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Move and position individuals in accordance with their plan of care

1 Understand anatomy and physiology in relation to moving and positioning individuals

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1.1 Outline the anatomy and physiology of the human body in relation to the importance of correct moving and positioning of individuals
– Anatomy is the study of skeleton of the body, and physiology is about the function of the organs, cells, and tissues. Anatomy and physiology are inextricably linked, and this explains that the muscles are attached to the body. The spine column is made up of bones(vertebrae) and also contain inter vertebral disks, which work as shock absorbs. Each disk contains a nucleus in the center. A prolapsed or slipped disk is when the nucleus is squeezed out and is putting pressure on the spinal nerves. Muscles work by the fibres they contain contracting; this makes the muscle shorten. When the muscle shortens it pulls on the tendon and then on the bone to which it is attached. Muscles are connected to bones by tendons.

When moving and positioning individuals, it is important to ensure the individual is not moved more than their body is capable of, as muscles can only move bones at the joint as far as the joint allows. It is also important to move and handle correctly to ensure nerve fibres are not damaged as they are delicate, but also important as they send impulses in the body which enable muscles to relax and contract. When an individual is moved and positioned it is important this happens smoothly. Sudden movements or pulling in any direction of an individual’s limbs or body can cause pulled muscles or tear tendons which can cause a lot of pain.

Putting pressure on an individual’s hand or arm when they are moving from one position to another can cause a bone to fracture. Fractures can also happen if there is an accident with for example equipment like a hoist and this falls onto the individual when moving/positioning them or using the wrong sling size and the individual falls out.

1.2 Describe the impact of specific conditions on the correct movement and positioning of an individual
-. An individual with dementia who is confused might not understand what we are saying and when we are supporting her to move so we have to show the individual by our actions and take time to do this. Individuals with arthritis have to be supported to move gently as they may be in a lot of pain and positioning or moving may be uncomfortable. An individual that has had a stroke might have one arm or leg stronger than the other so this needs to be taken into account when weight bearing or moving so as to avoid putting pressure on the weak side. An individual who is blind might need more reassurance and explanations about the move and what is around them as they cannot see.

People with Parkinson's disease can have rigid limbs that affect normal moving, so it is important to not force movement in the affected limb as it can cause pain and damage to the joint. As individuals with Parkinson's also have slower reactions, they will need more time to move and shouldn't be rushed. Carers should also be aware of non-verbal signs of pain and discomfort as the person may not be able to communicate their pain verbally
Carers should be aware of a person's movement if they have had a limb amputated, depending on where the limb was amputated and whether they have an artificial limb which can aid in movement.Carers should also be aware that people with Cerebral Palsy can have contracted muscles or joints that cause a fixed, rigid limb, so should accurately communicate when helping the person with moving and positioning.

2.1 Describe how legislation and agreed ways of working affect working practices related to moving and positioning
-1) Legislation that is relevant includes the Management of Health and Safety at Work Regulations; this introduced the requirement for risk assessment, risks when moving and positioning individuals must be assessed, acted on and reviewed; also all staff must be trained in moving and positioning individuals. The Lifting Operations and Lifting Equipment Regulations (LOLER) introduced the requirement for employers to provide lifting equipment that is safe to use and maintained; staff must also be provided with training. The Manual handling Operations Regulations for employers states that they must carry out risk assessments for all moves and reduce the risk of injuries from happening and avoid dangerous moving and handling; the employees’ responsibilities include using all equipment as trained to do so, follow all health and safety working practices and avoid putting themselves or other staff, individuals or visitors at risk, reporting any hazards or risks to their employer
2) Agreed ways of working mean that employers must have workplace policies and procedures for moving and handling; these must be explained to staff and staff provided with training and supervision. It is also important that all employees, read these procedures, if they do not understand ask, that they attend training, are supported with understanding all individuals’ needs, the moves needed and all equipment being used

2.2 Describe what health and safety factors need to be taken into account when moving and positioning individuals and any equipment used to do this
-Before moving and positioning individuals I have to take responsibility for the health and safety of the service user, others and myself and while doing this adhere to the organisational policies in place and meet all health and safety obligations. I only move and positions individuals where I have had training to do so.

I do this by ensuring that I am wearing appropriate clothing and foot wear when I move an individual or am supporting them to change position to avoid any risk of being harmed; for example when using a hoist I must not wear open shoes or sandals. I also make sure that I do a manual risk assessment before performing any move or re-position. I do not use any equipment that I have not been trained to use and I check that there is enough space around me to carry out the move. All equipment needs to be checked that it is working correctly, if a hoist that it is charged, and all equipment must be clean and safe to use. I look out for any obstacles, like loose rugs, clothes and move them to one side. It is important the space around me is clean and comfortable. All moving and positioning must not be rushed. Infection control is also important, washing of hands before and after and wearing of PPE according to my workplace policy.

I also check with the individual their needs and preferences and check this against their plan. I then ask the service user for their agreement before the move and make sure I am using the correct equipment, that the sling and hoist are clean and safe to use and the correct ones for the individual; these must then be stored away safely to avoid any accidents or them being used for someone else. In the plan it includes the individual’s weight and the sling and hoist to use for their weight and for some individuals who are tall for example they need a much longer sling to support their head and body. Also to take into account is whether the individual will keep their arms in the sling or whether they may decide not to or may become anxious when being moved.

3.5 Describe what action should be taken if the individual’s wishes conflict with their plan of care in relation to health and safety and their risk assessment
-If an individual asks me to move them in a different way than is stated in their care plan and risk assessment I will explain to the individual what their care plan and risk assessment says, the risks involved and my responsibilities to only follow the care plan. If the individual still insisted then I would explain that I would need to report this to my supervisor.
I must also record the risks, the date I identified these and the actions I take.

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