
gait belt
Wheelchair Transfer
Key Factors
 From a sitting
position:
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place patient’s feet
shoulder’s width
apart and place
strong leg slightly
behind weaker leg
swing leg rests out
of the way or remove
them from
wheelchair
Wheelchair Transfer
Key Factors
 Proper balance
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instruct patient to lean forward slightly
before assisting them to an upright
position
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this will transfer weight from their buttocks to
their feet and will minimize their loss of
balance from the upright position
Wheelchair Transfer
Key Factors
 For best support
 keep patient
close to you
during the
transfer (keep
your elbows next
to side of your
chest) and
support their
weight
Wheelchair Transfer
Key Factors
 assist patient to
stand
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on count of three
step back when
patient stands
support patient in
upright position
Wheelchair Transfer
Key Factors
 cont.
 backup to
wheelchair
 have patient
place both
hands on
wheelchair arms
 assist to lower
weight to
wheelchair
Wheelchair Transfer
Key Factors
 Ensure patient safety
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ask patient to scoot back in wheelchair or assist by
pushing against one knee at a time
place footrest on chair & lower foot plates
remove gait belt
secure patient in chair when appropriate
DO NOT allow chair to move with patient’s feet on the
floor
 Align patient
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use pillows, props as needed
Devices to Assist Ambulation
 canes
 used to compensate
for impaired
balance or to
improve stability
 more functional on
stairs & narrow,
confined areas
 can be stored &
transported easier
than walkers or
crutches
quad cane
standard
cane
Key Factors of
Canes
 a standard cane provides limited stability
because of its’ small base of support
 a quad cane has a broad base, and will
provide greater stability than the standard
cane
Key Factors of
Canes
 cane used on the unaffected side
 ambulation begins with the cane, then the
affected side, and then the unaffected side
follows through providing a 3-point base
upon completion of the move
Devices to Assist Ambulation
 Walkers
 an ambulation aid,
usually with 4
contacts that are
placed on floor and a
frame to support
patient’s weight and
provide stability
during ambulation
Trochanter
level
Key Factors
of Walkers
 a standard walker
without wheels
should be used when
there is an affected
side
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the lead foot with this
scenario is the
affected side
Key Factors
of Walkers
 a wheeled walker is to
be used when a patient
is experiencing an
unsteady gait or
limited endurance and
there is no affected
side
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the lead foot with this
scenario is the
dominant side
Key Factors During
Ambulation with Walker
 patient’s feet stationary when walker is moving
 patient’s feet should be shoulder’s width apart,
and one slightly ahead of the other
 never slide walker, unless equipped with wheels
 healthcare worker stands slightly behind and to
the affected side of patient in most cases
 grasp gait belt from underneath
Key Factors of
Assistive Devices
 device must be
adjusted to fit
patient
 place hand piece of
device at
approximately the
trochanter level (of
hip), with a slight
bend of patient’s
elbow
slight elbow
flexion
greater
trochanter
Key Factors of
Assistive Devices
 device does not prevent falls, however
does reduce risk of falls when used
properly
 must not be used as device for standing
Safeguarding
Falling Patient
 know the patient’s capabilities/disabilities
 know if there is an affected side
 use gait belt around patient’s waist for
support and maintain hold at mid back
while walking
 support patient’s anterior shoulder with
hand not holding gait belt to prevent
forward motion in case of a fall
Safeguarding
Falling Patient
 healthcare worker walks on unaffected side
(there will be exceptions) and slightly behind
patient.
 stay close to patient at all times
 as patient becomes limp, step one foot
between patient’s feet broadening your
stance to provide a temporary support for
the patient’s hips
Safeguarding
Falling Patient
 hand on patient’s shoulder pulls patient
back against healthcare worker’s body and
patient temporarily sits on thigh between
their legs
 the hand that was on the shoulder now
drops to the belt so both hands are on the
belt and approximately 6-8” apart
Safeguarding
Falling Patient
 keep your elbows close to your body and
pull patient back short distance by
stepping back from between patient’s legs
 begin squatting while keeping your back
straight
 gently lower patient’s hips to sit on floor
 release belt, and slide hand up to
head/neck and support them to floor