Test 3

Ergonomics in Nursing

  • Purpose of Ergonomics:

    • Prevent injuries in the workplace.

    • Proper body movement during daily activities.

    • Prevention and correction of posture-related problems.

    • Enhancement of coordination and endurance.

  • Key Role of OSHA:

    • Occupational Safety and Health Administration (OSHA) emphasizes the importance of ergonomics, especially in healthcare settings, such as hospitals.

Common Injuries in Nursing

  • The most common injury in nursing:

    • Back injuries are significant due to repetitive lifting and moving of patients.

    • Maintaining back health is crucial for effective work performance.

Safe Patient Handling and Mobility (SPHM)

  • Safety measures for moving patients:

    • Protect both patient and healthcare worker during transfers.

    • Emphasis on using the legs for lifting instead of the back.

  • Reference: Table 34.3 on page 1247 for activity variations and assessment priorities.

Body Positions and Movements

  • Key Movements:

    • Abduction: Moving away from the body center.

    • Adduction: Bringing back towards the center.

  • Flexion and Extension:

    • Flexion: Bringing limbs inward.

    • Extension: Extending limbs outward.

  • Rotation:

    • External Rotation: Rolling outward from the hip.

    • Internal Rotation: Rolling inward towards the body.

  • Cautions with bedridden patients:

    • Avoid excessive external and internal rotation to prevent joint dislocations.

  • Pronation and Supination:

    • Pronation: Palms facing down.

    • Supination: Palms facing up.

Patient Positioning

  • Supine and Prone Positions:

    • Supine: Lying on the back.

    • Prone: Lying on the stomach.

    • Fowler's Position: Sitting up at 45-60 degrees; high Fowler's is at a 90-degree angle.

Complications of Bedridden Patients

  • Risks include:

    • Contractures: Muscle shortening leading to reduced mobility (e.g., plantar flexion contractures leading to foot drop).

    • Pneumonia: Can result from immobility; prevention strategies include deep breathing exercises.

    • Blood Clots (Thrombi): Prevention techniques include compression stockings and SCDs (Sequential Compression Devices).

Movement and Mobility Aids

  • Importance of Early Mobilization Post-Surgery:

    • Quickly getting patients moving to avoid complications associated with immobility.

  • Equipment for Assistance:

    • Trapeze Bar: Helps patients move and exercise.

    • Footboards and Splints: Prevent foot drop and maintain foot position.

    • Wedges: To maintain hip alignment.

Assessing Patient Mobility and Safety

  • Properly assess:

    • Patient's ability to bear weight and balance before transferring from bed to a chair.

    • Always transfer towards the stronger side to prevent falls.

Physical Assessment Practices

  • General Assessment:

    • Begin assessing patients upon first contact; observe gait and movements.

  • Types of Assessments:

    • Focus Assessment: Targeting immediate concerns (e.g., chest pain).

    • Comprehensive Assessment: Initial full review of patient health.

    • Ongoing/Shift Assessment: Regular updates on changing patient conditions.

    • Emergency Assessment: Quick evaluation in life-threatening conditions using ABCs (Airway, Breathing, Circulation).

Skin Assessment and Observations

  • Key Observations:

    • Inspect skin for color, lesions, and vascularity.

    • Palpate for temperature, moisture, texture, and turgor.

  • Characteristics of Common Skin Issues:

    • Cyanosis: Blue tint indicating lack of oxygen.

    • Jaundice: Yellow tint from excess bilirubin.

    • Pallor: Paleness indicating poor blood flow.

    • Edema: Swelling due to excessive fluid.

Respiratory Assessment

  • Main method: Auscultation for respiratory sounds.

  • Be aware of signs of anaphylaxis such as wheezing and shortness of breath.

  • Differentiate between local allergic reactions (swelling and redness) and systemic reactions (anaphylaxis).

Cardiovascular and Neurological Assessment

  • Assess the Point of Maximum Impulse (PMI) for heart function.

  • Familiarize with testing procedures for cranial nerves, including:

    • Olfactory (Smell): Identifying scents.

    • Optic (Vision): Using Snellen charts.

Summary of Patient Care and Transfer Practices

  • Focus on using proper ergonomic techniques and supportive equipment to ensure patient and caregiver safety.

  • Continuously monitor patient status and make adjustments to care plans as needed.