BODY MECHANISM

NURS 101
COMFORT WORNA LOTSE
Introduction
 Some of the most common injuries
sustained by members of the health
care team are severe musculoskeletal
strains. Many injuries can be avoided
by the conscious use of proper body
mechanics when performing physical
labour
Definition

Body mechanics is the utilization of correct

muscles to complete a task safely and
efficiently, without undue strain on any
muscle or joint and injury to both the nurse
and patient.
OR
It is the efficient use of the body as a means
of locomotion
 Body mechanics involves the concepts
of center of gravity, line of gravity and
base of support in relation to body
alignment and balance.
 Centreof gravity: is the point at which
the entire weight of the body is
centred and balanced
 Lineof gravity: is located midline and
forms a vertical line from the middle of
the forehead to the midpoint between
the feet
 Baseof support: the point of object in
contact with its supporting surface,
which is the feet.
Principles of Good Body Mechanics
 The broader the base of support, the
lower the center of gravity and the
greater the stability and balance.
 Body balance can therefore be enhanced
by widening the base of support and
lowering the center of gravity bringing it
closer to the base of support.
Principles cont’d

The best practice for body mechanics can

be summed up in the following principles;
1. Maintaining a Stable Centre of Gravity
2. Maintaining a Wide Base of Support
3. Maintaining the Line of Gravity
4. Maintaining Proper Body Alignment
1. Maintaining a Stable Centre of
Gravity
Keep your centre of gravity low by
 Keeping your back straight.
 Flexthe knees and hips instead of
bending at the waist.
This distributes your weight evenly
between the upper and lower body and
therefore helps maintain balance.
2.Maintaining a Wide Base of Support

This will provide you with maximum

stability while lifting.
 Spread your feet apart.
 Place one foot slightly ahead of the
other.
 Flex your knees to absorb jolts.
 Turn with your feet.
3. Maintaining the Line of Gravity

This can be achieved by

 Keeping your back straight.
 Keepthe objects being lifted close to
your body.
4. Maintaining Proper Body
Alignment
 Keep the Spine straight

 Place head in a neutral position (head

up)

 Keep all extremities in functional

position
General Guidelines for Lifting

 Assess patient and environment

 Decide how patient is to be lifted.
 Prepare area, move equipment and secure
it into suitable position
 All principles of good body mechanics
should be applied
 Grasp should be firm avoiding tender and
painful areas
Guidelines cont’d
 Stand close to patient
 One nurse should always act as leader
for the co-ordination of movement
 Bend at the knees and hips; keep your
back straight.
 Liftstraight upward, in one smooth
motion.
 General considerations for
performing physical tasks
 It is easier to pull, push, or roll an
object than it is to lift it.
 Movements should be smooth and
coordinated rather than jerky.
 Less energy or force is required to keep
an object moving than it is to start and
stop it.
Consideration cont’d
 Keep the work as close as possible to
your body. It puts less of a strain on your
back, legs, and arms.
 Keepthe work at a comfortable height to
avoid excessive bending at the waist.
 Keep your body in good physical
condition to reduce the chance of injury
WHY proper body mechanism?
Use proper body mechanics in order to avoid
the following:
 Excessive fatigue.
 Muscle strains or tears.
 Skeletal injuries.
 Injury to the patient.
 Injury to assisting staff members
Advantages/Benefits of PBM
 Maintains good body alignment
 Maintains balance of the body
 Prevents fatigue and deformities (kyphosis,
lordosis, scoliosis)
 Promotes physiological functions of the body
 Reduces expenditure of energy
 Prevents and reduces the risk of musculoskeletal
injuries
Transferring a patient from bed to Chair

Assisting patient to a chair from the bed

Purposes
 Toenable change of position without
injury
 To maintain good body mechanics
Procedure
1. Explain procedure to patient and instruct him/her on
how to co-operate
2. Assist patient to a sitting position on the side of the
bed. Position a chair at 45 degree angle to the bed or
parallel with the bed. ( if it is a wheel chair, ensure
that the wheels are locked and the foot plate is raised)
3. Spread your feet apart
4. Flex your knees and hip in line with patient's knees
5. Reach under the axilla of patient and place hands on
scapula
Procedure cont’d
6. Help patient up to a standing position on a count
of three while straightening your hips and knees
7. Pivot on foot that is farthest from the chair
8. Ask patient to sit only after he feels the seat of the
chair on the back of his knees
9. Instruct patient to use arm rest of chair for support
if present
10. Flex your hips and knees and lower patient to chair
11. Align patient properly to a sitting position
 Transferring Patient Between a
bed and Stretcher
Shifting a helpless patient from bed to
stretcher or from stretcher to bed

Purposes
 To transfer patient safely
 To maintain proper body alignment
Procedure
1. Explain procedure to patient and how he has to
co-operate
2. Adjust patient bed in preparation for the transfer
 Adjust the bed to be in flat position
 Raised the bed/stretcher from where the patient is
to be transferred to a slightly higher level
 Ensure that, the wheels of the bed and stretcher
are locked
Procedure cont’d
 Untuck the draw sheet out from both sides of the
bed pulling along a flat surface
3. Move patient to the edge of the bed and position
the stretcher
 Roll draw sheet to the patient’s side
 Position the patient to the edge of the bed and
cover him with a sheet
 Place the stretcher parallel to the bed next to the
patient and lock it wheels
Procedure cont’d
4. Position yourself for the transfer
 The first nurse should kneel on the bed on
the other side away from the stretcher
 The other two nurses should reach over the
stretcher holding the draw sheet, one nurse
at the head and chest areas of the patient
supporting head and neck and the other
nurse supporting at the waist and thigh area
Procedure cont’d
5. Transfer the patient securely to the stretcher
 In unison with the other staff members place your
body tightly against the stretcher
 Roll the pull sheet tightly against the patient
 Instruct patient to flex his neck and head during the
move if possible, place his arms across his chest
 Flex your hips, and pull the patient on the pull sheet
in unison directly towards and on to the stretcher.
Procedure cont’d

6. Make patient comfortable, unlock the

stretcher wheels and move the
stretcher away from the bed.
7. Raise the stretcher side rails and/or
fasten the safety straps on patient
QUESTIONS?
BED MAKING
Hospital Beds
Objective
By the end of this topic, students will be able
to;

 able to make various types of beds which

include simple unoccupied beds, occupied
beds and special beds.
 Identify and use various bed accessories
What is Bed Making?
This refers to the technique in
arranging or preparing a bed in a
systematic pattern which is aimed
at receiving and making patient
comfortable as well as for the
purpose of sleep and rest.
Purpose of bed making
The
 main objective of bed making is to receive patients with
various types of conditions conveniently.
Specific objectives include:
To provide comfort

Promote patient’s safety

To facilitate movement of the patient

To maintain clean environment to reduce transmission of

microorganism.
To facilitate easy observation and examination

Components of a bed
 Thebasic component of the hospital bed is the
bed stud. Bed stud is the framework of the
bed and is made of iron and wire springs. It is
usually painted to suite the colour of the ward
and its measurement is 6ft by 3ft.
 The height is 26inches/66cm and this is
convenient to give care to all types of
patients. Beds in the ward should be placed at
least 5ft apart.
Others cont’d
Other components include:
 Mattress –covered with protective waterproof material
and should be firm to provide good alignment of the body
as well as support.
 Pillow-stuffed with cotton or feathers and used to
support the head of patient.
 Blanket – mostly made of wool and always placed next
to the top sheet. It is used to provide warmth to the
patient.
 Counterpane- light in colour and weight used in covering
the entire bed
Others cont’d
 Draw sheets-made of mainly heavy cotton and the
standard size of it is 12 yards wide and ½ yard long. It
is usually placed across the bed of the patient’s
buttocks.
 Draw mackintosh-made of rubber or plastic and
about 30inches square with a piece of material
stitched to each other and is placed under the draw
sheet which covers it completely. It protects the
bottom sheet from soiling.
 Long mackintosh also made of rubber and long
enough to cover the whole mattress. It is used to
protect bottom line and mattress
Patient’s unit
 Bed accessories

 Side rails (safety rails)-prevent clients

from falling out of bed as well as helping
client to change positions
 Bed cradles- a frame used to lift the
weight of bedclothes off the client or
from touching all or part of the client’s
body (patients with burns, skin ulcers,
lesions, fractures)
 Foot board/rest- this is made of wood
and usually fitted at the foot end of the
bed to to prevent abnormal plantar
flexion or a deformity foot drop in client
under prolong bed
 Bed accessory cont’d
 Back rest- also made of wood and used to
aid patient to sit in upright position while in
bed especially in cardiac conditions. This
may be part of bed
 Sand bags- these are made of rubber/ lint
and are filled with sand. They are used to
demobilise limbs of patients especially with
fractures
Accessory cont’d

 Fracture board- these are made of wood and

used to prevent mattress from sagging when
nursing patient with fracture. They are usually
placed on the springs of the bed before placing the
mattress
 Trapeze - horizontal bar hanging on chains, is
often attached to a large overhead frame
connected to the bed
 it is used by the client to pull up to a sitting
position or to lift the shoulders and hips off the bed
Heart Table/Cardiac Table
Bed blocks
Bed cradle
 Rubber/Air Ring
 Rubber/Air Ring-This is made to
relief pressure from the patient. The
inflated rubber is usually placed under
patient’s buttocks. A towel is placed on
it before a patient sits on while in bed.
It is commonly used by patients with
cardiac conditions who have difficulty
in breathing when lying.
Rubber Air Ring
Hot Water Bottle
Electric Blankets
Trapeze
Rules of bed making

 Get all requirements needed together.

 Two nurses must work together in harmony.
 Bed linen should be straightened and made
neat to avoid crumps and creases.
 Patients must not be exposed unduly in the
case of occupied bed.
 Always place pillows with their mouths
away from the door.
Rules cont’d
 Two chairs must be available to place linen
on. A bed table could also be used.
 Any conversation during bed making should
involve patient.
 Bed should be made to receive patient
conveniently.
 Forroutine bed making, the ward should be
closed to traffic except staff.
 Principles/ general
instructions of bed making
 Washhands thoroughly before bed making
and after handling soiled linen- OBSERVE
UNIVERSAL PRECUTIONS
 Hold linen away from uniform
 Handle linen carefully and avoid shaking it,
tossing it into laundry hamper or floor.
 Placesoiled linen in a linen hamper before
discarding it.
Principles cont’d
 When striping and making a bed, conserve
time and energy by striping and making up
one side as completely as possible before
working on the other side
 Toavoid unnecessary trip to the linen supply
area, gather all needed linen before starting
to make bed
 Neverput one patients linen on another
person’s own.
 Patients face must never be covered by sheet
Principles cont’d
 Patient must never be exposed during bed making
 when pillows are being shaken by the nurse, the
nurse must turn away from the patient
 Anyconversation during bed making must involve
the patient.
 Extraassistance should be sort when patient
needs to be lifted.
 Make use of body mechanics
 Raise the bed to a comfortable working height
 Classification
Open beds- cover sheet, blankets, top sheets
are opened up to the draw sheet(Fanfold ) to
enable easy assess
It is a bed that is already assigned to a client

Closed bed – is made to receive a new client.

Top covers are pulled over the head of the bed
and the pillow is placed on top of the linens or is
covered with the coversheet
it is made following discharge of patient
Closed and Open Beds
 Making a simple unoccupied bed

In order to make a simple unoccupied bed, the

following items should be put on the trolley
 Two large cotton sheets.
 One draw mackintosh.
 One draw sheet.
 One or two pillows and their slips.
 One blanket (optional).
 One bed cover/counterpane
 Making a mitered (envelop)
corner
(A) The sheet is hanging over the side of the bed.
 (B) Grasp the edge of the sheet about 12 inches from the
foot of the bed lift it up, forming a triangle. Lay the
triangular fold on the top of the bed, and smooth the
hanging portion of the sheet against the side of the
mattress.
 (C) Tuck the hanging portion of the sheet underneath the
mattress, while holding the triangular fold taut against the
top of the bed.
 (D) Bring the triangular fold back down over the edge of
the mattress, and tuck it underneath. This process is the
same for the upper corners of the bed and for the top
linens.
Making a mitered(envelope)
corner
Procedure
 Wash and dry hands
 collectand arrange items on trolley and send
to bedside
 Turnand inspect mattress then wash and dry
hands.
 Placetwo chairs at the bottom of the bed and
arrange linen according to preference.
 Place bottom sheet evenly on the bed, tuck
the sheets under the mattress using envelop/
mitred corners starting from the top.
Procedure cont’d

 Pullsheets tight so that there are no

 crumps/creases
Place pillow at the top part of bed with opened
ends away from the door
 Place draw mackintosh across the bed with
the upper corner under the edge of the pillow.
 Cover mackintosh with draw sheet and tuck in
with one side more than the other.
 Placetop sheet on the draw sheet with the
wrong/rough side uppermost and about
Procedure cont’d
 Fold
over at the bottom and tuck in loosely to
prevent restriction of point feed
 Placebed cover or counterpane loosely over
the bed
 Tuckin at the bottom end under the mattress
using envelop corners.
 Fold top sheet over the counterpane at the
top.
 Tuck in all sides under mattress.
 Remove chairs and trolley and place back the
locker
cont
MAKING AN OCCUPIED BED

 An occupied bed is a bed in which a

patient has occupied.
 Theprocedure of making an occupied
bed is basically the changing of soiled
draw sheets or bottom sheets or even
draw mackintosh of a patient in bed.
 Two methods can be used to change
the sheets; the side to side method
or top to bottom method
 Requirements

Extra requirements need to make the

bed include:
A draw sheet
A draw mackintosh (if necessary)
A long sheet
A pillow case
 Dirty linen receptacle
 Procedure

 Explain procedure to patient, then

provide privacy
 Collect and arrange items on trolley
 Placetwo chairs or a heart table at the
bottom of the bed and arrange sheets
in order use
 Wash and dry hands.
 Side to Side Method

 Ifdraw sheet is soiled, roll patient gently from

side to side and supported by assisting nurse.
One hand behind the shoulders and the other
behind the buttocks.
 Rolldirty bottom sheets under patient (bottom
sheet, draw sheet and mackintosh if necessary)
 Cover the bed with clean rolled bottom sheets
halfway of the bed
 Place draw mackintosh and draw sheet across
bed tucking in greater part nearest to the door.
 Side to Side cont’d
 Remove dirty bottom sheets and place it in
the receptacle
 pulltight and tuck in sheets while
removing crumps or particles
 Cover patient with top sheet and bed cover
 Clear equipment and remove screen
 Wash and dry hands and document
procedure
 Top to Bottom Method

 Hold top sheet over patient’s shoulder with hand.

 Move patient to the foot end of the bed with the
help of an assistant and let him or her lean on a
heart table with a pillow
 Support patient and remove pillow and place it on
a chair
 Roll dirty bottom sheets under patient
 make top half foundation of bed with clean sheets
 Arrange pillow(s) at the top half of bed
 help patient back to the lying position keeping him
covered
 One nurse lifts the patient’s legs while the other
removes the soiled bottom sheet and pulls down the
clean bottom sheet, draw mackintosh and draw
sheet.
 Pull sheets tight and tuck in
 Finish making beds using top bed cloths
 clear equipment and remove screen
 Wash and dry hands and document procedure
 SPECIAL BEDS

ADMISSION BED
 Thisbed is made to facilitate easy
admission of patient, to provide
warmth to patient in beds and to bath
the patient if necessary.
 Requirements (extra)

The following items should be added to those

required for simple beds.
 Long mackintosh/waterproof sheet
 One or two blankets/sheets if necessary
 Bed blocks
 Bed cradle
 Backrest or any other accessory depending
on patient’s condition.
 Procedure
 Make up bed as for a simple bed until draw sheet
is in position.
 Cover bottom lining with a long waterproof sheet
including a pillow.
 Placeone blanket over the water proof sheet and
tuck in round or fold under it.
 Placehot water bottles on or electric blankets if
available.
 Place second blanket to cover the hot water bottle
 Procedure cont’d
 Puton the top linen and turn over at the
bottom.
 Place a counterpane loosely over the top
bed clothes.
 Tuck in bed clothes on the other side and
then fold the bed cloths over at the sides
nearest the door, leaving it opened to
facilitate quick admittance.
 Remove hot water bottles/electric blanket on
patient’s arrival
 OPERATION BED

 Thisbed is specially made to receive

patient on his return from the
operating theatre. The objective of
making such a bed includes
counteracting shock and then
protecting linen from soiling by saliva,
respiratory secretion or vomitus
 Extra Requirements
 waterproof sheet and dressing towel- Protecting
the bed from secretion of the mouth
 Two
covered hot water bottles- to keep the patient
warm
 Bedblocks /bed elevators- uses to elevate either
bottom or top of bed
 Bed cradle- to keep weight of linen directly off
the patient.
 Intravenous infusions stand- to hang infusion
 Oxygen apparatus- to give oxygen prn
 Extra Requirement cont’d

Vomit bowl Galipot with gauze swabs

Dressing towel A mouth gag

Kidney dish containing Injection tray

Dissecting forceps Receivers for soiled swabs

Swab holding forceps Cup containing mouth wash

Tongue holding forceps TPR tray/BP apparatus

Spatula A chart for recording

 Procedure
 Make up simple bed until draw sheet level.
 Place mackintosh and dressing towel in place
of pillow at the bed top of the bed and leave
pillow on a chair.
 Place two covered hot water bottles or
electric blanket if available on top of draw
sheet of bottom lining.
 Place blanket on bed over hot water bottles
 Put top clothes on as for admission bed.
Procedure cont’d
 Turn back the bottom end of the top clothes.
 Foldthe top bed clothes at the open side in
three parts over the bed for easy admission of
patient.
 Place post anaesthetic tray by bed side
 Arrangeother bed accessories by bedside- drip
stand, bed rail, blood pressure apparatus
 Remove the hot water bottles before patient is
put in bed.
 CARDIAC BED
 This is a special bed made to keep patient
sitting or upright position in order to
enhance/ease breathing to provide
comfort to patient, especially with chronic
heart disease or failing heart and those
with severe respiratory disease where
breathing is difficult.
 Toprovide warmth and prevent pressure
sores. Patient will feel cold if there is
impediment of circulation
 Extra Requirements

A back rest Sand bags if necessary

Extra pillows Bed cradle

Bed table with plastic Extra sheets if necessary

covered soft pillow

Air-ring in a cotton cover Covered hot water

bottles

Foot rest or bolster

 Procedure
 Make bed as for simple bed until draw sheet
level.
 Place
back rest at the top of bed and arrange
as many pillows as necessary behind patient.
 Place covered air-ring under patient’s
buttocks to prevent pressure sores.
 Placetop sheet on the bed with the wrong
side uppermost and fold sheets over at the
bottom.
 Procedure cont’d
 The counterpane maybe placed last
and then leave patient comfortable in
bed.
 Placeheart table in position with the
covered pillows for patient to lean on.
 Placefoot rest and bolsters in position
at foot end of the bed, to prevent
patient from slipping down.
 Placesputum mug and bell within reach
of patient.
 DIVIDED BED
This is a special bed made to facilitate observation,
examination and treatment of certain conditions with
minimum disturbance. It is made in two separate parts with a
division in the centre. Aim includes;

 To dress pelvic and abdominal wounds conveniently.

 Observe for bleeding of lower limb amputation
(stump).
 Catheterize patient with convenience.
 Treatfracture of femur
 Examine the rectum or vagina and lower abdomen of
patient.
 Extra requirements
A white cotton sheet
A counterpane and blanket
 dressing mackintosh and towel
 Two sand bags
 Roller towel or strong calico
 Tourniquet and towel
 Bed blocks/elevators
 Bed cradle
 Procedure

 Thebed is made as for a simple bed until draw

sheet is in position.
 Place dressing mackintosh and sheet in position
 Put bed accessories in position if necessary
-Place sand bags with roller in position
-put towel and tourniquet in a tray by the
bedside
-Elevate foot end of bed
-Put bed cradle In position
Procedure cont’d
 Puttop bed clothes over the bed cradle in
two sections with the bottom part
overlapping the top by 10-15cm
 Fold back bed clothes at the side of the
division for observation, examination or
treatment when necessary
 AMPUTATION BED

The bed is modified to nurse patients who

have had an amputation of the lower
limb. Bed is to;
 Facilitatethe dressing of stump as well
as its visibility.
 Observe for bleeding
 For
immobilization of the stump to
prevent it from quivering.
 Extra requirements

 Dressing mackintosh and towel

 Two sand bags
 Roller towel
 Bed blocks
 Bed cradle
 Procedure
 Place
dressing towel and mackintosh at where the
stump will lie.
 Toprevent quivering of the stump. The second roller
towel is placed over the thigh and held firmly by
placing the sand bags over it at either side of the
thigh.
 Thecradle is then placed over the stump and the bed
made up on the cradle in two divided segments with
the bottom part overlapping the top part.
 The bed clothes are folded back at the sides of the
division for observation, examination or treatment
where necessary.
 Procedure cont’d
 The tourniquet may be tied to the bottom
part of the bed or left in a tray with towel
and placed by patient to check sadden
severe haemorrhage.
 Ifstump is above the ankle, flannelette
sheet is placed on patient with the cage or
cradle in position, and then top clothes
arranged and turned back over the cage
and tucked in at the bottom thus exposing
the stump to view.
 FRACTURE BED
A fracture bed is made to provide a firm
base and to prevent sagging of the
mattress to ensure alignment of the
fractured limb.
 Extra requirements
 Fracture boards
 Bed blocks or elevator
 Sand bags
 Bed cradle
 Procedure

 Place fracture board under the

mattress to provide firm base and
make bed as simple bed until the draw
sheet is in position.
 Place bed cradle in position
 Tuck in sheet at the side or fold back
 DRYING A PLASTER OF
PARIS
This bed is made to dry a plaster cast. It is used to
immobilise a fractured limb of the body. It is
applied moist and when dried, it’s hard and firm.

 Extra requirements
 Fracture boards
 Pillow covered with plaster sheet
 Dressing mackintosh and towel
 Bed cradle
 Procedure
 Placefracture boards, under the mattress to
provide firm base and make bed as simple
bed until the draw sheet is in position.

 Place cradle in position if necessary.

 Place top bed clothes in position and tuck in

or fold over the bottom side to make patient
comfortable.