FUNDA LAB

• Contributing factors to most injuries

  • Months or years of poor body mechanics
  • Life stresses
  • Poor posture
  • A loss of flexibility
  • A general lack of physical fitness
• How to prevent injuries

  • Use good body mechanics
  • Stay physically fit and active
  • Use mechanical assist devices when possible (lifts, carts, dolly)
  • Get help when necessary
• Body Alignment


  The positioning of joints, tendons, ligaments and muscles while in standing, sitting and lying positions
• Body Balance


  A state of the body achieved when the center of gravity is balanced over a wide, stable base of support and a vertical line falls from the center of gravity through the base of support
• Posture


  The position of the body in relation to the surrounding space. It is the relationship of various body parts at rest or any phase of activity
• Mobility


  A person's ability to move about freely owing to his/her voluntary motor and sensory control of the body's regions
• Immobility


  When the individual is confined to a position and is unable to move or change positions independently
• Bed Rest


  An intervention in which the client is restricted to bed for therapeutic reasons
• Weight


  The force exerted on a body by gravity
• Friction


  A force that occurs in a direction to oppose movement
• Anatomical Position


  A position wherein the individual stands erect (upright position) facing the observer, with feet on the floor and arms placed at the sides, and the palms of the hands turned forward
• Kyphosis


  An abnormal condition of the vertebral column characterized by increased convexity in the thoracic spine, the clients shoulder are slouched & vertebral bones are prominent. It is common in middle aged & older adult
• Lordosis


  An abnormal condition of the vertebral column characterized by an exaggerated curvature of lumbar spine
• Scoliosis


  An abnormal condition of the vertebral column characterized by lateral deviation
• Body mechanics


  The coordinated efforts of the musculoskeletal and nervous systems. It is the way the body moves and maintains balance while making the most efficient use of all its parts
• Reasons for using good body mechanics


  • Muscles work best when used properly
  • Correct use of muscles makes lifting, pulling and pushing easier
  • Correct applications of body mechanics prevents unnecessary fatigue and strain and saves energy
  • Correct applications of body mechanics prevents injury to self and others
• Base of support


  The portion of the body in contact with the floor
• Center of body weight


  The point around which body weight is balanced. Usually located in the midportion of the pelvis or lower abdomen, depending on body build
• Any object you hold adds to the weight on the base of support affecting the location of your center of gravity
• The body is most stable when the center of gravity is nearest the center of the base of support
• The body is most stable when the line of gravity bisects the base of support
• 8 basic rules of good body mechanics


  • Maintain a broad base of support
  • Bend from the hips and knees to get close to an object and keep back straight
  • Use the strongest muscle to do the job
  • Use the weight of your body to push or pull an object
  • Carry heavy objects close to your body
  • Avoid twisting your body. Turn your body and feet to change direction
  • Avoid bending for a long period of time
  • If a patient or object is too heavy, get help
• Sitting and computer station work

  • Sit close to your work
  • Hips, knees and ankles are open to 90 degrees
  • Elbows are open to 90-120 degrees
  • Wrists are in relaxed and neutral position (not bent)
  • Both feet are flat on the floor or use a foot rest
  • Shoulders are low and relaxed
  • Head and neck are aligned with spine
  • Do not slump or lean forward or downward to reach for work
  • Do not sit for more than 60 minutes without getting up or changing position
  • Raise the height of the computer screen so screen is at or slightly below eye level
• Standing

  • Bring your work close to you
  • Put one foot up, shift your weight and position frequently
  • Keep your work at a comfortable height
  • Wear comfortable shoes and stand on an anti-fatigue mat, if possible
  • Do not stand in one place too long
  • Do not stand bent forward at your waist or neck
  • Do not lock your knees into a straight or overextended position
• Pushing

  • Push whenever possible
  • Keep head up, knees bent, and back straight
  • Keep the load in front and use both hands
  • Remain close to the item being pushed
• Pulling or Twisting

  • Do not pull when you can push
  • Do not twist your body
  • Do not lean forward
• Carrying objects or lifting items

  • Test the load first
  • Use a cart/transfer device whenever possible
  • Pivot with your feet - don't twist at waist
  • Use both hands
  • Keep objects near your body and directly in front of you
  • Ask for assistance with heavy items
• Lifting

  • Do not lift in a bent-over, stooped position
  • Do not twist at waist
  • Do not lift with one hand
  • Do not lift with outstretched arms
  • Do not keep feet together
• Reaching

  • Keep back straight
  • Reach with two hands
  • Face the object
  • Stand on a stable step-stool to reach high items
  • Bend knees slightly
• Patient movement or transfer

  • Update yourself on the patient's physical limitations or condition
  • Let the patient know what you are going to do so they may assist
  • Position the patient for transfer
• Prepare yourself/team

  • Keep feet apart, knees bent with back and head straight
  • Be close to patient
  • Use transfer device to assist in moving patient: transfer belt, slide board
  • Pivot feet, don't twist waist
  • Have adequate number of persons to transfer patient (based on patient's size and/or type of transfer required)
  • Use mechanical lifts when possible
  • Lock wheels of bed, wheelchair or stretcher
  • Adjust position and height of bed, wheelchair or stretcher
  • Do not attempt to move patients by yourself. This may cause injury to yourself or the patient
• Complications of improper body mechanics

  • Musculo-skeletal injuries
  • Complications of immobility, e.g. pressure sores, contractures, etc.
  • Muscle fatigue
  • Orthostatic hypotension
  • Hypotension bronchopneumonia
  • Decreased basal metabolic rate
• Ergonomics


  The science of designing equipment and devices that fit the human body and its movements
• Procedures for moving, lifting and positioning of patients


  Good posture and body mechanics and assistive devices are necessary when inactive patients require positioning and moving. An inactive patient's position is changed to relieve pressure on bony areas of the body, promote functional mobility (alignment that maintains the potential for movement and ambulation), and provide for therapeutic needs
• Transferring


  A nursing skill that helps the dependent client or client with restricted motility attain positions needed or desired safely
• Mobilization


  Plays important role in rehabilitation as physical activity maintains and improves joint motion, increases strength of the musculoskeletal system, promotes circulation, relieves pressure on skin (pressure points), and improves respiratory function
• Equipment needed for transfers

  • Transfer belt
  • Slide board
  • Wheelchair
  • Stretcher
  • Lifts e.g. hydraulic lift
• General instructions in moving and lifting patients

  • Maintaining a good anatomical position of the body
  • Use longest and strongest muscles extremities to provide energy needed in strenuous activities
  • Keep the object or the patient close to the body to prevent unnecessary strain on the muscles as this brings the centre of gravity of the object/patient close to the centre of the gravity of the body
  • Place the feet apart to provide a wide base of support. This facilitates better body balance
  • Flex knees to come closer to the object/ patient
  • Keep work close to the body
  • Maintain the four body curves of human body and work with their proper alignment
  • Slide, roll, push or pull an object rather than lift in order to reduce the energy needed to lift the weight against pull of gravity
  • Keep the body above the object and the use the weight of the body to pull or push the object
  • Avoid disturbances/ interruptions in the path of movement of patients
  • Move obese patients by sliding them rather than lifting them
  • Seek assistance when lifting or moving heavy patients
  • The height of the bed should be adjusted to a height that allows the nurse to keep her back as erect as possible while moving the patient in the bed. This reduces the injury to the lower back
  • The patient is moved to the edge of the bed before he is lifted from the bed. This helps the nurse to keep her trunk more erect
  • When moving a patient by more than one nurse, each nurse assumes the responsibility for supporting one of the patient's body sections. The areas to be supported include head, shoulders, chest, hips, thighs and ankles
  • In order to coordinate the movements of the nurses and to maintain the patient's body in correct alignment, the nurse gives the signal by counting 1,2,3 etc. with each activity of the procedure
  • Unless contra-indicated, encourage the patient to use his abilities as much as possible
  • Observe the patient for symptoms of orthostatic hypotension e.g. fainting, dizziness, sweating etc.
  • Do not support the patient under his armpits, since injury to major nerves and blood vessels may occur
  • Always lock the wheels of the bed, stretcher or wheel chair while transferring the patient so as to increase the maximum static friction between the wheels and floor
• Positioning


  Placing the person in such a way to perform therapeutic interventions to promote the health of an individual. Placing the person in a proper body alignment for the purpose of preventive, promotive, curative and rehabilitative care
• Areas to be supported during patient positioning

  • Head
  • Shoulders
  • Chest
  • Hips
  • Thighs
  • Ankles