Rationale

A nurse engaged in clinical practice daily performs a variety of

physical tasks, including reaching, stooping, lifting, carrying,
pushing, and pulling.
Practiced incorrectly, any of these has the potential to cause strain,
fatigue, or injury to the nurse or patient.
With practice, using the principles of body mechanics, the nurse will
move smoothly and surely, minimizing personal strain, conserving
energy, and enhancing the safety, comfort, and confidence of patients.
 Contributing Factors
Most injuries are the result of:

Months or years of poor body mechanics

Life stresses

Poor posture

A loss of flexibility

A general lack of physical fitness

 How Can You Prevent Injuries?
Most injuries can be avoided by using good
prevention methods.
Use good body mechanics
Stay physically fit and active
Use mechanical assist devices when possible
(lifts, carts, dolly)
Get help when necessary.
 TERMINOLOGIES
There are various terms used in
relation to body mechanics.
Some of these terms are:
Body Alignment and posture
are similar and refer to the
positioning of joints, tendons,
ligaments and muscles while in
standing, sitting and lying
positions.
 TERMINOLOGIES
Body alignment means that an
individual's center of gravity is
stable
Correct body alignment reduces
strain on musculoskeletal
structures, aids in maintaining
adequate muscle tone, promotes
comfort, and contributes to balance
and conservation of energy.
 TERMINOLOGIES
Body Balance- It refers to a
state of the body achieved
when the center of gravity is
balanced over a wide, stable
base of support and a
vertical line falls from the
center of gravity through the
base of support.
TERMINOLOGIES
Weight is the force exerted on a
body by gravity.
The force of weight is always
directed downward, which is why
an unbalanced object falls.
Unsteady patients fall if their
center of gravity becomes
unbalanced because of the
gravitational pull on their weight.
TERMINOLOGIES

Weight- It is the force exerted on a body by gravity.

Friction- It is a force that occurs in a direction to oppose movement.

The greater the surface area of the object that is moved, the greater is
the friction. A larger object produces greater resistance to movement.
In addition, the force exerted against the skin while the skin remains
stationary and the bony structures move is called shear.
 TERMINOLOGIES

Anatomical Position- It refers to a position wherein the

individual stands erect (upright position) facing the observer,
with feet on the floor and arms placed at the sides, and the
palms of the hands turned forward.
TERMINOLOGIES
Body mechanics is a term that describes the
coordinated efforts of the musculoskeletal and
nervous systems.
It is the way the body moves and maintains
balance while making the most efficient use of
all its parts.
Reasons for using good body
mechanics
1. Muscles work best when used properly.
2. Correct use of muscles makes lifting, pulling and
pushing easier.
3. Correct applications of body mechanics prevents
unnecessary fatigue and strain and saves energy.
4. Correct applications of body mechanics prevents
injury to self and others.
3 Major Concepts
1. Base of support: The portion of the
body in contact with the floor
Broad base = stability
3. Center of body weight. The point
around which body weight is balanced.
Usually located in the midportion of
the pelvis or lower abdomen,
depending on body build.
3 Major Concepts
3. Line of Gravity Imaginary
vertical line passing through
the center of gravity.
The body is most stable when
the line of gravity bisects the
base of support
Principles of Basic Body Mechanics
Principles of Basic Body Mechanics
Weight is balanced when the center of
gravity is directly above the base
provided by the feet. In this position, an
individual can maintain balance and
stability with the least amount of
effort.
When this posture is not maintained,
the potential for strain, fatigue, and
poor stability is increased.
Principles of Basic Body Mechanics
A person or an object is more stable if the
center of gravity is close to the base of
support.
Apply this principle when an object is
picked up from the floor by bending the
knees and keeping the back straight (thus
keeping the center of gravity directly above
and close to the base of support) rather
than by bending forward at the waist.
Principles of Basic Body Mechanics
Enlarging the base of support in
the direction of the force to be
applied increases the amount of
force that can be applied.
Place one foot forward when you
push a heavy object (such as a bed
with a patient in it), or place one
foot back when you move a patient
toward the side of the bed.
 Principles of Basic Body Mechanics
Tighten or contract your supporting
muscles before beginning a lifting task to
prevent injury.
Supporting muscles are the muscles of
the abdomen and lower back that provide
stability and support to lower spine. If you
practice tightening the supporting
muscles continually, you will eventually do
it automatically when you prepare for any
activity. This technique can be taught to
patients.
Principles of Basic Body Mechanics
Facing in the direction of the task to be
performed and turning the entire body in
one plane (rather than twisting) lessens the
susceptibility of the back to injury.
When the back is twisted, one group of
muscles is stretched while the other is
contracted. Muscles that are stretched are
weaker and more susceptible to injury. Also,
the spine functions less effectively when it is
twisted. Teach this principle to patients who
are standing and reaching for objects or
clothing.
 Principles of Basic Body Mechanics

Lifting should be undertaken by bending the legs and using the leg
muscles rather than by using the back muscles.
Because large muscles tire less quickly than small muscles, you
should use the large gluteal and femoral muscles rather than the
smaller muscles of the back. The large, compact muscles of the legs
are stronger and less prone to injury than the broad, flat muscles of
the back. In addition, if the back muscles are strained they may be
injured. Ligaments, tendons, and even the intervertebral disks may
be injured as well. Back injuries are one of the major health
problems in adult workers, resulting in pain, disability, and economic
loss to the individual, the employer, and society. Back problems are
the major reason people seek medical care.
 Principles of Basic Body Mechanics
It takes less energy to move an object on a
level surface than to move it up a slanted
surface against the force of gravity.
Therefore, you will need less effort to move
a patient up toward the head of the bed if
you first lower the head of the bed. Be sure
to check to see whether the patient can
tolerate flat position before lowering the
head of the bed. Patients can use this
principle to move themselves up in bed.
 Principles of Basic Body Mechanics
Less energy is required to move an
object when the friction between the
object and the surface on which it rests
is minimized.
Because friction opposes motion, you
can make the task of moving a patient
in bed easier by working on a smooth
surface such as taut sheet. A smooth
sheet also allows patients to move
more effectively.
 Principles of Basic Body Mechanics
It takes less energy to hold an object close
to the body than at a distance from the
body; it also is easier to move an object
that is close. Muscles are strongest when
contracted and weakest when stretched.
Therefore, hold heavy objects close to your
body, and move the patient near to your
side of the bed to conserve energy. Patients
walking with equipment, such as an
intravenous pole or walker, should be
instructed to keep the equipment close to
the body.
 Principles of Basic Body Mechanics
The weight of the body can be used as force to
assist in lifting or moving.
When you help a patient stand, you can use the
weight of your body by rocking back,
counterbalancing the patient’s weight. You can
use the patient’s weight by placing his or her legs
in a knees-up position before moving him or her
from side to side or up in bed. It is essential to
explain this maneuver to the patient to elicit
cooperation. Patients will also be able to move
themselves more easily if they use their body
weight to facilitate turning.
Principles of Basic Body Mechanics
Smooth, rhythmic movements at
moderate speed require less energy
than rapid jerky ones. Smooth,
continuous motions also are more
accurate, safer, safer and better
controlled than sudden, jerky
movements.
You will work more effectively if not
hurried. Also caution patients not to
feel hurried when moving.
Principles of Basic Body Mechanics
When an object is pushed, it absorbs
part of the force being exerted,
leaving less force available to move
the object. When an object is pulled,
all of the force exerted is available
for the task of moving.
Using this principle, when moving
patients, pull steadily rather than
pushing, which is much less effective
 Principles of Basic Body Mechanics
It takes less energy to work on a surface at
an appropriate height (usually waist level)
that it does to stoop or stretch to reach the
surface.
The back is susceptible to injury and fatigue
from excessive bending. Therefore, raise the
bed or overbed table to an appropriate
height for maximum working comfort to
prevent fatigue. If patients are using a
working surface of any type, be sure that
surface is at an appropriate height.
8 Basic Rules of Good Body Mechanics
1. Maintain a broad base of support.
- Feet 8 to 10 inches apart
- One foot slightly forward
- Balance weight on both feet
- Point toes in the direction of
movement
 8 Basic Rules of Good Body
Mechanics

2. Bend from the hips and knees

to get close to an object and
keep back straight.

Do not bend from the waist

 8 Basic Rules of Good Body
Mechanics
3. Use the strongest muscle to do
the job.
- Located in the shoulders, upper
arms, hips and thighs.
This is because the broad flat
muscles of the back are weakest
when stretched and flattened and so
are very susceptible to injury when
heavy objects are lifted.
 8 Basic Rules of Good Body
Mechanics

4. Use the weight of your body to

push or pull an object.

Push, Pull or Slide instead of lift.

 8 Basic Rules of Good Body
Mechanics

5. Carry heavy objects close to

your body.
 8 Basic Rules of Good Body
Mechanics
6. Avoid twisting your body. Turn
your body and feet to change
direction.
7. Avoid bending for a long
period of time.
 8 Basic Rules of Good Body
Mechanics

8. If a patient or object is

too heavy, get help.

 Hospital Beds
The frame of a hospital bed is divided into three
sections.
This permits the head and the foot to be elevated
separately.
Most hospital beds have electric motors to operate the
movable joints.
The motor is activated by pressing a button or moving a
small lever, located either at the side of the bed or on a
small panel separate from the bed but attached to it by a
cable, which the client can readily use.
Hospital Beds
Hospital beds are usually 66 cm (26 in.) high and 0.9 m (3 ft) wide,
narrower than the usual bed, so that the nurse can reach the client
from either side of the bed without undue stretching.

The length is usually 1.9 m (6.5 ft).

Some beds can be extended in length to accommodate very tall

clients.
 Hospital Beds
Long-term care facilities for ambulatory clients usually have low beds to
facilitate movement in and out of bed.

Most hospital beds have “high” and “low” positions that can be adjusted either
mechanically or electrically by a button or lever.

The high position permits the nurse to reach the client without undue
stretching or stooping. The low position allows the client to step easily to the
floor.
 Common Bed Positions
Fowler's position - Head of bed raised to angle of 45
degrees or more; semi-sitting position; foot of bed
may also be raised at knee
While patient is eating, reading, visiting, watching TV
During nasogastric tube insertion and nasotracheal
suction
Promotes lung expansion for client with respiratory
problem
Eases difficult breathing
Relief from lying positions
To assist a client to a sitting position on the edge of
the bed
Common Bed Positions
Semi-Fowler's Head of bed raised 15
and 45 degrees, typically at 30
degrees; inclination less than Fowler's
position; foot of bed may also be
raised at knee
Promotes lung expansion, especially
with ventilator-assisted patients
Used when patients receive oral care
and for gastric feedings to reduce
regurgitation and risk of aspiration
Common Bed Positions
Trendelenburg's Entire bedframe tilted
with head of bed down
Used for postural drainage of basal
lung lobes
Facilitates venous return in patients
with poor peripheral perfusion
Common Bed Positions
Reverse Trendelenburg's Entire
bedframe tilted with foot of bed
down
Used infrequently
Promotes gastric emptying
Prevents esophageal reflux
Common Bed Positions
Flat Entire bedframe horizontally parallel
with floor
Used for patients with vertebral
injuries and in cervical traction
Used for patients who are hypotensive
Patients usually prefer for sleeping
To assist clients to move and turn in
bed
Mattresses
Mattresses are usually covered with a
water-repellent material that resists
soiling and can be cleaned easily.
Most mattresses have handles on the
sides called lugs by which the mattress
can be moved.
Many special mattresses are also
used in hospitals to relieve pressure on
the body’s bony prominences, such as
the heels. They are particularly helpful
for clients confined to bed for a long
time.
Mattresses
Many special mattresses are also
used in hospitals to relieve pressure on
the body’s bony prominences, such as
the heels.

They are particularly helpful for

clients confined to bed for a long time.
 Side Rails
Side rails, also referred to as bed rails, are
used on both hospital beds and stretchers.
They are of various shapes and sizes and
are usually made of metal.
A bed can have two full-length side rails or
four half- or quarter-length side rails (also
called split rails).
Some side rails have two positions: up and
down.
Others have three: high, intermediate, and
low.
Footboard or Footboot
These are used to support the
immobilized client’s foot in a
normal right angle to the legs to
prevent plantar flexion
contractures
 Bed Cradles
A bed cradle is a device designed to keep the top bedclothes
off the feet, legs, and even abdomen of a client.
The bedclothes are arranged over the device and may be
pinned in place.
There are several types of bed cradles. One of the most
common is a curved metal rod that fits over the bed.
Part of the cradle fits under the mattress, and small metal
brackets press down on each side of the mattress to keep the
cradle in place.
The frame of some cradles extends over half of the width of
the bed, above one leg
 Intravenous Rods
Intravenous rods (poles, stands, standards),
usually made of metal, support IV infusion
containers while fluid is being administered to a
client.
These rods were traditionally freestanding on
the floor beside the bed.
Now, IV rods are often attached to the hospital
beds.
Some hospital units have overhead hanging
rods on a track for IVs.
Bed Making
Keep a patient's bed clean and comfortable.
This requires frequent inspection to be sure that linen is
clean, dry, and free of wrinkles.
When patients are diaphoretic, have draining wounds, or
are incontinent, check more frequently for wet or soiled
linen.
Usually you make the bed in the morning after a patient's
bath or while he or she is bathing, in a shower, sitting in a
chair eating, or out of the room for procedures or tests.
Bed Making
Throughout the day straighten linen that is loose or
wrinkled.
Also check the bed linen for food particles after meals and
for wetness or soiling.
Change any linen that becomes soiled or wet.
When changing bed linen, follow principles of medical
asepsis by keeping soiled linen away from the uniform.
Bed Making
Place soiled linen in special linen bags before placing in a
hamper.
To avoid air currents that spread microorganisms, never
shake the linen.
To avoid transmitting infection, do not place soiled linen
on the floor.
If clean linen touches the floor or any unclean surface,
immediately place it in the dirty-linen container.
Bed Making
During bed making use safe patient-handling procedures.
Always raise the bed to the appropriate height before changing
linen so you do not have to bend or stretch over the mattress.
Move back and forth to opposite sides of the bed while applying
new linen.
Body mechanics and safe handling are important when turning or
repositioning a patient in bed.
When patients are confined to bed, you must make an occupied
bed.
Bed Making
Organize bed-making activities to conserve time and energy.
The patient's privacy, comfort, and safety are all important when
making a bed.
Using side rails to aid positioning and turning, keeping call lights
within the patient's reach, and maintaining the proper bed position
help promote comfort and safety.
After making a bed, return it to the lowest horizontal position and
verify that the wheels are locked to prevent accidental falls when the
patient gets in and out alone.
Bed Making
Wash hands thoroughly after handling a client’s bed linen.
Linen for one client is never (even momentarily) placed on
another client’s bed.
When stripping and making a bed, conserve time and
energy by stripping and making up one side as much as
possible before working on the other side.
To avoid unnecessary trips to the linen supply area, gather
all linen before starting to strip a bed.
Changing an Occupied Bed
Some clients may be too weak to get out of bed.
Either the nature of their illness may contraindicate their sitting out
of bed, or they may be restricted in bed by the presence of traction
or other therapies.
When changing an occupied bed, the nurse works quickly and
disturbs the client as little as possible to conserve the client’s energy,
using the following guidelines:
■ Maintain the client in good body alignment. Never move or position
a client in a manner that is contraindicated by the client’s health.
Obtain help if necessary to ensure safety.
Changing an Occupied Bed
■ Move the client gently and smoothly. Rough handling can cause the client
discomfort and abrade the skin.

■ Explain what you plan to do throughout the procedure before you do it.
Use terms that the client can understand. Encourage client participation
when appropriate.

■ Use the bed-making time, like the bed bath time, to assess and meet the
client’s needs.