POSITIONING

• International Patient Safety Goals (IPSG)

  • Identify patients correctly
  • Improve healthy communication
  • Improve the safety of High-Alert Medications (HAM)
  • Ensure correct surgery
  • Reduce the risk of healthcare-associated infections
• 5 MOMENTS OF HAND HYGIENE

  1. Before touching patient

  2. Before aseptic procedure

  3. After body fluid exposure

  4. After touching patient

  5. After touching patient’s surroundings
• Protective personal equipment (PPE)

  • Gloves
  • Gown
  • Mask
  • Eye goggles
  • Surgical caps
• Application (G.M.G.G)

  1. Gown

  2. Mask

  3. Goggles

  4. Gloves
• Removing PPE (G.E.R.M)


  1. Gloves

  2. Eye shield

  3. Robe

  4. Mask
• ISBAR is a communication tool that helps facilitate effective communication between healthcare team members during handover
• ISBAR

  1. Identity

  2. Situation

  3. Background

  4. Assessment and action

  5. Recommendation and response
• Assistive devices

  • Wheelchair
  • Motorized wheelchair
  • Canes
  • Crutches
  • Walkers
• All FOWLER'S POSITIONS are for breathing and lung expansion
• Fowler's Positions

  Used for breathing and lung expansion
• Trendelenburg's Position


  1. Entire bedframe tilted with head of bed down

  2. Used for postural drainage

  3. Facilitates venous return in patients with poor peripheral perfusion

  4. Low BP = increase cardiac output
• Reversed Trendelenburg's Position

  1. Entire bedframe tilted with foot of bed down

  2. Promotes gastric emptying

  3. Prevents regurgitation or esophageal reflux

  4. For patients who have spinal cord injury
• Orthopneic (Tripod Position)

  1. Patient in a sitting position or on the side of the bed with an overbed table in front to lean on and several pillows on the table to rest on

  2. For patients with COPD, orthopnea (dyspnea when lying down)

  3. For maximum lung expansion
• Lithotomy Position

  1. The patient is on their back with hips and knees flexed and thighs apart, supported with raised stirrups

  2. For vaginal examination

  3. Most common position for childbirth
• Lateral (Side-Lying) Position


  1. The patient lies on one side of the body with the top leg in front of the bottom leg, and the hip and knee flexed

  2. Relieves pressure on sacrum and heels

  3. Surgical access for thorax, kidney, and hip
• Sim's (Semi-Prone) Position

  1. The patient assumes a posture halfway between the lateral and the prone positions

  2. For rectal examination

  3. For cleansing enema

  4. Allows access to anus

  5. Relieves lower body pressure

  6. Perineal area visualization and treatment
• Prone Position

  1. Total opposite of the supine position

  2. The patient lies on the abdomen with their head turned to one side, and the hips are not flexed

  3. For patients experiencing respiratory distress, including patients with severe cases of COVID-19 and ARDS

  4. Drainage of secretions

  5. Position for back surgery
• Knee-Chest (Lateral) Position

  1. The patient lies on their side

  2. Torso lies diagonally across the table

  3. Hips and knees are flexed

  4. Usual position for sigmoidoscopy

  5. Used for gynecologic and rectal examinations
• Knee-Chest (Prone) Position

  The patient kneels on the table and lowers her shoulders onto the table, so their chest and face rest on the table
• What is IPSG?

  International Patient Safety Goals
• what are the six IPSG?

  1.Identify patients correctly

  2. Improve healthy communication

  3. Improve the safety of High-Alert Medications

  4. Ensure correct surgery

  5. Reduce the risk of healthcare associated infections

  6. Reduce the risk of patient harm resulting from falls
• How long is the hand rub?

  20 to 30 seconds
• how long is the hand wash?

  40 to 60 seconds
• considered widely as the most effective means of preventing infection

  hand hygiene
• 5 moments of hand hygiene

  Before touching the patient

  Before aseptic procedures

  After body fluid exposure

  After touching the patient

  After touching patient's surroundings
• Examples of HAM

  Insulin

  potassium

  high concentrated electrolytes

  heparin
• for patient with vertebral and cervical traction


  supine
• commonly used for physical or general examination

  supine
• used on procedures involving the anterior surface of the body

  supine
• head of the bed is approximately 15-30 degrees. Foot may be also be raised at knee

  Low Fowlers
• to reduce lower back pain, prevent aspiration during tube feeding 


  low fowler's
• best position for patient to rest

  low fowler's
• HOB is raised approximately 30-45 degrees


  Semi Fowler's
• Promotes lung expansion, especially with ventilator assisted patients

  semi fowler's
• for oral care, for gastric feeding to reduce regurgitation and risk of aspiration

  semi fowler's
• HOB is raised 45-60 degrees

  Fowler's (Standard Fowler's)
• Proper lung expansion, for gastric feeding

  Fowler's (Standard)
• HOB is raised 60-90 degrees

  Full Fowler's or High Fowler's
• promotes lung expansion, ideal for NGT insertion

  Full Fowler's or High Fowler's
• for nasotracheal suction, eases difficult breathing, eating and defecating, and for upright chest x-ray

  High Fowler's