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Repositioning Patients to Prevent Pressure Ulcers Cheat Sheet by

Best Practice: Repositioning Patients to Prevent Pressure Ulcers
nursing     medical     practice     best     pressure     healthcare     ulcers     repositioning

Introd­uction

The current accepted “guideline for care” is to turn patients every two hours; however, there is much more involved in finding the right solution for your patient. The frequency of turns should be indivi­dua­lized based on such factors as:
Patient’s tissue tolerance
Level of activity and mobility
General medical condition
Overall treatment objectives
Skin condition
Comfort

Getting a patient ready

1. Explain to the patient what you are planning to do so the person knows what to expect. Encourage the patient to help you if possible.
2. Stand on the side of the bed the patient will be turning towards and lower the bed rail.
3. Ask the patient to look towards you. This will be the direction in which the person is turning.
4. Move the patient to the center of the bed so the person is not at risk of rolling out of the bed.
5. The patient’s bottom arm should be stretched towards you. Place the person’s top arm across the chest.
6. Cross the patient’s upper ankle over the bottom ankle.
If you are turning the patient onto the stomach, make sure the person’s bottom hand is above the head first.

Turning a patient

1. Adjust the bed to a level that reduces back strain for you. Make the bed flat.
2. Get as close to the patient as you can.
3. Place one of your hands on the patient’s shoulder and your other hand on the hip.
4. Standing with one foot ahead of the other, shift your weight to your front foot as you gently pull the patient’s shoulder toward you. Then shift your weight to your back foot as you gently pull the patient’s hip toward you.
You may need to repeat steps 3 and 4 until the patient is in the right position.

When patient is in the right position

1. Make sure the patient’s ankles, knees, and elbows are not resting on top of each other.
2. Make sure the head and neck are in line with the spine, not stretched forward, back, or to the side.
3. Return the bed to a comfor­table position with the side rails up. Check with the patient to make sure the patient is comfor­table. Use pillows as needed
 

Turn and Positi­oning Schedule

Rule of 30o guidelines

A good guideline for reposi­tioning a bedridden patient is the “Rule of 30” which means the head of the bed is elevated at no more than 30 degrees from horizontal and the body is placed in a 30-degree, laterally inclined position.

Positi­oning

In the laterally inclined position, tilt the patient’s hips and shoulders 30 degrees from supine, and use pillows or wedges to keep the patient positioned without pressure over the hips or buttocks.

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