Moving a patient to the side of the bed (one nurse)

Authors: V.Rednenko 

Editor: V.Rednenko 

Equipment for the practical skill:

• simulated patient (patient manikin)
• hospital bed with bedding
• chair

Clinical situation:

Patient N. is in the neurological department with acute cerebrovascular accident, he is assigned to change body positions every 2 hours in order to prevent bedsores. The patient lies on his back. Place the patient to the bed side.

Order of the skill performance:

Preparatory stage:

• Introduce yourself
• Identify patient
• Obtain informed consent to the procedure (if the patient's condition allows it)
  • Give all the information to the person about what the procedure involves, including the benefits and risks, whether there are reasonable alternative, and what will happen without this procedure
  • Explain what you are going to do.
  • Ask the patient to consent to procedure.
  • Explain to the patient how he can help.
• Make sure you have the necessary equipment and put it on the chair next to the bed
• Sanitize your hands, put on gloves
• Prepare the patient bed:
• fasten the bed brakes and make sure the wheels on the bed are locked.
• remove the bed side rails 
• adjust the bed to a horizontal position
• adjust the height of the bed (the patient lying on the bed should be at the level of the mid-thigh of the healthcare worker, which will reduce the effort required when moving the patient)

Main stage:

• Lower the head of the bed as low as the person can tolerate. Ask the person to lift her head, or if she is unable, gently lift her head and remove the pillow. Place the pillow against the headboard.
• Face the bed and position your feet so that one foot is about 12 inches (30 cm) in front of your other foot. Bend your hips and knees so that your upper back remains straight.
• Ask the person to cross her arms over her chest.
• Place one of your arms under the person’s neck and shoulders and the other arm under the person’s upper back. On your count of 3, rock backward and lift the person’s upper body toward you

• Reposition your hands, placing one hand under the person’s waist and the other under her thighs. Using the same motion, count to 3 and rock backward, lifting the person’s lower body toward you.

• Finally, reposition your hands under the person’s calves and feet and, on your count of 3, move the person’s lower legs toward you so that the person is in proper body alignment

• Moving the person to the side of the bed is usually the first step in another procedure. Continue with the other procedure as planned

Final stage:

• Ensure the person’s comfort and good body alignment.
• Adjust equipment for safety: Lower the bed to the level specifi ed in the person’s care plan. Make sure the wheels on the bed are locked. Place the person’s method of calling for help within reach. Lower or raise the side rails according to the person’s care plan.
• Clean up your work area.
• Remove gloves
• Wash your hands.