1) Stand opposite the patient;

2) Ask the patient to grab you by the waist, while holding the patient by the shoulders middle third. Your feet and the patient’s feet should be in a “foot to foot” position;

3) Take a step back, holding the patient and helping him to stand;

4) Turn to the left, continuing to hold the patient, help him stand in front of the chair;

5) Ask the patient to sit on a chair behind him, while holding the patient by the shoulders and using his knees to support his knees

6) Do not leave the patient alone until you are sure that he is sitting confidently and steadily;

7) Wash your hands.

The sequence of actions when transferring a patient from the “sitting” position on a chair to the “sitting” position on the bed

1) Stand facing the patient so that your knees and feet support the patient’s knees and feet

5) Wash your hands.

When moving a patient by one person, use lifting by rocking to help the patient get up and move to another place, provided that patient can participate in locomotion and control the position of his head and arms.

They begin by helping the patient move to the edge, gently rocking him from side to side and alternately moving his legs forward.

The patient's knees should be at a 90-degree angle with the knees and feet together. Stand with one foot next to the patient and the other in front of him, locking his knees.

In this situation you can:
- help the patient stand up;
- move it at an angle of 90 degrees from a chair to a wheelchair, etc.;
- turn it 180 degrees from the wheelchair.

In every case rocking carried out according to the same principle: they begin to move rhythmically , shifting your body weight back and forth while keeping the patient close to you.

In this case, the impulse of rocking back and forth is transmitted to the patient, and there is no need to lift the patient.

Do a few preparatory rocking motions to establish the rhythm, then move more intensely, stimulate the patient (“Get ready, do”), and the movement is done.

You can use the method axillary grip or pelvic holds , or waist belt to help the patient stand up or move him from a sitting position at a 90-degree angle to another position.
The sequence of actions when transferring the patient from the “sitting” position on a chair to the “lying” position

1) Stand facing the patient so that your knees and feet support the patient's knees and feet

2) With your knees slightly bent, grab the patient by the body, while the patient’s hands are passively folded on his knees;

3) Slightly tilting the patient’s body towards you, help him rise from the chair;

4) Turning to the right, help the patient sit on the bed. Do not release the patient until you are sure that he is sitting securely;

5) Stand to the patient’s right; Place your right hand under his knees, hold his left hand behind his back at the level of his shoulder blades;

6) Raise the patient’s legs onto the bed, while turning him around his axis by 90 0, lower his head onto the pillow;

7) Make sure the patient feels comfortable, cover him;

8) Wash your hands.

When raised patient in bed or moving from bed to chair and vice versa is used Shoulder lift method

(known in practice as the "Australian uplift").

This method should not be used when the patient is unable to sit. Also, this method is not suitable for patients with injuries, disease or pain in the shoulder, chest, or upper back .

If possible, set the bed at a height that is halfway between your hip and knee, and make sure the bed is on the brake. Help the patient sit up. One nurse supports, and the other can provide a pillow, etc. Stand on both sides of the bed, facing each other, close to the bed and slightly behind the patient so that your shoulders are level with the patient's back. Legs occupy stable position, presenter foot in the direction of movement. Bend your hips and knees and keep your back as flat and straight as possible.

Place your shoulder, which is closest to the patient, from a position behind the patient's chest and under the armpit, while the patient puts his hands on his back personnel .

Place your hands at the wrists under the patient's hips as close to the buttocks as possible. Place your other arm on the bed behind the patient to support your torso, with the elbow flexed and ready to bear weight during lifting.

Then you or your colleague, depending on who is the leader, give the command to raise. Straighten your trailing leg and the elbow that is helping the patient up, and shift your weight to your leading leg. Lift the patient completely out of bed and lower them by bending your leading leg and supporting elbow. In one motion, move the patient to short distance .

When it is not possible to use the shoulder lift method, an alternative method is used lifting with a stretched sheet

Make sure the sheet under the patient is between the chest and mid-thigh. Grasp the top corner of the taut sheet while helping the patient sit up. Then grab the bottom corners of the stretched sheet. Place your leading foot in the direction of movement and use your legs and body weight to bring the patient to an upright position in the bed gradually (one of nurses gives commands).
Lifting an obese patient requires two people on each side.

Holding the patient by the belt

(performed by one nurse, the patient is able to help)

Indications: support and movement of the patient who is able to assist

Stages	Rationale
1. Explain the procedure to the patient and obtain consent	The patient’s right to information is respected and his participation in the procedure is ensured.
2.Assess the patient’s condition and environment
3.Stand to the side of the patient, facing him. Place one foot next to his leg and the other in front of his legs, fixing his knees.	Fixing the knees ensures patient safety and reduces the risk of falling.
4. Place the thumbs of both hands behind the waistband of the patient’s trousers (patient’s skirt), then clasp it with your entire hand. Note: An additional wide belt can be placed on the patient.	Ensures reliable fixation and safety of the patient when moving. Prevents the belt from slipping on chest when moving
5.Make sure the belt is securely fastened.	Patient safety is ensured
6. Ask the patient to help you and support himself by placing his hands on your lower back or clasping your belt	The safety of the nurse and the patient is ensured.
7.Wash and dry your hands after the procedure.	Infectious safety is ensured

Supporting the patient while walking (performed by one nurse)

Indications: helping a person walk after an injury, stroke, etc.

Stages	Rationale
1.Explain the principle of holding while walking.	The patient's conscious participation in the procedure is ensured.
2.Assess the patient’s condition and capabilities: -what he can do on his own; - what support he needs; - does he need aids(cane, crutches, walker).
3. Assess the surrounding environment (floor moisture, slippers, foreign objects on the floor, equipment standing in the patient’s path).	Patient safety is ensured.
4.Stand next to the patient. Apply a “thumb-palm grip”: hold the patient’s right hand in yours right hand(or left in left). The patient's arm is straight, resting his palm on the nurse's palm with his thumbs clasped together.	Provides reliable patient support and safety.
5.Support the patient’s elbow with your other hand or grab the patient’s waist.	Patient safety is ensured.
6.Stand as close to the patient as possible, support his knees right foot(the sister stands on the right) if the patient honors himself with uncertainty.	In this position, it is easier to keep a person from falling, using minimal effort.
7. Move next to the patient until he feels insecure.	Patient safety is ensured.
8.Wash and dry your hands at the end of the procedure.	Infectious safety is ensured.

Mattress – Slider “Easy Movement”

Sanitary and epidemiological conclusion No. 77.01.06.561.P.038152.05.07 dated May 25, 2007. “Easy movement” is a very simple, convenient and effective device for moving patients from gurneys to a bed, operating or manipulation table, etc. The mattress-slider “Easy Movement” is designed for moving bedridden patients from one surface to another (bed, gurney, operating room, manipulation table, etc.) The slider makes moving patients an easy job for medical personnel and creates comfort and safety for patients. In the work of a nurse, the slider provides an invaluable service, especially when it comes to patients who need special care. It can be easily folded and then used again to move patients. Withstands a load of 200 kg. The surface on which the patient lies must be flat and hard . The height difference between the gurney and the surface can be 15 cm

It is best to move the patient together. When moving a patient from a hospital bed (operating table, etc.) to a gurney, the operator on the side of the bed easily supports the patient by the shoulders and buttocks, facing him. Another operator from the side of the gurney (operating table) unfolds the mattress-slider and (etc.) places it under the patient on 1/3 or ¼ of his body. The bedside operator places the patient on the edge of the slider mattress and, in a slow, gentle motion, rolls the patient on the slider mattress from the hospital bed to the gurney. When moving the patient back from the gurney to the bed (operating room, table, etc.), all actions are repeated, but in reverse order and the operator from the side of the hospital bed removes the mattress slider.

SLIDER PROCESSING

The sliding cover is waterproof. It can be wiped with a damp cloth, can be washed at a temperature of 60 ° C, but not in a washing machine. Disinfect (wash) with any disinfectant that does not corrode the synthetic polymer. For processing, we recommend products that do not contain strong oxidizing agents (chlorine, peroxide) with a cleaning effect, for example, “Brilliant” - 0.5-2% solution, “Brilliant Light” - 0.15-3% solution, “Diamond Paradise” - solution 0.1% -2%, etc. containing alcohols, for example “Diamond Spray”. A board in synthetic fabric can also withstand any gentle disinfectants with a detergent effect, including those based on alcohol. Do not rub a gray board with a hard brush.

ATTENTION!

1. Personnel must be familiar with the instructions for use.

2. Before moving the patient, the gurney must be firmly moved to the hospital bed (operating table, etc.) and secured by the operator.

3. The height difference between surfaces should not be higher or lower than 15cm

4. It is prohibited to use brute force when carrying out manipulations to move patients!!!

It is performed by two or more people using the “hand grab” method; the patient can sit, but does not move independently (Fig. 2.32).

Rice. 2.32.

1. Explain the procedure to the patient, make sure he understands it and obtain his consent to perform it. Introduce everyone involved in the move.
2. Set the height of the bed to the height of the chair. Assess your surroundings.
3. Help the patient sit down (the patient's legs are not lowered).
4. One of the nurses stands behind the patient - puts one knee on the bed and does an “over-arm grab.”
5. Move the patient to the edge of the bed. Support him by standing on the floor with both feet behind him.
6. The second nurse places the chair comfortably and close to the bed, but so that the patient does not rest his elbow on the bed when sitting on the chair.
7. The same nurse stands opposite the chair facing the patient. Legs are bent at the knees (squatting position), one leg is put forward.
8. She puts her hands under the patient’s knees and, on the count of three, drags his legs to the edge of the bed, while the other nurse lifts his torso and, bending her knees, lowers the patient onto a chair.
9. Place the patient comfortably on the chair.

Lifting the patient from a chair by rocking and moving onto a chair (bed)

Performed by one sister (Fig. 2.33).

Rice. 2.33.

Used for: moving the patient, if he can participate in it and control the position of the head and hands; the need to move the patient at a 90° angle from a chair to a wheelchair or other seat.

1. Explain the procedure to the patient, make sure he understands it and obtain his consent to perform it.
2. Assess your surroundings. Move both seats together, fixing the brakes and removing the side bars of the chairs.
3. Face the patient:
   • place your feet shoulder-width apart;
   • Hold the patient’s feet with one foot, and the chair leg with the other.
4. Ask the patient to lean forward so that his shoulder rests against the nurse's chest.
5. Move the patient to the edge of the chair, rocking it from side to side and moving the legs forward. The patient's knees are at an angle of 90°. Knees and feet together.
6. Place one leg next to the patient and support his knees with the other.
7. Start smoothly rocking, moving your body weight back and forth, keeping the patient close to you.
8. Warn the patient that on the count of three you will help him stand up.
9. Lift the patient and move him at a 90° angle to another chair.

Moving the patient from the “sitting on a chair” position to the “lying on the bed” position

Performed by one sister (Fig. 2.34).

1. Explain the procedure to the patient, make sure he understands it and obtain his consent to perform it.
2. Assess the patient's condition and environment. Set the bed brakes.
3. Hold the patient using one of the methods known to you (see Fig. 2.10).
4. Warn the patient that on the count of three you will help him stand up. While counting to three, swing. On the count of three, stand the patient, then turn with him, foot to foot, until his hips touch the edge of the bed.

Rice. 2.34.

1. Place the patient on the bed. Stand on the side facing him. Spread your legs 30 cm wide. Bend your knees. Keep your back straight!
2. Place your hand under your knees, grab them from above, and with your other hand grab the patient’s shoulders.
3. Raise the patient's legs onto the bed, turning his torso 90°, and lower his head onto the pillow.
4. Cover the patient and make sure he is lying comfortably.

Transferring a patient from bed to gurney and back

Performed by four people, bed with variable height (Fig. 2.35).

Rice. 2.35.

After the operation, the patient remains anesthetized for some time, or conscious, but experiences pain. When starting to move onto a gurney (bed), you need to know in which area the operation was performed, as well as other restrictions. During the transfer, visitors are asked to temporarily leave the room. You need to ask someone to hold the IV, drainage tubes and other devices.

1. You and your assistant stand on one side, the other two sisters on the other side of the bed. Secure the brakes.
2. Place the gurney on the side of the bed where you will be moving the patient. It is necessary to leave space to be able to stand between the bed and the gurney.
3. Cover the patient with a sheet or blanket. Tell him to hold the sheet or blanket with his hands while you roll the sheet up at his feet.
4. Move the patient to the edge of the bed.
5. Unfold the sheet and leave it on the mattress (without tucking it in). Wrap the top sheet around the patient, tucking the ends under it. Stand close to the bed to prevent the patient from falling.

Note. The head of the bed is in a horizontal position. Two nurses stand on the opposite side of the wheelchair and hold the patient; two other assistants move the gurney to the edge of the bed.

Note. Make sure the gurney is level with the bed. Do not leave space between the bed and the gurney. Check that the sheet is on the mattress.

1. Secure the brakes on the gurney.
2. Roll the sheet into a roll and hold it in your hands on all sides, palms up.
3. Two sisters kneel on the free part of the bed (after placing the protector).
4. On the count of “three” (the leader gives the command), all four lift the sheet and transfer the patient to the gurney along with the sheet. Make sure the patient is lying in the middle.

Note. If the gurney is equipped with belts, secure the patient with them.

1. Transport the patient to the destination: one nurse is at the head of the bed, the other is at the patient’s feet.

When transferring a patient from a gurney to a bed:

1. Place the gurney close to the bed, secure the brakes, and release the edges of the sheet on the gurney.
2. Two assistants kneel on the bed with the protector down.
3. All the sisters fold the edges of the sheet towards the center.
4. On the count of “three” (the leader gives the command), everyone lifts the sheet, holding it by the edges with their palms up, and moves the patient to the edge of the bed.
5. The nurses, kneeling on the bed, go down to the floor and hold the patient while others move the gurney.
6. Move the patient, tuck the sheet under the mattress and straighten it.
7. If necessary, place a small pillow under your head. If the patient experiences pain when moving, or the bandage gets wet, or there is blood in the drainage tubes, report to the doctor.

Change seats on a chair or wheelchair the patient can do it independently or with your help. Opportunity change seats independently helps to restore independence and self-assertion. The ability to do this correctly will be useful for replanting V wheelchair, when using the toilet, bathroom and when getting into a car.

Moving independently from bed to wheelchair

When transferring from a bed, its height should be at the same level as wheelchair or a chair.

First, prepare a robe, slippers, chair or wheelchair for the patient;

Help the patient get dressed and sit up in bed so that his feet touch the floor;

Wheelchair or the 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 sick moves on wheelchair, the brakes are fixed on the chair, the armrest on the side close to the patient and the footrest are removed;

The patient should sit on the edge of the bed, lean on it with one hand, and grab the armrest of the wheelchair with the other;

Then he gets out of bed, leaning on the bed with one hand and the other on the armrest of the chair, turns his back to chair and carefully sits down in it.

At moving from wheelchairs into the bed, the patient holds on to the armrest of the chair with one hand, and leans on the bed with the other, then stands up with wheelchairs leaning on the bed with one hand and holding the armrest with the other armchairs, turns his back to the bed and carefully sits down on it.

At 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 a patient from a bed to a chair or wheelchair and back

Such boards reduce friction when sliding and can be useful for patients with strong hands, but unable to lean on their legs when transplanting.

• Armchair or the chair is moved close to the bed, the chair is put on the brakes, and the armrest is removed from the chair on the side of the bed.
• The patient should sit in bed, keeping his feet on it, so that the chair is on his side.
• The patient should transfer his body weight to the buttock farthest from the chair.
• The patient places one end of the board under the buttock closest to the stroller.
• Leaning with one hand on the bed and the other on the free edge of the board, the patient slides into the chair along the board, pressing it against the seat.
• After sitting down in a chair, he takes out the board from under him.
• Sitting in chair, He moves legs off the bed and places them on the footstool. In the same way you can move from armchairs on the bed.

Transferring from bed to chair and back with the help of a caregiver

Explain your plan to the patient moving I encourage him to help as much as possible;

Prepare a robe, slippers, chair or wheelchair. The bed should be at the same height as the chair ( wheelchair);

Place the patient in bed so that his feet touch the floor;

Place a chair or wheelchair at a slight angle to the bed on the side that the patient is physically stronger;

Put the bed on the brakes. If you move a patient to wheelchair, remove the armrest, footrest and lock the brakes;

Help the patient get dressed and put on shoes;

Your knees should be bent and your back straight. Place one hand under the patient's shoulders and the other under his hips. Don't twist your back at the waist;

Ask the patient to hug you around the waist or shoulders (but not around the neck!), and you put your hands under his arms, leaning forward;

When your patient is ready for moving, his buttocks should be on the edge of the bed so that he can maintain balance when you move his body mass 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 wheelchair or on a chair;

Bend your knees, tighten your abdominal and buttock muscles, keep your back straight;

Stand as close to the patient as possible. Warn him that on the count of “3” you will help him get up. On each count, rock back and forth slightly to create momentum. On the count of "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 you. wheelchair. Ask the patient to alert you when he feels the edge armchairs back surface hips;

Carefully lower the patient into armchair. To do this, you need to bend your knees and keep your back straight. When lowering into a chair, the patient can help you if he puts his hands on the armrest armchairs. After the patient sits in armchair, put the armrest and footrest in place, place the patient’s feet on the stand.

Moving along the board from a bed to a wheelchair with the help of a nurse

Armchair or move the chair close to the bed, armchair put on the brakes, remove the armrest from armchairs from the side of the bed;

The patient should sit in bed, keeping his feet on it, so that armchair was at his side;

The patient must bear weight own body to the farthest one in relation to chair buttock;

Slip one end of the board under the one closest to him. stroller buttock;

Stand behind the patient and place your hands on his waist;

The patient should rest on the bed with one hand, and with the other on the free edge of the board;

Then, leaning on the free edge of the board and bending it towards chair, the patient, with your help and the help of the other hand, should move to armchair;

Pull the board out from under it;

Move his feet off the bed and place them on the footrest. In the same way you can move from armchairs on the bed.

Transferring from chair to chair independently

• Move armchair, on which you want to change seats, as close as possible to yourself on the healthy side and at right angles to chair on which a person sits;
• Move to edge armchairs. Place the foot of the sore leg straight in front of you, closer to the edge of the seat, the foot of the healthy one -
  closer to the far leg armchairs, to which you need to change;
• Lean forward and slightly towards what you want armchairs;
• With your healthy hand, grasp the remote armrest of the second armchairs;
• Rise up from the seat and transfer your body weight to your healthy leg, turning your back to chair, in which you need to sit;
• Descend into armchair, monitoring the correctness and convenience of landing.

• Setting up the heating pad

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The patient can transfer from bed to chair or wheelchair independently or with your help. The height of the bed should be at the same level as the wheelchair or chair.

Moving independently from bed to wheelchair

• First, prepare a robe, slippers, chair or wheelchair for the patient;
• Help the patient get dressed and sit up in bed so that his feet touch the floor;
• The 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 is moved to a wheelchair, the brakes on the chair are fixed, the armrest on the side close to the patient and the footrest are removed;
• The patient should sit on the edge of the bed, lean on it with one hand, and grab the armrest of the wheelchair with the other;
• Then he gets out of bed, leaning on the bed with one hand and the other on the armrest of the chair, turns his back to the chair and carefully sits down in it.

When moving from a wheelchair to a 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 holding the armrest of the chair with the other, 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 a patient from a bed to a chair or wheelchair and back

Such boards reduce friction when sliding and can be useful for patients with strong arms, but who are unable to rely on their legs when transferring.

• The armchair or stool is moved close to the bed, the chair is put on the brakes, and the armrest is removed from the chair on the side of the bed.
• The patient should sit in bed, keeping his feet on it, so that the chair is on his side.
• The patient should transfer his body weight to the buttock farthest from the chair.
• The patient places one end of the board under the buttock closest to the stroller.
• Leaning with one hand on the bed and the other on the free edge of the board, the patient slides into the chair along the board, pressing it against the seat.
• After sitting down in a chair, he takes out the board from under him.
• Sitting in a chair, he moves his legs off the bed and places them on the footrest. You can move from a chair to a bed in the same way.

Transferring from bed to chair and back with the help of a caregiver

• Explain your transfer plan to the patient and encourage him to help as much as possible;
• Prepare a robe, slippers, chair or wheelchair for the patient. The bed should be at the same height as the chair (wheelchair);
• Place the patient in bed so that his feet touch the floor;
• Place a chair or wheelchair at a slight angle to the bed on the side that the patient is physically stronger;
• Put the bed on the brakes. If you are transferring a patient to a wheelchair, remove the armrest, footrest and lock the brakes;
• Help the patient get dressed and put on shoes;
• Your knees should be bent and your back straight. Place one hand under the patient's shoulders and the other under his hips. Don't twist your back at the waist;
• Ask the patient to hug you around the waist or shoulders (but not around the neck!), and you put your hands under his arms, leaning forward;
• When your patient is ready to move, his buttocks should be on the edge of the bed so that he can maintain balance as you move his 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 to ensure that his legs do not get tangled when he turns his body to sit in a wheelchair or on a chair;
• Place your leg, which is further from the chair, between the patient’s knees with your knee facing him, and the other in the direction of movement;
• Bend your knees, tighten your abdominal and buttock muscles, keep your back straight;
• Stand as close to the patient as possible. Warn him that on the count of 3 you will help him get up. On each count, rock back and forth slightly to create momentum. On the count of 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 the patient's body until he is positioned directly in front of the wheelchair. Ask the patient to alert you when he feels the edge of the chair on the back of his thighs;
• Carefully lower the patient into the chair. To do this, you need to bend your knees and keep your back straight. When lowering into a chair, the patient can help you if he places his hands on the armrest of the chair. After the patient sits in the chair, put the armrest and footrest in place, and place the patient's feet on the stand.

Moving along the board from a bed to a wheelchair with the help of a nurse

• Move the armchair or chair close to the bed, put the brakes on the chair, remove the armrest from the chair on the side of the bed;
• The patient should sit in bed, keeping his feet on it, so that the chair is on his side;
• The patient must transfer the weight of his own body to the buttock farthest from the chair;
• Place one end of the board under his buttock closest to the stroller;
• Stand behind the patient and place your hands on his waist;
• The patient should rest on the bed with one hand, and with the other on the free edge of the board;
• Then, leaning on the free edge of the board and bending it towards the chair, the patient, with your help and the help of the other hand, should move into the chair;
• Pull the board out from under it;
• Move his feet off the bed and place them on the footrest. You can move from a chair to a bed in the same way.