Nursing: Lifting, Transferring and Positioning of Patients


Lab Report
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ABSTRACT

Lifting, transferring and positioning of patients is frequently undertaken by
nurses on each working day. This is necessary for patient comfort, medical
reasons and completion of self care needs. Lifting can be done in numerous ways.
As well as the nurse physically lifting or moving patients, a number of devices
are also available to assist in the transfer of patients. These range from
straps that are attached to or placed under the patients, to mechanical hoists
and lifters. Any assistance the nurse has is beneficial for both the patient
and the health care worker, as patient\'s weights are generally heavier than the
nurses physical capabilities. This, combined with incorrect lifting techniques,
can result in muscle strain, or more seriously, spinal injury for the nurse, and
discomfort, muscle strain or further injury for the patient.

INTRODUCTION

When lifting, transferring or positioning patients, the most important
consideration is safety. Any of these procedures need to be undertaken with it
in mind. This safety is inclusive of both the patient and the health care
worker. Communication is an important part of the lifting process as the nurse
should elicit information from the client to find out how and when they prefer
to be moved. This allows the patient to be involved in the decision making
process and be fully aware of what is occurring. By communicating with the
client, the nurse is also aware of whether or not the patient is experiencing
any discomfort during or after the lift.

The actions of lifting, transferring or positioning need to be completed for
numerous reasons, including relief of pressure points. Due to the patient being
in one position continuously, they are prone to the development of pressure
areas. In terms of patient needs, being in the same position constantly is
physically uncomfortable. However, mentally, a change in the immediate
surroundings is also beneficial for the patient. It is also necessary for the
patient to be moved for completion of their self care needs. This includes
their hygiene needs, which include, bathing or showering, elimination, hair,
oral and nail care.

METHOD

When lifting, transferring or positioning patients manually, safety is the most
important factor. This safety is for the nurse themselves as well as for the
patient. One aspect of safety is for the nurse to utilise "good body mechanics"
(Kozier et al 1995, p.879). This refers to the nurse having balance, which can
be achieved with the feet being spread approximately shoulder width apart, which
gives stability and a "wide base of support" (Kozier et al 1995, p.888).
According to Kozier et al, (1995 p.879) balance is also achieved by correct body
alignment and good posture. The use of correct body alignment reduces the
strain on muscles and joints, and makes lifting the clients much easier.

When lifting clients, the first thing the nurse should do is explain to the
patient what they are doing and ask the patient if there is any particular way
they would prefer to be moved. This allows the patient to have some opinion
about what is being done to them.

The next thing that should be done when moving a patient is a routine assessment.
The nurse may assess the situation by firstly observing the patient and reading
the nursing care plan. The nurse needs to be aware of the patients capabilities
to see how much they can do or if they can assist in any way. Another important
part of assessment is observing the surrounding environment, to be sure there is
no obstructions or other hazards which may be injurious to the nurse or patient
before, during or after the move.

The next phase is that of planning the move. The nurse decides how the patient
will be moved from their current position to where they are going. This may
involve the nurse getting assistance for the lift, either from other health care
workers or by mechanical devices, such as a lifter or hoist. When moving or
lifting the client, wherever possible the nurse should have assistance. This
assistance is necessary for both nurse and client safety. This is supported by
Kozier (1995 p.910), who says, wherever possible,

"the preferred method is to have two or more nurses move or turn the client".

When moving clients physically, there are different types of moves that can be
used. When moving a client up in bed, the client should be encouraged to help
if possible. The nurse can ask the patient to bend their knees, so that when
the nurse is ready, the