POSITIONING

 

Positioning means placing the client in a good, comfortable position with legs and arms in a relaxed, easy position. 

 

Why is Proper Positioning Important? 

• To help the client to be comfortable

• To relieve pressure on various body parts

• To improve circulation

• To provide proper body alignment

• To prevent health problems caused by being in bed for long periods of time such as bed sores.

 

Procedures:

• Have any necessary assistive equipment ready.

• Get assistance, if necessary.

• Use good posture and position when lifting or positioning a client.

• Change the client’s position as needed or specified. Repositioning every 2

• hours is common practice. This is individual to each client and should be

       specified.  When you check a bedbound client for toileting or a diaper change, the position should be changed at that time. 

• Check the skin, on a regular basis, for signs of redness or irritation.

• Make sure the client is safe and comfortable.

• Report any changes to your supervisor.

 

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5.  LIFTING

 

• Do not lift anything that is too heavy for you.

 

• Use proper posture at all times. Maintain lower back in good alignment while standing or sitting. Proper posture decreases the chance of back injuries.

 

• Secure additional assistance if needed for safe moves.

 

• If lifting a heavy load, work with the force of gravity by pulling, pushing, rolling, or lowering, rather than working against the force of gravity by lifting the load.

 

• Stand close to the object or client to be moved.

 

• Have feet at least 12 inches apart with one foot slightly in front of the other.

 

• Keep back straight, knees and hips flexed, weight distributed on both feet, and shoulders in line with pelvis.

 

• Use as many muscle groups as possible for moving the object or client. Leg and arm muscles reduce the workload on the back and support the load.

 

• When working at lower levels, do not stoop by bending over.

 

• To change the direction of the movement, pivot feet, with short steps, and the whole body without twisting the upper torso. To lower an object or client, always bend straight down toward the resting place; never twist to lower an object or client. Lowering straight down prevents twisting sprains and injuries to the back.

 

• Coordinate movements with the client or the staff member assisting with moving the client or object.

 

 

 

When lifting a heavy object or client:

• Squat

• Stand to lift

• Carry object or client close to the body

• Carry using muscles that pull shoulder blades together. Lifting in this

       manner lessens back strain.

 

 

 

 

 

 

 

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6.  HOYER LIFT

 

The PCA must be trained to use any equipment. The Supervisor needs to make sure the PCA uses the equipment correctly. Check with your agency on the Hoyer lift policy.

 

The care manager may order a Physical Therapy evaluation.  The Physical Therapist will teach the PCA how to use the equipment.

 

The Boom of the lift does not swivel. Center the client's weight over the base legs at all times. Do not attempt to lift the consumer with the mast/boom assembly swiveled to either side. Always keep the client-facing the attendant operating the lifter.

 

Transfer from Bed

If the client is in a hospital bed, raise side rails and have the client hold onto rails. Raise the level of the bed to the highest position before moving the client onto the sling. This will reduce strain on the caregiver's back. Also, when the client is ready to be lifted, lower the side rail and the level of the bed, decreasing the distance the client has to be elevated.

 

Positioning the lift for use:

• With the legs of the base open and locked, use the steering handle to push the lift into position.

• Lower the lift for easy attachment of the sling.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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7.  SAFE TRANSFERS

 

• Bed to chair and return - If this is a pivot transfer, the PCA must ensure the chair is positioned close to the bed. The client should have secure fitting shoes or slippers on for transfers. The PCA will position himself/herself in front of the client, place his/her feet against the toes of the client, put his/her arms under the client's arms, place one knee in front of the client’s knee and stand straight up, holding on to the client

      at all times.

 

• Bed to wheelchair and return - The PCA must ensure the wheelchair is in the correct position with the wheels locked in place. Make sure the wheelchair is positioned so the client’s feet will not become entangled in the footrests. If footrests are movable, fold the person up and out of the way.

 

• Bed to toilet/commode and return - The PCA should ensure the bedside commode is properly positioned beside the bed to allow the client to transfer with minimal exertion.

 

• Bed to tub/shower and return – The PCA should ensure the client is wearing secure fitting shoes or slippers. Assist the client to a sitting position on the side of the bed. Assist the client as needed to a standing position; offer stand-by assistance to the bathroom.

 

• Chair to commode and return - Ensure the client is wearing secure fitting shoes or slippers. Assist the client to a standing position; provide standby assistance to the bathroom.

 

• Chair to tub and return - Ensure the client is wearing secure fitting shoes or slippers. Assist the client to a standing position. Provide stand-by assistance to the bathroom. Assist the client to disrobe and step into the tub.

 

• Wheelchair to tub and return - Ensure the client is wearing secure-fitting shoes or slippers. Roll the wheelchair into the bathroom and lock the wheels. Assist the client to a standing position. Assist the client in disrobing, and stepping into the tub.

 

• Wheelchair to commode and return - Ensure the client is wearing secure fitting shoes or slippers. Roll the wheelchair into the bathroom and lock the wheels. Assist the client to a standing position. Assist the client in pulling down his/her underpants, and help him/her to sit safely on the commode.

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