Outline the anatomy and physiology of the human body in relation to the importance of correct moving and positioning of individuals.
We need to know the normal range of movement of the muscles and joints so when moving, handling and positioning a person we know the limits of each limb. We need to take into consideration other factors that may inhibit a person’s movement such as:
This should all be written within the individuals care plan as well as a step by step plan on that has been agreed with them on how to move and handle them.
We need to understand that elderly people are not as supple as younger people and even if they do not suffer movement restriction through a medical condition. They bruise easier too and so great care has to be taken when handling, moving and positioning them especially when assisting them to sit up or when using the hoist strap.
Failure to follow the care plan and any presenting conditions can lead to causing the individual injury, pain and discomfort.
It may also lead to legal action being raised.
Describe the impact of specific conditions on the correct movement and positioning of an individual. There are many conditions that can impact on movement and positioning of people. People with arthritis normally have stiff painful joints and are limited movement in certain areas. When moving or positioning a person it is important to take care doing this so there is reduced pain and discomfort. Some people may suffer from cerebral palsy, as a result of this, some of their muscles may be contracted or joints will be causing a fixed rigid limb. Anyone who is looking after someone who has cerebral palsy will need to ensure they use effective communication and be careful whilst moving and handling them.
People with Parkinson’s disease can have rigid limbs that affect normal moving, so it is important to not force movement in the affected limb as it can cause pain and damage to the joint. As individuals with Parkinson’s also have slower reactions, they will need more time to move and shouldn’t be rushed. Carers should also be aware of non-verbal signs of pain and discomfort as the person may not be able to communicate their pain verbally. Carers should be aware of a person’s movement if they have had a limb amputated, depending on where the limb was amputated and whether they have an artificial limb which can aid in movement. Carers should also be aware that people with Cerebral Palsy can have contracted muscles or joints that cause a fixed, rigid limb, so should accurately communicate when helping the person with moving and positioning.
Describe how legislation and agreed ways of working affect working practices related to moving and positioning individuals. Every time care workers move or support an individual they are performing manual handling on that individual. According to health and safety executive (HSE) 50% of all reported accidents are from the health and social sector and in particular with moving and handling. To reduce the amount of accidents and injuries, there is legislation in place to protect everybody. Few examples of legislations; Lifting operations and
Ensures that equipment used is safe and suitable and has had regular safety checks in line with legislation. Manual handling operations regulations 1992, health and safety at work act 1974- we must take safety and load into consideration. These legislations are in place to make sure it is a legal requirements for employers to make sure the health, safety and welfare of their employees is maintained and for employees to have a duty of care for themselves and others.
Describe what health and safety factors need to be taken into account when moving and positioning individuals and any equipment used to do this. Factors that need to be taken in to account with manual handling activities is to look at the four areas- task, individual, load and environment. Key factors to consider in each element are:
The Task Does the activity involve twisting, stooping, bending, excessive travel, pushing, pulling or precise positioning of the load, sudden movement, inadequate rest or recovery periods, team handling or seated work? The Individual Does the individual require unusual strength or height for the activity, are they pregnant, disabled or suffering from a health problem. Is specialist knowledge or training required? The Load Is the load heavy, unwieldy, difficult to grasp, sharp, hot, cold, difficult to grip, are the contents likely to move or shift? The Environment Are there space constraints, uneven, slippery or unstable floors, variations in floor levels, extremely hot, cold or humid conditions, poor lighting, poor ventilation, gusty winds, clothing or Personal Protective Equipment that restricts movement?
Access up-to-data copies of risk assessments documentation. Risk assessment is the most important factor to decide what a hazard in the workplace is. It is clear that precautions should be put into place so that the risk is minimized with altogether when the risk is determined to be significant enough. The first step is to look for hazards: Being a social career, we have to go round of the workplace and check for potential dangers which will minimize the risks towards residents as well as whole team members
The second step is to decide who might be harmed and how: We have to decide who might be particularly at risk and how we can remove potential harm to residents as well as ourselves and service users We can summarize the third step that health care assistants must analyse whether there have been sufficient precautions put into place to counter the hazard. The next step is to record findings: On the way of risk assessment, we have to inform to senior staff or nurse in-charge verbally or mention on the record We should always check that the risk assessment has been carried out before we conduct any tasks and then to follow the steps identified in the assessment to reduce the risk (Nolan, 2005).
Similarly, risk related with lifting and moving people can be arranged in a systematic, practical way by applying the risk management principles outlined by Identifying the factors likely to cause injury,
Assessing the potential risks to workers and other persons affected by the work, Implementing control measures to eliminate or reduce the risks, and Monitoring and review the effectiveness of the control measures
The moving and handling risk assessments.
Individual care plan: A nursing care plan can be defined as a set of actions the nurse/health care personal will implement to resolve nursing problems identified by assessment where the creation of the plan is an intermediate stage of the nursing process. The care plan contains information about person’s day to day care .It should give details of any assistance required to wash or bath it may include using a bath hoist .It will also include the person’s preference, for example if the person prefers to bath or shower. It should give details of the person’s mobility. If the person uses a frame to walk this should be recorded. If a person requires walking aid and the help of one or two members of staff to walk, this has to be recorded in the care plan identify any immediate risks to the individual.
Meaning and importance of communication in moving and handling individuals: Communication can be defined as a dynamic process in which people attempt to share their internal states with other people through the use of different symbols (McDaniel, et.al, 2009). Any decision that we make is only as good as the information it is best on. Communication is vitally important to the quality of care. Staffs needs to communicate effectively if they are to give the best possible care.
As a care assistant, we have to work closely with residents where residents may express their condition with us. For example, a resident may say “he/she is finding difficult walk around because the pain in her/his knees is so bad and the tablets which she/he is having is not working”. This is significant information which we have to report our nurse, because effective communication leads to the residents receiving effective treatment to control pain and improve mobility. As I’m working with vulnerable and old people, they are dependable on care staff working in the home .Therefore we have a duty to act in a professional way and protect the confidentiality of information that achieve during their care.
Describe actions to take in relation to identified risk. Once you have analysed and evaluated the risks in your workplace, you then need to draw up an action plan that details how to treat, get rid of or manage the risk. This could involve changing a treatment process or introducing a safer system that can control or act as a barrier to the risk. When treating identified risks consider: what are the existing controls? Are there gaps? What are your objectives for treating the risk? What controls are practical and sustainable? Check with staffs who work in the area. Is the design of the control right? Is it helping you achieve your objectives? Are you involving staff who will need to implement changes? The action plan will detail what work is done to manage and control risks and allow you to monitor changes over time.
It will also identify the priorities for risk treatment and record which risks are to be tolerated. If you identify a major risk that cannot be managed or tolerated in your work area this needs to be discussed and dealt with by management. An example of risk toleration could be not installing the required number of hand-washing sinks in aging health premises, at huge cost, to meet current infection control recommendations. Risk control measures to make up for the lack of sinks could include easy availability of alcohol hand wash, good signage to existing sinks and notices to prompt hand washing. It could also include putting the refurbishment or replacement of older health premises onto the planning and capital works program. Describe what actions should be taken if the individual’s wishes conflicts with their care plan in relation to health and safety and their risk assessments.
If the individuals’ wishes conflict with their care/support plan in relation to health & safety & their risk assessment you would need to ensure that the individuals’ wishes were listened to & respected & that their, your own, & others, health & safety was not put at risk. Include the individual in the risk assessment to help prevent conflict from arising, help them feel empowered, the reasons why it’s necessary, that it’s for them as well as the people that are helping them, ask the individual why they object/disagree – give them time to explain, give reassurance, try to reach a compromise that is safe & protects individual, yourself & others’ well-being, explain the consequences for themselves e.g. They may fall if they walk down the steps, injuries that may occur. Report to your line manager, record in the individuals’ notes/support records, etc. Risk assessment/support/care plan may need reviewing/revising. Explain to the individual your reasons.
Adequate space for the move in agreement with all concerned
That potential hazards are removed
Apply standard precaution for infections prevention and control When I have to move the person then I should be careful and I must explain the person before assist them, what is going to happen and try as much as possible to keep away from lifting altogether, trying rather to roll, to slide or to turn the person. The use of simple and fairly inexpensive aids will eliminate the need lifting or heavy handling. Moving and handling has special rules: I need to make sure that I have enough space to move smoothly and freely. Move any obstructions for space to move, place my feet comfortably apart so that I have a firm base. Always stand as close as possible to the person to be moved, bend at the knees so that I can use the strong leg muscles, do not bend or twist at the waist. Try to maintain the ‘S’ shape of My spine to help to reduce the strain on my back .
Demonstrate effective communicate with the individual to ensure that they understand the details and reasons for the action /activity being undertaken and agree the level of support required. Choose the right time -avoid leaving discussions about heavy topics such as finances or weekly planning until late evening. Few people will be thrilled to be faced with sorting out major issues when they’re at their most tired. Instead, leave heavy topics for mornings and afternoons when people are alert, available, and more likely to be able to respond with clarity. An intimate conversation Choose the right place If you need to tell someone something that isn’t going to be well received (such as news of a death or a breakup), don’t do it in public, around colleagues or near other people.
Be respectful and mindful of the person receiving the communication and communicate to them in a private place. This will also enable you to provide space to open dialog with them about the communication, and helps to ensure that the two-way process is occurring properly. Remove distractions. Turn off all electronics that could go off during the conversation. If the phone rings, laugh it off the first time, then turn it off immediately and continue talking. Do not allow external distractions to act as crutches that keep side-tracking your concentration. They will distract both you and your listener, and effectively kill the communication. Be attentive when listening and ensure that your facial expressions reflect your interest.
Listen actively. Communication is a two-way street. Remember that while you are talking, you are not learning. In listening, you will be able to gauge how much of your message is getting through to your listeners and whether or not it is being received correctly. It can be helpful to ask listeners to rephrase some of what you have said in their own words if they appear to be returning confused or mistaken views to you. . Be vocally interesting. A monotone is not pleasing to the ear. A good communicator will use “vocal colour” to enhance communication.
To obtain valid consent for planned activity one must: Complete the valid consent form according to local policy, procedures and protocols 2.check the individual’s or relevant other clear understands and confirm valid consent and authorization. Explain the reasons for the clinical option covered in the valid consent form 4.check the individual’s identification details according to local guidelines before advice and information when you are unable to resolve issues around the valid consent and authorization. 5.1 Follow the care plan to ensure that the individual is positioned using the agreed technique and in a way that will avoid causing undue pain or discomfort.
Individual care plan: A nursing care plan can be defined as a set of actions the nurse/health care personal will implement to resolve nursing problems identified by assessment where the creation of the plan is an intermediate stage of the nursing process. The care plan contains information about person’s day to day care .It should give details of any assistance required to wash or bath it may include using a bath hoist .It will also include the person’s preference, for example if the person prefers to bath or shower. It should give details of the person’s mobility. If the person uses a frame to walk this should be recorded. If a person requires walking aid and the help of one or two members of staff to walk, this has to be recorded in the care plan
Demonstrate effective communication with any others involved in the manoeuvre. The ability to communicate effectively is essential for all aviation instructors. However, communication does not occur automatically even though the instructor has a high level of technical knowledge in a particular subject area. The beginning instructor must understand the complex process involved in communication, and become aware of the common barriers to effective communication. Mere awareness of these factors is not enough. The new instructor must also develop a comfortable style of communication that meets the goal of conveying information to students. Communication takes place when one person transmits ideas or feelings to another person or group of people. Its effectiveness is measured by the similarity between the idea transmitted and the idea received. The process of communication is composed of three elements: the source (sender, speaker, transmitter, or instructor), the symbols used in composing and transmitting the message (words or signs), and the receiver (listener, reader, or student).
The three elements are dynamically interrelated since each element is dependent on the others for effective communication to take place. The relationship between instructor and student also is dynamic and depends on the two-way flow of symbols between the instructor and student. The instructor depends on feedback from the student to properly tailor the communication to the situation. The instructor also provides feedback to the student to reinforce the desired student responses. As indicated, the source in communication is the sender, speaker, transmitter, or instructor. The instructor’s effectiveness as a communicator is related to at least three basic factors.
First, an ability to select and use language is essential for transmitting symbols which are meaningful to listeners and readers. Second, an instructor consciously or unconsciously reveals his or her attitudes toward themselves as a communicator, toward the ideas being communicated, and toward the students. 5.3 Describe the aids and equipment that may be used for moving and positioning. • A selection of hoists – e.g. hoists to raise fallen individuals from the floor, standing hoists, mobile hoists etc.
Use equipment to maintain the individuals in the appropriate position. There are a vast range of moving and handling aids available. They are suitable for different levels of mobility/immobility as well. There are “banana” boards, which are shaped like a boomerang, and are used by people that have upper body mobility, but immobility or weakness in their lower body to transfer themselves from bed to chair. You have machines for transferring/moving people like standing and raising aids, which consist of a strap that goes around the back and under the arms and is then attached to a machine on a wheeled base that helps the person to stand and you can then move them from chair to bed/toilet etc. There are hoists, which consist of a hammock like sling which is placed underneath a person, and then attached (usually at four places) to a central arm of the hoist which then lifts the person and you can then transfer them from bed to chair etc. You can get bath slings which enable you to use the hoist for bathing too. There are ambulates, which is basically a chair attached to a winch which then enables you to lift the person and transfer them into the bath.
There are slip sheets, which is a slide sheet that you place underneath the person and it is used to move them up and down their bed. There is “PAT” slides, which are used to transfer people from trolley to bed. There are little things that the person can hold and then use them to move themselves up the bed in stages. There are little ladders that you can attach to the end of a bed which the person can the use to move themselves up and down the bed. 5.5 Encourage the individual’s active participation in the manoeuvre. It is important that you encourage people to participate actively as much as
possible in any moving and positioning activity. When people become unwell or go into hospital, there is a temptation for them to believe that they can do far less than they are capable of. In the past, some staff encouraged this behaviour because they found it quicker and easier to take over and do things for the person, rather than wait for them to do it for themselves.
However, it is the responsibility of all care staff to actively promote the independence of people. For example, you could promote a person’s independence by encouraging them to get out of bed. You can encourage somebody to turn over in the bed rather than manually rolling them. This could then allow you to change their bedding, assist them with a bed bath or to change their clothes. There are some simple instructions to help the person to do this. Ask the person to turn their head in the direction you want them to move.
Ask them to bend the leg on the other side and put their foot flat on the bed. Ask them to reach across their body with their opposite arm. This will help the upper part of their body to turn into the roll. By pushing their foot into the bed, they should be able to turn themselves over. If a person needs to use a bedpan, you can get them to assist in the move by following these instructions. Encouraging people to participate actively in moving and positioning activities is important as it can increase their self-esteem and promote their independence, as well as making the procedure easier for the care worker.
Monitor the individual throughout the activity so that the procedure can be stopped if there is any adverse reaction. Stress is defined as ‘the adverse reaction people have to excessive pressures or other types of demand placed on them’. This is distinct from normal workplace pressure, which can create a ‘buzz’ and be a motivating factor. This adverse reaction can seriously affect the mental health of employees, for example through anxiety or depression, and also have a significant effect on their physical health.
Demonstrate how to report and respond the activity noting when the next positioning manoeuver is due. Standard precautions and health and safety measures include hand washing/cleansing before during and after the activity; the use of personal protective clothing and additional protective equipment; handling contaminated items; disposing of waste; safe moving and handling techniques and untoward incident procedures.
Describe when advice and/or assistance should be sought to moving and positioning an individual safely. First assess the situation and what movement you seek. You must ask the questions such as can the individual weight bare and use equipment such as a Zimmer frame or stand aid ?, Does the movement require the use of two carers and equipment such as a hoist? You must never move a person by yourself or drag them. If the individual suffers from sores or similar skin conditions it could tear the skin, therefore the slide sheet will be needed to move an individual in bed to prevent undue strain on the carer or pressure on the individual. 6.2 Describe what sources of information are available about moving and positioning individuals. Well for first to always keep up to date with the latest changes in the manual and handling regulations. Within your work the place it is up to the manager/senior career or your head of care to report or re-write any changes made. The internet is a good one to as well as who ever went through and passed your manual handling course with you will always is up to date with the latest regulations, policies and procedures. contact them. Risk assessment and care plans should be updated with the changes these should state the requirements for the individual and there needs for specific manual and handling equipment.
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