I have been searching the net for information about this, but I could not find what I was looking for. I know about not rotate the affected hip internally, and when sitting, keep knees below hip. But if we have a total bedbound patient who needs a linen change, diaper change, or a suppository, how could we move the patient without affecting the hip? Any feedback would be appreciated.
Jan 15, '07
Put pillow(s) between legs ,log roll to unaffected side. Can log roll to affected side , but generally not as comfortable to do so.
Jan 15, '07
Logroll! The things you want to avoid are internal or external rotation of the hip until cleared by the MD or PT. With the way hips are done now a days...patients get up and start moving the day following surgery...so you need to look at your MD orders and see what limits they have put on the patient.
When I have to change linens or attends...I have another person there with me. Premedicate for pain, and get the bed into a good position (flat and raised for good back posture), and treat the body like a single unit...all parts must roll together (have pt 'hug' themselves). Roll first to the uneffected side down...really push that stuff underneith so you don't have to roll the pt too far on the other side to retrived linens or diaper. Then roll them back on their back...wait a bit so they can catch their breath, and prepare them for the next turn which will hurt more frankly...I have pts breath OUT and turn them only as much as I absolutely have to...grab the linens and get them flattened. Patient back on back and it should be done! Always tell the patient what and why as you go along.
Also be prepared for any pt movements that can hinder the roll. Some people grab at things...this is to be watched or you could wind up with a injured neck/back/arms! I tell folks to hug themselves and not move their arms and let me roll them...and I WON'T let them fall at all because I am standing in the way of that!
If you are unsure, I also will ask a PT to help me or teach me the proper way!
I work ortho med surge, and log roll with pleanty of help is best! ALSO, as experience has taught me...excuse the relatives/friends! They will get in the way MOST during this time, and watching their loved ones in pain isn't nice. I simply say "for modesty, please wait outside for a few minutes while we clean her/him...thank you". Also they get in the way BIG TIME if you need a few people! I say it is best to get them out for that moment...or in the case where they Wouldn't leave..I open the bathroom door (which is out of the way) and have them stand in the doorway of the BR...that keeps them out of the way, they can't easily grab the patient to try to help, and reminds them they are NOT there to do this type of care for the patient!