Posture
Postural Awareness
Principals of Proper Body Mechanics
1) Mentally and Physically plan for the activity
2) Position yourself close to the object to be moved to use short lever arms
3) Widen your base of support (BOS)
4) Avoid twisting your body when you lift
5) Maintain your center of gravity (COG) close to the object’s COG
6) When possible, push, pull, roll, or slide object rather than lifting it
a. Use a step ladder or step stool for objects overhead for better control
Lifting Technique
Traditional Lifting Model
1) Stoop or squat to lower your COG closer to the object
2) Activate your core musculature to stabilize your spine
a. Perform an isometric contraction of your abdominals
3) Use the major muscles to do the lifting such as your legs, pecs and biceps.
a. NOT YOUR BACK
4) Keep a straight spine and rise to upright by using your legs
5) Hold the object close the body and at waist level
Transfer Techniques
I. General Precautions During Transfers
1) Predetermine the patient’s mental and physical capabilities to perform the transfer
2) Proper clothing and footwear should be suitable for transfer
3) Mentally preplan the activities and sequence associated with transfer
4) Select, position, and secure equipment before transfer
a. Use a gait belt
5) Be alert for unusual events that may occur
6) Avoid guarding the patient by using clothing or grasping his/her arm
7) Position yourself to guard and protect the patient throughout the transfer
II. Conditions Requiring Special Precautions During Transfers
1) Total Hip Arthroplasties (THA)
a. Do not let resident cross legs
b. Do not flex hip beyond 90’
2) Low Back Pain
a. Log rolling vs. segmental rolling
3) Osteoporosis
a. Avoid traction, rotational or compressive forces
b. They may fracture vertebral bodies or other bones just by transferring
4) Wounds
a. Avoid sliding or dragging the patient
i. This creates shear force
5) Weakened extremities (paralysis or stroke)
a. Pulling on an involved or weakened extremity should be avoided.
i. ESPECIALLY the shoulder
III. Supine to Sit Dependant
a. Moving Body to Edge of Bed
i. Segmental Body Movements
ii. Roll Resident into Sidelying
iii. Pivot Motion
1. Arm under upper back and head
2. Support thighs with other arm
3. Bring legs over edge of bed to create leverage to assist upper body into vertical position
Sit to Stand Dependant (One Person)
a. Not Recommended
Sit to Stand Dependant (Two Person) )
a. Emphasis on planning ahead with co-worker
b. Get Resident to edge of Surface
c. Have Resident Lean Forward “Nose over Toes”
d. IF available and resident comprehends, have resident assist with arms on arms of chair, couch, or by pushing off on bed.
e. Maintain proper postural awareness by bending at the knees and hips (not the back)
f. Keep resident close to your body.
g. Assist Resident forward and Up
Sit to Stand [Minimal-Moderate Assist (One Person)]
a. Emphasis on planning ahead with co-worker
b. Get Resident to edge of Surface
c. Have Resident Lean Forward “Nose over Toes”
d. IF available and resident comprehends, have resident assist with arms on arms of chair, couch, or by pushing off on bed.
e. Maintain proper postural awareness by bending at the knees and hips (not the back)
f. Keep resident close to your body.
g. Assist Resident forward and Up
Special Notes: Wheelchair/Chair should be place at 45 to 90 degrees to landing surface.
Gait belt may be utilized in all instances.
Floor to Standing (One Person)
- Assist resident to prone position.
- Assist to hand and knees position (all fours)
- Assist to a high kneeling position
- Assist to half kneeling position
- Resident may use firm object to assist
- Gait belt may be utilized to assist patient up.