a nurse is about to transfer to a chair a patient who has a weak left leg This is a topic that many people are looking for. passionistsisters.org is a channel providing useful information about learning, life, digital marketing and online courses …. it will help you have an overview and solid multi-faceted knowledge . Today, passionistsisters.org would like to introduce to you Stand Pivot Bed to Chair – No Assistive Device. Following along are instructions in the video below:
Strategies for safe movement of patients as shown in this video are general in nature nature they can apply to many types of patients. But may need to be modified certain diagnosis. Impairments or precautions that a given patient might have thus for a specific patient.
The strategies shown may need modification. If you are unsure of how to safely move an individual patient. Its recommended that you consult with the occupational or physical therapists at your facility.
Whenever assisting a patient with movement. It is important to instruct the patient in ways that they can assist with the movement if the patient knows what to expect because you are communicating with them they are less likely to move in a way that may come as a surprise to you and throw off your own balance also instructing them how to assist helps promote their independence and completing the movement and makes your job easier as you may not have to provide as much physical assistance. This video is going to demonstrate how to transfer an individual from the bed to a bedside chair using a standing pivot technique this technique may be useful for someone who has weakness in their legs or who may need some assistance with balance during the transfer.
An assistive device will not be used in this video. This video assumes that you have already gathered any items that you may need such as a gait belts or non slip socks prior to transferring the patient into a sitting position. It also assumes that you have already positioned the chair.
As close as possible to the bed prior to assisting the patient into sitting the first thing you will note in the video is the position of the chair to maximize safety during the transfer you want to minimize the distance the patient needs to travel if your patient is known to be able to bear weight. Fairly well and can even ambulate. It may not be necessary to have the chair this close however the medical and therefore functional status of our patients can change.
So if the patients ability to complete the transfer successfully is in question. It will always be most safe to have the chair of this close fasten. A gait belt around the patients waist near her center of mass then ensure that her feet are positioned firmly on the floor.
You may need to assist the patient in scooting. Forward in order to position her feet appropriately next. Make sure.
The patient has a wide base of support or stance. And her feet are pulled under her shes going to lean forward. As she stands so that her center of mass moves over her base of support and pulling her feet back places them in the best position as i help the patient stand my feet are in a wide stance and i keep my back straight.
I assist the patient up by using the gait belt to direct her center of mass up and forward on a diagonal here. You see that simply pulling straight up on the gate belt. Isnt terribly effective and is uncomfortable for the patient.
Compared to using the belt to direct the patient center of mass forward and up also youll see that when standing the patient is holding on to my elbows or forearms. This is preferable to holding on near my shoulders. If the patient were to start falling.
She would likely pull on my neck. Which could lead to injury next. Im going to maintain contact with the patient with the gait belt as she shifts her weight back and forth to turn i keep my feet in a wide stance as she does this because this will make me the most stable the patient contacts.
The chair prior to sitting. And i squat down keeping my back straight as i help her control her descent into the chair. A variation on this transfer technique is to provide additional assistance to help the patient keep one knee extended to help transfer some patients you may need to block one leg.
Usually the weaker one if they have some asymmetry of strength this is done by first placing your foot along the outside of their foot and placing your leg across their upper shin. Make sure your other leg is positioned shoulder width apart and slightly behind the leg that is blocking the patients weaker leg. Assist.
The patient understanding as was described in the stand pivot transfer without the knee block. The patient then pivots or shuffles her feet towards the chair as the patient pivots her feet towards the chair you may need to keep the weaker leg supported by having your leg against her upper shin to keep the lake from buckling lower the patient into sitting. As was described before while maintaining contact with her weaker leg prior to initiating the transfer to the bedside chair.
You should assess the patients potential to tolerate the transfer once you have them sitting at edge of bed. It is best to remain close to the patient and even keep a hand on the patients trunk. While they are sitting so that you can feel if they need any assistance with their sitting balance.
A patient who is struggling to sit will also have difficulty moving into a bedside chair. You should also be observing the patient for any signs of lightheadedness since they likely will have just transferred into sitting from supine you can also be asking the patient how they feel as pain or nausea can identify in this sitting versus. The supine position.
You can consider conducting the egress tour. Icu mobilization test to assess the patients ability to bear weight prior to leaving the bedside. See the capture falls website for information on those assessment tools.
If the patient has one leg. That is stronger than the other. It is helpful to have the patient transfer towards their stronger leg for example.
If the patient has right sided hemiparesis. Following a stroke. The chair that the patient is transferring toward should be placed on their left side.
It is important to think about which side the patient will be transferring towards prior to even getting them up into sitting so that the chair can be placed on the most appropriate side of the bed. The transfer will be easier if you transfer toward the patients strong side and thus safer for you. And the patient.
If strength is fairly equal in both legs. It does not matter to which side the patient transfers. If there is an asymmetry of strength.
It is important to recognize that if you transfer towards the patient strong side going from bed to chair. You would be transferring towards or weaker side going from chair to bed. If the patient has been sitting up in a wheelchair.
The easy remedy is to just turn the chair around or move it to the other side of the bed. However if the chair or even the bed cant be moved you should at the very least anticipate that the patient will likely need more assistance going towards their weaker side also if the patient has one leg that is stronger than the other it might be helpful to have the individual pull the stronger leg back relative to the other one so that it is closer to the bed prior to standing this position allows the stronger leg to raise the body. Most effectively to a standing position both feet should still be shoulder width apart.
If the individual does not have one leg that is stronger than the other positioning one foot posterior to the other is less than important. But you should still ensure that both feet are shoulder width apart to maximize the patients ability to balance once they are in standing the knee blocking method shown in this video is the one that i personally prefer and find easiest to do. However.
There are other methods to block knees during transfers such as using both of your legs to block one or both of the patients knees. I would encourage you to consult your therapy staff to determine how to best utilize. These techniques with individual patients lastly.
If the patient is going to remain in the chair. After you leave the room for fall risk reduction. Ensure that the personal items and a call light are within the patients reach and set a chair alarm.
If indicated for that patient. It would also be appropriate to remind the patient to call for assistance prior to getting up from the chair you .
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