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The aim of this chapter is to provide guidance on various aspects of moving and positioning patients, acknowledging the need to be clinically effective and, where possible, evidence based. It relates to moving and positioning of adults and does not specifically cover positioning of children or neonates.
The main objectives of the chapter are to:
- outline the general considerations regarding moving and positioning
- provide guidance on the principles of moving and positioning whether the patient is in bed, sitting or preparing to mobilize
- consider optimal moving and positioning including modifications for patients with different clinical needs.
The principles of moving and positioning will relate to the effect on the patient, but the practitioner needs to ensure that they consider their own position regarding the safety aspects of manual handling. For recommendations and further information on safe manual handling, refer to government (HSE , 2012) and local trust policies, the manual handling advisor or the physiotherapist (PT).
In this chapter the general principles of moving and positioning will be discussed first followed by considerations of positioning for patients with specific clinical needs, which will require modification or additional considerations of the general principles. The first specific clinical area covered will be moving and positioning of unconscious patients and patients with an artificial airway. Following this, there will be a section looking at additional considerations and modifications for patients with different respiratory requirements. The next section of the chapter will relate to the specific moving and positioning needs of patients with a neurological problem, including the management of patients with spinal cord compression. The final clinical area to be considered will relate to moving and positioning considerations and modifications for upper and lower limb amputees.