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Bed Positioning For Optimum Patient Safety and Support - MODULE
Bed Positioning For Optimum Patient Safety and Support - MODULE
Bed Positioning For Optimum Patient Safety and Support - MODULE
Contents
Instructions........................................................ 2
Learning Objectives .......................................... 2
Module Content................................................. 3
Job Aid .............................................................. 10
Posttest ............................................................. 11-12
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If you have any questions about the material, ask your supervisor.
The Job Aid on page 10 may be customized to fit your department and then
used as a quick reference guide.
Learning Objectives
When you finish this module, you will be able to:
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B) Brain Injury
Clients can have brain injuries from multiple causes that include external
trauma to the head, trauma to the arteries supplying blood to the brain, drug
overdose, tumors, and brain anoxia. Brain injuries can cause a wide variety of
physical deficits that include hemiparesis as described above, monoplegia, and
abnormal reflexes. There can also be cognitive changes that can include posttraumatic amnesia (PTA), agitation and confusion. Patients that have brain injuries
can have varying states of arousal that include coma, vegetative state, general
unresponsiveness, and reduced or hyper alertness. Additional medical problems
may include aphasia, dysphagia, epilepsy and changes in autonomic function.
Because of the wide range of needs of the client with a brain injury, it is
important to identify the special needs of each individual. Knowledge based
creativity may be required by the care taker as all possible needs can not be
foreseen by this module. The client who is in PTA may be dependent to recall and
follow medically necessary precautions. A restless client may require frequent
repositioning. Some of these possible situations will be covered below under IV
Positioning Techniques: C) Special Positioning Needs.
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III.
Theory
IV.
Positioning Techniques
Always ensure that the sheets and pads are free of wrinkles to avoid
discomfort and additional pressure on the skin. Bulky linens and heavy cloth bed
pads are contributors to skin breakdown and should be avoided. Tools such as the
Sally Roller and Sally Tube should be utilized whenever possible to reposition and
to transfer the patient. They will also prevent shearing of skin during positioning.
A. Supine
When positioning a client in supine, the head, neck, shoulders, and hips
should be as symmetrical as possible. To support the desired alignment, pillows
may be required to support the head and lower extremities.
Care should be taken when placing a pillow under the clients knees for
comfort. While this is allowable for brief periods, it can lead to shortening of the knee
and hip flexor muscles if used for a prolonged period of time. It can also create
increased pressure on the clients heels.
Extremities with edema should be elevated above the level of the
clients heart with pillows or positioning wedges.
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The clients bed should be situated so that the majority of the room is on their
hemiplegic side to improve attention and awareness of that side.
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JOB AID
References
Davis, J.Z. (2001). Neurodevelopment treatment of adult hemiplegia: The
Bobath Approach. In Pedretti, L.W., & Early, M.B. (Eds.). Occupational
therapy practice skills for physical dysfunction (5th ed.). (pp 624-640). St.
Louis, MO: Mosby.
Minor, M.A.D., & Minor, S.D. (1995). Patient care skills (3rd ed.). Norwalk, CT:
Appleton & Lange.
Umphred, D.A. (Ed.). (1995). Neurological rehabilitation (3rd ed.). St. Louis,
MD: Mosby.
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