Positioning and Bed Mobility

Fowlers: hosital positon

Supine: on back

Positoning General Guidelines, make sure positioned correctly, have them do it without us moving much ourselves. We have to promote indipendence on their part. Make patient do as much as possible, always let them do as much as they can first before you intervene

  • AMAP/ANAP - as normal as possible. As much as possible

  • Maintain normal spinal alignemtn as much as possible from multiple planes

  • use good body mechanics, not just patient but you as well

  • consider the enviornment - something on floor that will make you slip, patient has proper footwear on

  • Provide a way for the patient to call for help, they have phone with them, can reach phone and can have call bell nearby, always make sure they have access to help beofre you leave room.

Positoning Objective

In-patient: long term positoning, safety key to both in and out patient. Make sure theyre in right positoning.

Short term: comofortable, not laying on arm, make sure theyre comfortable so you also have access to where youre treating.

Short term

  • safety

  • comfort

  • access, some type of treatment soon

Long-term positioning

  • safety

  • prevention - prevent bed sores, contracutres

  • comfort

Short term positoning checklist

  • patient is safe

  • good spinal alignemnt

  • accessibility of necessary areas of the body, if they need a pillow etc

  • trunk and extremitites supported for comfort

  • positoned well within enviornment (line of sight, communication)

  • special needs accommodated

Short term positoning: supine

Short-term positoning: prone

Long term positoning

  • Clear airway

  • good spinal alignemtn

  • minimized pressure over bony prominences

  • minimized gravity creating shearing forcces

  • cushioned support surfaces

  • immobile extremities elevated

  • prevent joint and soft-tissue contractures

  • trunk and extremiites support and stibilized

  • long term functional positons

  • optimize interaction with the enviornment

  • special needs accomodated

General Psotional Progressions - each one the other is harder than the last. Dont have to include every single one

  • supine/supine on elbows

  • prone on elbows

  • hoolying

  • rolling

  • bridgin

  • quadruped (on all fours)

  • sitting

  • kneeling

  • half-kneeling (on one knee)

  • modified plantigrade

  • standing

Bed mobility tasks

  • identify your objective - hey move down move up etc

  • explain and communicate with the patient

  • Control centrally direct distally (CCDD)

    • control the patients movements by applying forces centrally; direct the patient’s movements using distal body segments.

    • move someoen not by their arm but by their core

Bed mobility tasks

  • provide a 1,2,3 so you and patient can work together

  • dont get patient to scooch across bed, older patients have weaker skin can break

Hoolying

  • hips knees flexed, power positons, helps use glutes and quads

Scooting up in bed - Lift, shift, lower, not dragging skin

Scooting sideways - lift, shift, lower

After spine roll, log roll should be doing that.