1120 Bed Mobility and Transfers

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What are the goals of bed mobility?

Patient independence
Safety

Bed mobility

Movement w/in the bed

Benefit of bed mobility before transfer?

Proper positioning for pt. to transfer

Why do we teach bed mobility?

Prevent pressure sores
Prevent joint contractures
Improve independence

How do you actively involve the pt. in bed mobility?

Demonstrate
Relevant
Ask for head control and positioning of extremities

How do you reduce energy expenditure?

Use proper body mechanics.

Bed mobility considerations

Cognitive Abilities
Physical Abilities: ROM, endurance, strength, flexibility, balance
Safety
Precautions
Independence levels
Frequency

Bed mobility complicating factors

Pathology
Surgery
secondary diagnosis
physiological status
mental status

Bed mobility techniques

Roll - like a log w shoulders and knees at same time.
-pt should roll into PTA
scoot - same position, shift wt. from 1 side to other.
bridging - lift bottom and move
prone prop - on stomach, propped on elbows, shift elbows s/s

What is the most common bed mobility?

Supine to sit
- flex knees, roll toward PTA to side lying
-provide support at shoulder
-have pt push up arms and swing legs at same time
-lower bed so feet can rest on floor

What technique is used for prone/supine and s/s?

Roll

What techniques are used for supine up/down?

Scoot
Bridge

Do bed mobility excercises always have to be done in bed?

No. A mat table works just as well.

Transfer?

Movement of a person from one surface to another.

Supervision?

Verbal cues
Tactile - touch cues

Transfers in order of assistance needed

Independent
Standby assistant
Guard - close -- contact
min
mod
max
dependent

Independent assistance

no physical supervision or assistance to consistantly perform safely.
Assistive devices may be used.

Standby assistance - SBA

verbal cues
no touch
close enough to provide assistance if needed

Guard - close and contact

close guard - closer than SBA, no touch
contact guard - hands on pt. or belt

min. assist

pt performs 75% or more

mod assist

pt performs 50 - 75%

max assist

pt performs 25 - 50%

dependent

requires total physical assistance

Transfer precautions

hip replacements - (see next card)
back surgery - log roll
burns
sci
osteoporosis
syncope - dizziness
hemiplegia

Hip replacement transfer precautions

2-3 months, lateral
-no hip flexion passed 90*
-no adduction passed midline
-no internal rotation

Transfer training preparations - (10)

Cognitive ability
Instructions
Position pt and secure equip.
Apply gait belt
No slip shoes
Weight bearing status
Proper body mechanics
Clear surroundings
Solicit assistance
Safety

Types of transfers

bed/gurney
sup/sit
sliding board
stand pivot - pt's back toward object to which pt is lowered
wc/bed
wc/floor
car

Bariatric (obese) pt considerations

2-3 person lift
mechanical lift
hoyer (?)

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