Performed by one nurse, the patient can help (Fig. 2.28)

Rice. 2.28.

It can be used when moving from a functional bed to a functional wheelchair with a movable (removable) footrest, and to a chair.

Used when changing position; transportation.

1. Assess the patient's condition and environment. Attach the bed brakes.
2. Put a chair (wheelchair) next to the bed. If possible, lower the bed to the level of a chair. At the wheelchair, move the footrest, fix the brakes.
3. Use one of the ways to hold the patient (Fig. 2.10).
4. Stand on the side where the wheelchair (chair) is located. Do not put pressure on the patient's armpits!
5. Inform the patient that on the count of three, you will help him to his feet. Counting, sway slightly. Having put the patient on the count of "three" on his feet, turn with him until he is with his back to the wheelchair (chair).
6. Ask the patient to tell you when they touch the edge of the wheelchair (chair).
7. Lower him into a wheelchair (on a chair): bend your knees and hold the patient's knees with them, keep your back straight. The patient will help you by placing his hands on the handle of the wheelchair (on the edge of the chair) and lowering himself into it.
8. Seating the patient in a chair (on a chair) is comfortable.

Transferring a patient from a “sitting on a bed with legs down” position to a wheelchair with a non-removable footrest

Performed by two people, the patient can help (Fig. 2.29). Use for subsequent transportation.

Rice. 2.29.

1. Explain to the patient the course of the procedure, make sure that he understands it and obtain consent to the procedure.
2. Assess the patient's condition and environment. Attach the bed brakes. Place the wheelchair at the patient's feet. If possible, lower the bed to the level of the chair.
3. One sister stands behind the wheelchair and tilts it forward so that the footstool touches the floor. The second sister (assistant) stands in front of the patient, sitting on the bed with his legs down, the sister's legs are spaced 30 cm apart, knees bent.
4. Ask the patient to grab the sister by the waist, hold him by the shoulders.
5. Pull the patient to the edge of the bed so that his feet (in non-slip shoes) touch the floor (Fig. 2.29, a).
6. Place one leg between the patient's knees, the other in the direction of movement.
7. Press the patient in the “hug” position, gently lift him, without pulling or turning. Do not put pressure on the patient's armpits!
8. Warn him that on the count of three you will help him up. While counting, sway slightly with it. On the count of three, put the patient, turn with him until he takes a position with his back to the wheelchair. Ask the patient to warn you when he touches the edge of the gurney.
9. Lower the patient into a wheelchair: bending your knees, hold the patient's knees with them; keep your back straight. The patient can help by placing their hands on the armrests of the wheelchair.
10. Release the patient, making sure that he is securely seated in the chair.
11. Place the patient in the chair comfortably.
12. If necessary, transport the patient, release the brake.

Placement of the patient in a wheelchair

Performed by two people (Fig. 2.30).

Rice. 2.30.

1. Check if wheelchair brakes are engaged.
2. Stand behind the wheelchair behind the patient.
3. Provide yourself with reliable support: with one foot lean on the back of the chair, put the other foot back. Bend your knees.
4. Ask the second sister (assistant) to sit on one knee to the side of the patient, raise his legs to the level of the hips and put them on your knee.
5. Support the patient's head with your chest or shoulder. Make a hand grip. Keep your back straight, tensing the muscles of the abdomen and buttocks.
6. Tell the patient and assistant that on the count of three you will move the patient to the back of the chair.
7. On the count of three: the assistant slightly lifts the patient's hips and moves them to the back of the chair; you pull the patient to the back of the chair using the slide.
8. Make sure that the patient feels comfortable, remove the wheels of the wheelchair from the brakes.

Transferring a patient from bed to chair (wheelchair)

Performed by two or more people using the "shoulder lift" method; the patient can sit, but does not move independently (Fig. 2.31).

Rice. 2.31.

1. Explain the procedure to the patient, make sure that he understands it and obtain his consent to the procedure.
2. Put a chair next to the bed. Assess the environment.
3. Help the patient to sit closer to the edge of the bed with legs dangling.
4. Stand on both sides of the patient facing him. Both sisters put their hand under his hips and hold each other in a "wrist grip" (see figure 2.10), supporting his hips.
5. Both sisters put their shoulders under the shoulders of the patient, and he puts his hands on the backs of the sisters. Bend your free arm at the elbow, resting it on the bed. Legs apart, knees bent.
6. One of the sisters gives the command. On the count of three, both straighten their knees and elbows, stand up and lift the patient. Support the patient's back with your free hand while you carry them to the chair (wheelchair).
7. Each nurse places a supporting hand on the chair arm or seat and lowers the patient into the chair by bending the knees and elbow. Make sure you lower the patient into the chair at the same time. The chair should not lean back: one of the sisters holds the back of the chair.
8. Position the patient comfortably in a chair.

(or a wheelchair) using the “shoulder lift” method

(performed by two or more nurses)

Indications: the patient can sit, but cannot move independently with the help of legs.

Contraindications: shoulder injury, chest and upper back pain.

3. Put a chair (wheelchair) next to the bed, make sure the bed and wheelchair are on the brake.

4. Move and seat the patient in a position with legs hanging freely.

5. Stand on both sides of the patient facing him.

6. Bring the hand closest to the patient under his hips (both nurses take each other's hands with a "carpal grip").

7. Support the patient by the hips as close to the buttocks as possible.

8. Substitute the shoulders in the armpits of the patient, and the patient puts his hands on the back of honey. nurses (both nurses monitor the observance of the correct biomechanics of their body in order to prevent back injuries).

9. Use your free hand, bent at the elbow, as a support, leaning with it on the bed behind the patient's buttocks (keep your legs apart, bend your knees).

10. To ensure synchronization of actions, one of the m/s gives the command: “On the count of “three”, straighten your knees and elbow until the m/s stand straight.”

11. Move the patient to a chair (wheelchair) supporting his back with his free hand.

12. Place your holding hand on the armrest or chair seat.

13. Lower the patient into a chair (wheelchair) by bending your knees and elbow (talk among yourselves to make sure you lower the patient into the chair at the same time, pay attention that the chair does not tilt back, for this one of the nurses can hold the back of the chair ).

14. Make sure the patient is sitting comfortably and comfortably.

15. Wash your hands, dry with a disposable tissue or individual towel.

Rice. 2 stage moving method

"Shoulder raises"

(on the command "Raise the patient")

Rice. 3 stage moving method

shoulder raises, moving

patient on a chair

Retention of the patient by the method " axillary grip»

Indications: support and movement of the patient, able to provide assistance.

Execution sequence:

3. Stand on your side facing the seated patient.

4. Put one foot next to it, and the other, slightly turning the foot, in front of the patient's legs, fixing his knees.

5. Draw one hand into the far axillary cavity of the patient, and draw the second brush in the direction from behind and to the front with the palm up ( thumb located outside, outside the armpit).

6. Make sure you are able to move your body weight freely from one foot to the other and that you are standing comfortably.

7. Ask the patient to help him lean forward from the hip so that his shoulder, which is closer to you, rests firmly on your torso.

8. After holding, wash your hands, dry with a disposable tissue or individual towel.

Indication: transportation to the operating room for surgery.
Equipment: wheelchair, pillow, mattress, sheets.
Sequencing:
1. Determine how the patient's bed is located in the ward.

Read about how to prepare yourself and the surgeon for the upcoming operation.

3. Place the wheelchair close to the patient's bed; one nurse should stand on the side
wheelchairs, the other - from the side of the bed.
4. Ask the patient to help healthcare workers move from bed to stretcher.
Put the patient's pillow from the bed on the stretcher, follow the position of the patient's hands
(hands should lie along the body; if the patient is obese, then place your hands on the front of the thigh).
6. Cover the patient with a sheet or blanket and tuck the ends under the mattress on the gurney.
7. Transport the patient to the operating room, one nurse - At the head, the other - at the foot end of the gurney.

Note. In the preoperative room, the patient takes off his clothes. The patient is transferred from the ward gurney to the operating room gurney in the same way as from bed to gurney.

Transferring a patient from wheelchair to operating table and vice versa

Sequencing:
1. Explain to the patient the course of the upcoming manipulation.
2. Bring the gurney with the patient into the operating room.
h. Place the gurney close to the operating table (head end to head end).
4. Get up from the side of the gurney for two nurses (from the surgical department) and from the side of the table - for two operating sisters.
5. Bring both hands to the forearm towards each other:
standing at the head of the patient enclose right hand under the neck and shoulders of the patient, the left arm - under chest(hands of nurses should join under the patient); standing by lower extremities patient, put the right hand under the pelvis, the left hand under the patient's knees (the hands of the nurses should join under the patient).
6. Transfer the patient to the count of "three" (the command is given by one of the nurses). All four lift the patient and transfer them from the gurney to the operating table.
Note. The patient is also transferred from the operating table to a stretcher.
The patient after surgery may remain for some time in a state of anesthesia or, being conscious, experience pain. When starting to shift the patient, it is necessary to know in which area the operation was performed, and also to remember about the delivered dropper or drainage.

Transferring a patient from a wheelchair to a bed after surgery

Sequencing:
1. Determine how the patient's bed is located in the ward (the wheelchair is located in relation to the bed: at an angle, parallel, sequentially, close).
2. Explain to the patient the course of the upcoming manipulation.
h. Choose one of the proposed methods for positioning the wheelchair in relation to the bed. Leave enough space to stand between the bed and the wheelchair.
4. Prepare the patient's bed.
Note. If the operation was performed under local anesthesia, you need to put a pillow at the head. If under general anesthesia, remove the pillow. The patient should be without a pillow for 6-8 hours.
5. Stand between the bed and the gurney for three nurses. Bring hands under the patient to the forearm:
the nurse standing at the head of the patient puts her right hand under the neck and shoulders of the patient,
left - covers the opposite hand of the patient, as if hugging him;
a nurse standing in the middle puts her right hand under the patient's shoulder blades, her left hand under lumbar region;
a nurse standing at the patient's pelvis puts her right hand under the lumbar region, the left hand under the patient's knees.
6. Transfer the patient from the wheelchair to: the bed on the count of "three" (one of the sisters gives the command).
The nurse at the head turns around and the paramedics carry the patient in their arms.
7. Carefully place the patient on the bed, cover with heat and take the gurney out of the room.
Note. If the patient has a drain tube or other devices, another person is required to hold the drain.

The patient can change from bed to a chair or wheelchair on their own or with your help. The height of the bed should be at the same level as the wheelchair or chair.

Self-transfer from bed to wheelchair

• First, a dressing gown, slippers, a chair or a wheelchair are prepared for the patient;
• Help the patient to dress and sit up in bed so that his feet touch the floor;
• A wheelchair or chair is placed at a slight angle to the bed on the side of the patient that is physically stronger;
• The bed is put on the brakes;
• If the patient moves to a wheelchair, the brakes are fixed at the chair, the armrest is removed from the side close to the patient, and the footrest;
• The patient should sit on the edge of the bed, lean on it with one hand, and grasp the armrest of the wheelchair with the other;
• Then he gets out of bed, leaning with one hand on the bed and the other on the arm of the chair, turns his back to the chair and carefully sits down in it.

When moving from a wheelchair to bed, the patient holds on to the armrest of the chair with one hand, and leans on the bed with the other, then gets up from the wheelchair, leaning on the bed with one hand, and with the other - holding on to the armrest of the chair, turns his back to the bed and carefully sits on her.

When moving from bed to chair and back, you can use the same techniques as when moving from bed to wheelchair. For the safety of the patient, it is better to use a chair with armrests.

Using a smooth board to move the patient from bed to chair or wheelchair and back

Such boards reduce sliding friction and may be useful for patients with strong arms, but unable to lean on their feet when transplanting.

• An armchair or chair is moved close to the bed, the chair is put on the brakes, the armrest is removed from the chair from the side of the bed.
• The patient should sit in bed without taking his legs off her, so that the chair is on the side of him.
• The patient must transfer the weight of his body to the buttock farthest from the chair.
• The patient slips one end of the board under the buttock closest to the wheelchair.
• Leaning with one hand on the bed, and with the other on the free edge of the board, the patient slides into the chair along the board, pressing it to the seat.
• After sitting down in a chair, he takes out a board from under him.
• Sitting in a chair, he moves his legs off the bed and puts them on the footstool. In the same way, you can move from a chair to a bed.

Moving from bed to chair and back with the help of a sitter

• Explain your transfer plan to the patient and encourage him to help as much as he can;
• Prepare a bathrobe, slippers, a chair or a wheelchair for the patient. The bed should be at the same height as the chair (wheelchair);
• Place the patient in bed with his feet touching the floor;
• Place a chair or wheelchair at a slight angle to the bed on the side that is physically stronger for the patient;
• Put the bed on the brakes. If you are transferring the patient to a wheelchair, remove the armrest, footrest and lock the brakes;
• Help the patient to dress and put on shoes;
• Your knees should be bent and your back should be straight. Place one hand under the patient's shoulders and the other under his hips. Do not turn your back at the waist;
• Ask the patient to put his arm around your waist or shoulders (but not around your neck!), and you put your hands under his arms, leaning forward;
• When your patient is ready to move, their buttocks should be on the edge of the bed so they can keep their balance as you move their body weight forward. The patient's feet should be on the floor, and the heels should be slightly turned in the direction of movement. This is necessary so that his legs do not get tangled when he turns his body to sit in a wheelchair or chair;
• Place your leg, which is further from the chair, between the knees of the patient with your knee towards him, and the other in the direction of movement;
• Bend your knees, tighten the muscles of your abdomen and buttocks, keep your back straight;
• Get as close to the patient as possible. Warn him that on the count of 3 you will help him up. Rock back and forth slightly for each count to create momentum. On count 3, holding the patient close to you and keeping your back straight, lift the patient using your body as a lever;
• Turn yourself at the same time as turning the patient's body until he is in a position directly in front of the wheelchair. Ask the patient to warn you when he feels the edge of the chair on the back of his thighs;
• Gently lower the patient into a chair. To do this, you need to bend your knees and keep your back straight. While sinking into a chair, the patient can help you if he puts his hands on the arm of the chair. After the patient sits in the chair, put the armrest and footrest in place, place the patient's legs on the stand.

Moving plank from bed to wheelchair with the help of a sitter

• Move the chair or chair close to the bed, put the chair on the brakes, remove the armrest from the chair from the side of the bed;
• The patient should sit in bed without taking his legs off her, so that the chair is on the side of him;
• The patient must bear the weight own body on the buttock farthest from the chair;
• Slide one end of the board under the buttock closest to the stroller;
• Stand behind the patient and put your hands on his waist;
• With one hand, the patient should lean on the bed, and with the other - on the free edge of the board;
• Then, leaning on the free edge of the board and bending it to the chair, the patient, with your help and the help of the other hand, should move to the chair;
• Pull the board out from under it;
• Move his legs off the bed and place them on the footstool. In the same way, you can move from a chair to a bed.