CARE TO PATIENT WITH
LIMITED MOBILITY USING
NURSING PROCESS
DEFINITION OF TERMS
• Immobility refers to the state of being unable to move or having limited
movement. This can occur due to various reasons such as physical injury,
medical conditions, or prolonged bed rest. It can also be described as
being immovable or fixed.
• Body mechanics is the study of how the body moves and functions,
particularly in relation to the musculoskeletal system.
• It involves understanding the principles that govern safe and effective
movement, which is crucial in various fields such as healthcare, fitness, and
manual labor.
• Proper body mechanics helps to prevent injuries, optimize performance,
and maintain overall physical well-being.
• Alignment is defined as the relationship of the individual body segments
to each other
• Body alignment refers to how the head, shoulders, spine, hips, knees,
and ankles connect and line up with each other. Body alignment is the
most important thing regarding body mechanics and posture.
• Proper body alignment gives less stress to the spine and helps the
person to have good posture.
• If a body is not in proper alignment, the muscles and joints will
compensate for the position. Thus, it increases the fatigue and strain of
muscles and joints.
Normal body alignments for standing,
sitting and lying
• Posture is the position in which you hold your body upright against
gravity while standing, sitting, or lying down.
• Proper Sitting Posture: Shoulders over
hips, feet flat on the floor, low back
support provided, and chin aligned
over the chest.
• Proper Sleeping Posture: When lying on
your back a pillow support should be
utilized under the knees. Remember a
pillow should support the neck not the head
Purpose of Maintaining Body Mechanics
• To assist client move from one place to another for different reasons
• To promote comfort
• To promote good body alignment to prevent complications in cases of
prolonged bed rest
• To prevent further damage e.g. in fractures
• Enhancing Patient Comfort
Assist patients with limited mobility (Lifting
to/from bed, Stretcher/wheel chair
Assessment:
• Is it appropriate time for the procedure
• What support will you need for the procedure
• What is the client’s general condition
Equipment:
• Clean sheet and blanket
• Stretcher
• Pillow and pillow cases
• Clean readymade bed
• Gloves (If necessary)
Moving a patient from stretcher to bed
• Assess patient’s status in order to plan correctly
• Ask for three nurses to help in lifting the patient
• Inform the patient , wash hands, dry and put on glove if necessary
• Organize the three nurses to stand on the side of the stretcher facing
the bed, as close to the stretcher as possible facing the client
• The three nurses put their arms as far as possible under the patient.
One nurse support client’s head and shoulders, one support the back
and buttocks, and the third nurse support the thighs and ankles.
• With legs slightly apart, they lift the patient onto bed. Make sure the
patient is well covered with the top sheet. Position patient comfortably
by arranging pillows, and tidying the rest of the bed
Moving client from bed to chair
• Two nurses will be needed for the procedure
• Inform the patient about the procedure and obtain his cooperation
• Wash hands, dry them and put on gloves if necessary
• Place chair/wheelchair close to the side of the bed
• Help patient to sit at the edge of the bed for a few seconds to prevent orthostatic
hypotension
• Two nurses join hands under patient’s thighs, and other hands support the back.
Patient should put his hands around nurses’ shoulders
• Both nurses stoop and lift the patient simultaneously, they rotate slowly so that the
chair is behind the patient
• Put the patient gently on the chair, position him to be comfortable in the chair.
• Put slippers on his feet and cover him well with sheet to prevent chilling
Turning patient in bed
• Explain to the patient what you are planning to do so the person knows what
to expect. Encourage the person to help you if possible.
• Screen the bed for privacy.
• Stand on the opposite side of the bed the patient will be turning towards, and
lower the bed rail.
• Remove patient’s top linen leaving him covered with a top sheet
• Adjust bed accessories that need protection during movement
• Standing with one foot ahead of the other, shift your weight to your front foot
(or knee if you put your knee on the bed) as you gently pull the patient's
shoulder toward you, one arm under the patient’s shoulder and the other arm
under his hips.
• Turn to your near leg to move patient towards you, then put the side rail back
up.
• Reference
• Bunker Rosdahl, C. (1999). Basic nursing (7th ed.). New York: Lippincott Williams & Wilkins.
• DeLaune, S. C., & Ladner, P. K. (2002). Fundamentals of nursing: Standards & practice (2nd ed.). USA: Delmar Cengage
Learning.
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Oakland, CA: Wesley.
• KMTC-VVOB. (2009). Skills lab project: Nursing procedure manual. Kenya.
• Lynn, P. (2011). Taylor’s clinical nursing skills: A nursing process approach (3rd ed.). New York: Lippincott Williams & Wilkins.
• MOHSW. (2008). Basic nursing procedures: A manual for nursing practice in Tanzania (3rd ed.). NCP: KIUTA.
• Moshi, N., & Karungura, J. (2005). Basic nursing procedures. KCMC Nursing Profession.
• Paulinus, S. (2004). Basic nursing care (2nd ed.). Tanzania: Ndanda-Peramiho:Benedictine.
• Potter, P., & Perry, A. (2005). Fundamentals of nursing (6th ed.). USA: Mosby.
• Rider Ellis, J. (1992). Basic nursing skills (5th ed.). New York: Lippincott Williams & Wilkins.
• Sorenson, K., & Luckman, J. (1994) Basic nursing: A psychophysiologic approach (3rd ed.). St. Louis: W. B. Saunders.
• Thomas, C. (1993). Taber’s cyclopedic medical dictionary. Philadelphia: F. A. Davis.
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