Safety Precautions Lesson Transcript

Unit 2: Body Mechanics

Lesson 1: Body Mechanics for Workers

Objectives
In this lesson you will:
• Define body mechanics.
• Identify the proper technique for lifting and moving.
• Identify the proper technique for pushing and pulling.

Overview
Careers in healthcare involve physical labor which includes often movement of the musculoskeletal system,
especially those of the back. Healthcare workers are often required to lift, carry, pull, or push objects and
patients. To maintain safety, minimize injuries, and maximize muscle productivity, it is important for
healthcare workers to know and understand how to use their muscles correctly. For this reason, healthcare
workers should learn and practice the principles of body mechanics.

Body Mechanics
Body mechanics is proper use of correct muscles to safely and efficiently complete a task, while avoiding
strain on any part of the body. Body mechanics uses proper body alignment, balance, and movement to
increase muscle productivity.

Benefits of Body Mechanics

Muscles are most productive when they are used correctly. When used correctly, muscles provide many
benefits. These include:

• Efficiencies are realized when lifting, carrying, pushing and pulling, thus saving time and energy.
• Risk of injuries to self or others is minimized.
• Avoidance of musculoskeletal strain.

Avoiding Injuries
Injuries resulting from improper muscle usage include muscle strains and sprains, fatigue, disc strain, disc
bulge, and disc herniation. Injury to the back is the most common injury experienced by healthcare
workers.

Back injury can be avoided by applying these simple principles of body mechanics:

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Safety Precautions Lesson Transcript
Unit 2: Body Mechanics
• Maintain a stable center of gravity.
• Maintain a wide base of support - This will provide you with maximum stability while lifting.
• Maintain a line of gravity - This line should pass vertically through the base of support.
• Maintain proper body alignment.

Lifting and Moving

Lifting and moving can apply to medium size and weight to large size and weight objects or patients. No
matter the size, there are some simple rules you can follow to keep yourself and patients safe.

Lifting and Moving (continued)

Apply the following principles of body mechanics when lifting an object or a patient:

• Provide a wide base of support by keeping feet shoulder-width apart. If your feet are too close
together, you may lose your balance when you are lifting.
• When lifting an object from the floor, bend at the hips and knees while keeping your back straight.
Do not bend at the waist. Bending at the waist will put unnecessary strain on your back.
• When lifting an object or patient, focus the lifting action on the strongest muscles in your body. The
muscles in your legs are much stronger than the muscles in your back.
• Use two hands to lift an object or patient. Using two hands will keep the weight of the object
balanced on both sides of your body.

Lifting and Moving (continued)

• Carry objects close to your body and with two hands. Keeping the object close to your body will
give you control of the object and will provide support for the weight of the object. Using two hands
will keep your body balanced.
• Point your toes towards the direction of movement. Do not twist. When you need to change the
direction of movement, pivot your feet and face your body toward the new direction.

If you believe you cannot lift or move an object or patient, be sure to ask for help. Never put yourself or
patients at risk of harm.

Body Mechanics for Pushing and Pulling

Pushing and pulling will most likely be a regular task in healthcare. Just like lifting and moving, there are
specific steps that can be used to keep yourself and patients safe.

Always assess the object or patient before beginning to push or pull, to ensure you can move weight by
yourself or need help.

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Safety Precautions Lesson Transcript
Unit 2: Body Mechanics

Body Mechanics for Pushing and Pulling (continued)

Apply the following principles of body mechanics when pushing or pulling an object or a patient:

• Use the weight of your body to push or pull an object. Do not rely on the strength of your arms and
upper body. Instead, lean your entire body into a push or a pull.
• Use both hands to push or pull an object or patient. Using both hands will distribute the weight
equally and keep your body balanced.
• In all movements, keep your shoulders back, your chin up, and look straight ahead. Practicing good
posture will keep your spine aligned and will alleviate pressure to the back.
• Avoid frequent twisting and turning.
• Always ask for help if a patient or object is too heavy for you to push or pull alone.

Lesson Summary
In this lesson, you:
• Defined body mechanics.
• Identified the proper technique for lifting and moving.
• Identified the proper technique for pushing and pulling.

Lesson 2: Body Mechanics for Patients

Objectives
In this lesson, you will:
• Identify equipment used to help patients maintain proper body mechanics.
• Define the four basic bed positions and their uses.
• Identify the four basic bed positions.

Body Mechanics for Patients

In the last lesson, we focused on body mechanics for the worker. In it, you learned how to apply the
principles of body mechanics properly using correct muscles to avoid injury to self and others. This lesson
will teach you how to use these same principles to keep patients safe from harm.

Rehabilitation and Geriatrics

One important way healthcare workers can assist patients with body mechanics is by teaching the proper
body mechanics. Proper body mechanics are especially useful for patients in rehabilitation and geriatric
patients who must adapt to physical limitations.

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Unit 2: Body Mechanics

Rehabilitation and Geriatrics (continued)

Physical therapists and occupational therapists spend many hours teaching patients how to perform
activities of daily living, such as dressing and bathing, by using correct body mechanics.

Additionally, therapists often teach patients how to use specialized equipment to help maintain proper body
mechanics in daily living. Examples include walkers, canes, wheelchairs, crutches, and hydraulic lifts.

Positioning Patients in Bed

Another way that healthcare workers can assist patients with proper body mechanics is by positioning them
correctly in bed.

Important aspects of positioning patients correctly include:

• Maintaining body alignment

• Providing physiological safety
• Ventilation and airway management

Positioning Patients in Bed (continued)

It is important to consider the patient's comfort, as well as how the patient's body will be affected. When
positioning patients in bed, healthcare workers must help patients keep their spines straight and avoid
twisting. Pillows and towel rolls are often used to elevate body parts and ensure proper alignment.

Standard Bed Positions

There are four basic positions for patients in bed.

Side-lying Position
The side-lying position, also known as lateral position, is used for comfort and for sleeping. This position
also helps to keep the airways clear for semi-conscious or unconscious patients.

Supine Position
The supine position, also known as dorsal position, is used for comfort and sleeping. This position is also
used to limit a patient's movement after certain surgical procedures.

Prone Position
The prone position is used for comfort and sleeping. It can also be used for back treatments or
examinations. This is the only position that allows full extension of hip and knee joints.

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Safety Precautions Lesson Transcript
Unit 2: Body Mechanics
Fowler's Position
The Fowler's position is used for patients with respiratory or cardiovascular problems. When a patient is
placed in this position, pressure on the abdomen is decreased and breathing becomes easier. This position
can be used at a 45° angle in the Semi-Fowler's position, or at a 90° angle in the Full-Fowler's position.

Procedure: Side-lying Position

Individual facilities may have specific procedures that their employees must follow for placing patients in
any of the four positions. Make sure that you know the process followed at any facility for which you
work.

The following process is an example of a side-lying procedure that might be found at any agency.
1. Assist the patient to the side of the bed that is opposite the side he or she will be facing when
turned.
2. Turn the patient onto the side, facing the correct direction. Keep both arms in front of the patient.
3. Place a pillow lengthwise behind the patient's back and tuck it firmly behind the patient. This pillow
is used to keep the patient from rolling over or twisting.

Procedure: Side-lying Position (continued)

4. Place a pillow beneath the patient's head and neck, keeping them as level as possible.
5. Position the patient's lower shoulder either slightly in front of the body or slightly behind the body,
depending on the patient's preference.
6. Position the arms according to the patient's preference. Place a pillow in front of the chest to support
the upper arm.
7. Position the legs so that they point toward the foot of the bed. Legs may be bent slightly for
comfort.
8. Place a pillow between the legs to keep hips level.
9. Cover the patient with a sheet or blanket from neck to feet.

Procedure: Supine Position

The following process is an example of a supine procedure that might be found at any facility.

1. Center the patient face-up on a flat mattress. Make sure the arms and legs are straight and pointing
toward the foot of the bed.
2. Place a pillow beneath the patient's head and neck, keeping the head as level as possible.
3. If instructed by your supervisor, do the following:
a. Place pillows or towel rolls on either side of the patient's hips to prevent rotating or twisting.
b. Separate the patient's legs with a pillow.
c. Place a towel roll under the patient's knees.
4. Cover the patient with a sheet or blanket from neck to feet.

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Safety Precautions Lesson Transcript
Unit 2: Body Mechanics

Procedure: Prone Position

The following process is an example of a prone procedure that might be found at any facility.

1. Center the patient face-down on a flat mattress.

2. Gently turn the head to one side.
3. Make sure the legs are straight and pointing toward the foot of the bed.
4. Ask the patient which position would be more comfortable - arms at the side or upward around the
head. Then position the arms accordingly.
5. Place a pillow beneath the patient's head and neck, keeping the head as level as possible.

Procedure: Prone Position (continued)

6. If instructed by your supervisor, do the following:
a. Place pillows or towel rolls on either side of the patient's hips to prevent rotating or twisting.
b. Separate the patient's legs with a pillow.
7. Cover the patient with a sheet or blanket from neck to feet.

Procedure: Fowler's Position

The following process is an example of a Fowler's procedure that might be found at any facility.

1. Center the patient on a mattress in the supine position. Make sure the hips are placed directly above
the joint in the bed frame.
2. Raise the head of the bed to a 45° angle for the Semi-Fowler's position or a 90° angle for the Full-
Fowler's position.
3. If using the Semi-Fowler's position, place a pillow behind the patient's head and neck. Do not use a
pillow for the head in the Full-Fowler's position.
4. Fold the patient's arms across the abdomen, and place pillows beneath the patient's elbows to
elevate and level the shoulders.

Procedure: Fowler's Position (continued)

5. If instructed by your supervisor, do the following:
a. Place pillows or rolled towels on either side of the patient's hips to prevent rotating or
twisting.
b. Separate the patient's legs with a pillow.
c. Place a rolled towel under the patient's knees.
6. Cover the patient with a sheet or blanket from neck to feet.

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Safety Precautions Lesson Transcript
Unit 2: Body Mechanics

Lesson Summary
In this lesson, you:
• Identified equipment used to help patients maintain proper body mechanics.
• Defined the four basic bed positions and their uses.
• Identified the four basic bed positions.

Lesson 3: Patient Transfers

Objectives
In this lesson, you will:
• Determine how body mechanics relates to patient transfers
• Identify principles of body mechanics to use during patient transfers

Patient Transfers
You’ve learned about body mechanics for healthcare workers, such as the proper techniques for how to
push, pull, lift, and move objects. Now it is important to discuss how to help patients with proper body
mechanics by aligning their bodies correctly in bed. Moving patients and helping patients move is called a
patient transfer.

Patient Transfers (continued)

Patient transfers are another aspect of body mechanics. When a patient is transferred from a bed to a
wheelchair or from a wheelchair to a bed, proper techniques must be followed to prevent injury.

Bed to Wheelchair Transfer

Individual agencies may have specific procedures that their employees must follow for transferring
patients. Make sure that you know the process followed at any facility for which you work.

The following process is an example of a transfer procedure that might be found at any agency:
1. Explain to the patient what you are about to do and provide privacy.
2. Place the wheelchair in a secure position. Whenever possible, the wheelchair should be placed
beside the bed and against a wall.
3. Lock the wheels of the wheelchair and move the footrests out of the way.

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Unit 2: Body Mechanics

Bed to Wheelchair Transfer (continued)

4. Lower the bed to its lowest position, and then elevate the head of the bed to at least a 45° angle.
5. Lower the side rail on the appropriate side of the bed.
6. Pull back the sheets and assist the patient to a sitting position at the edge of the bed. Make sure the
patient's feet can touch the floor. Give the patient a moment to gain his or her balance and avoid
dizziness. Help the patient put on a pair of slippers or shoes.
7. Put a transfer belt around the patient's waist over the clothing. Fasten the belt firmly but be sure
there is enough room to slip your fingers beneath the belt.

Bed to Wheelchair Transfer (continued)

8. Grasp the transfer belt on each side of the patient. Lean your body close to the patient by bending at
the hips and knees. Be sure to spread your feet to shoulder-width apart.
9. Instruct the patient to push off the bed with the hands when you count to three. On three, assist the
patient to a standing position. Press your knees and feet against the patient's knees and feet to keep
the patient from slipping.
10. Pivot your feet to face the wheelchair. Instruct your patient to make several pivot steps until the
back of the patient's legs touch the front of the wheelchair seat.

Bed to Wheelchair Transfer (continued)

11. Instruct the patient to grasp the armrests on the wheelchair and to bend at the knees. Slowly bend
your knees and help to lower the patient into the seat.
12. Remove the transfer belt and position the footrests so that the patient is comfortable. You may also
cover the patient's lap and legs with a small blanket.

Wheelchair to Bed Transfer

The following process is an example of a transfer procedure that might be found at an agency:

1. Explain to the patient what you are about to do and provide privacy.
2. Position the wheelchair beside the bed. Be sure that the wheels are locked and that the footrests are
moved out of the way.
3. Lower the bed to its lowest position, and then elevate the head of the bed to at least a 45-degree
angle.
4. Put a transfer belt around the patient's waist over the clothing. Fasten the belt firmly but be sure
there is enough room to slip your fingers beneath the belt.

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Safety Precautions Lesson Transcript
Unit 2: Body Mechanics

Wheelchair to Bed Transfer (continued)

5. Grasp the transfer belt on each side of the patient. Lean your body close to the patient by bending at
the hips and knees. Be sure to spread your feet to shoulder-width apart.
6. Instruct the patient to push off the armrests with the hands when you count to three. On three, assist
the patient to a standing position. Press your knees and feet against the patient's knees and feet to
keep the patient from slipping.
7. Pivot your feet to face the bed. Instruct your patient to make several pivot steps until the back of the
patient's legs touch the edge of the bed.

Wheelchair to Bed Transfer (continued)

8. Instruct the patient to bend at the knees; assist the patient if possible. Slowly bend your knees and
help to lower the patient onto the bed.
9. Remove the transfer belt and take off the patient's slippers or shoes. Help the patient lay down and
position the patient according to proper body mechanics.

Patient Falling
During a transfer, if a patient starts falling, lower them down to the closest flat surface to avoid injury to
self and the patient, then call for help.

Lesson Summary
In this lesson, you learned how body mechanics relates to patient transfers. Then you discovered how to
transfer a patient from a bed to a wheelchair and from a wheelchair to a bed.

In this lesson, you learned that:

• When a patient is transferred, principles of body mechanics must be followed to prevent injury to
the healthcare worker and to the patient.
• The wheels of a wheelchair must be locked during a patient transfer.
• If a patient is too heavy to lift alone, ask for help.

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