**SAFE PATIENT MOVEMENT VIDEO**

** I. Scene one, Hook and Toss**

A. Getting two caregivers and a patient into such a small space makes
this technique very awkward, and puts everyone involved at risk for
injury.

B. The technique requires that the caregivers bend at the waist and at
the same time lift and twist. This puts both the patient and the
caregivers at risk. The confined space does not allow for proper
alignment of the feet and torso of the caregivers.

C. Grasping the patient under the shoulders as is done in this technique
places pressure on the brachial plexus and can cause permanent nerve or
musculoskeletal damage especially in the elderly. *It should be noted
that this technique has been outlawed in England*.

** II. Scene two, Hugging Technique**

A. By not using a transfer or gait belt the caregiver is forced to grasp
the patient under the axilla once again. In doing so the patient\'s arms
go around the caregiver\'s neck, hence the name the hugging technique.
In this situation both the patient and the caregiver can be easily
thrown off balance, should the patient lean in any direction. One can
imagine the outcome, should the patient fall with the arms around the
caregiver\'s neck.

** III. Scene three, Horizontal transfer**

A. The transfer surfaces should always be even. In this scene, the bed
and the stretcher are not level.

B. In this technique the caregiver cannot avoid reaching and pulling,
which places stress on the lower back and shoulders of the caregiver.
Since this can not be avoided, a friction-reducing device should be used
to give support to the caregiver and to reduce the stress on the lower
back and shoulders.

C. Use of a friction reducing device reduces discomfort for the patient.
It also decreases the shear force on the patient\'s skin, thereby
decreasing the risk of rupturing the skin.

** IV. Scene four, Patient Fall**

A. The caregiver is distracted while ambulating the patient. One should
give ones full attention when ambulating a patient.

B. The area of ambulating is cluttered. One should clear the area prior
to ambulating a patient, so that the caregiver does not have to leave
the patient alone while clearing a path.

C. The caregiver did not assess the patient closely enough prior to
ambulating, thus putting both at risk for injury.

D. One should not try to catch a falling patient; one should try to
guide or ease the fall of a patient so as to decrease the risk of
injury.

** V. Scene five, Pulling a Patient up in Bed**

A. By not asking for help the lone caregiver must make the extra effort
of pushing the bed away from the wall and pushing it back again.

B. The lone caregiver does not use a friction reducing device, thus
putting more stress on her lower back and shoulder. Not using a friction
reducer also increases the shear force on the patient\'s skin.

C. The nurse leans over the bed rail to check the IV. Not lowering
either the rail or the bed and reaching out are the type of movements
that lead to cumulative trauma disorders, which are injuries caused by
repeatedly straining one part of the body.

** VI. Scene six, Transferring a Patient from Bed to Wheelchair Using a
Mechanical Lift**

A. One of the caregivers is not familiar with the lift, thus putting the
patient at risk due to misuse of the equipment.

B. Caregivers do not plan the transfer beforehand; thus the fact that
one of the caregivers does not know how to use the lift is not
communicated to the other. This makes the transfer awkward and puts the
patient at risk.

C. The patient is not properly assessed or informed of what is to take
place, therefore, the patient is even more confused and agitated.