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Difficulty: HardErgonomics and Safe Use of Equipment

A practical nurse enters a client's room and observes an unlicensed assistive personnel (UAP) attempting to manually pull a completely dependent client toward the head of the bed by grasping under the client's axillae (armpits). The client is 24 hours postoperative following a cervical spinal fusion. Which action should the practical nurse take first?

  1. A
    Delegate a rapid assessment of the client's upper extremity motor strength to the UAP to determine if the client can assist using a trapeze bar.
  2. B
    Assist the UAP by grasping the client's opposite axilla and pulling upward simultaneously while maintaining the bed in a semi-Fowler's position.
  3. Instruct the UAP to stop immediately, lower the head of the bed to a flat position, and use a friction-reducing sheet with additional staff assistance.Answer
  4. D
    Apply bilateral soft wrist restraints to ensure the client's arms remain secured and do not inadvertently compromise the cervical spine during the lift.

Answer

Instruct the UAP to stop immediately, lower the head of the bed to a flat position, and use a friction-reducing sheet with additional staff assistance.
The practical nurse must immediately intervene to stop an unsafe ergonomic practice. Manually lifting a completely dependent client by the axillae poses a severe risk for musculoskeletal injury to the healthcare worker and can cause brachial plexus nerve damage to the client. Furthermore, a client with a recent cervical spinal fusion requires strict neutral spinal alignment. The safest approach is to lay the bed flat, use a friction-reducing device, and employ an adequate number of staff to slide the client up without compromising the spine.

Step-by-Step Solution

1
Analyze the UAP's action.
The UAP is using a manual axillary drag on a dependent postoperative patient.
Identifying the immediate ergonomic and patient safety hazard is the first step in prioritizing care.
2
Consider the client's postoperative status.
The client is 24 hours post-cervical spinal fusion and requires strict neutral spinal alignment.
Surgical precautions dictate specific safe handling techniques and contraindicate manual dragging or elevated bed positions during movement.
3
Determine the safest ergonomic intervention.
The manual lift must be stopped immediately. A friction-reducing sheet with multiple staff members is required with the bed laid flat.
This approach minimizes physical strain on the healthcare workers, prevents brachial plexus injury, and protects the client's vulnerable cervical spine.

Key Concept

Ergonomics and Safe Patient Handling
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Topics

Ergonomics and Safe Use of Equipment

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