Moving a patient to the back position

Authors: V.Rednenko 

Editor: V.Rednenko 

Equipment for the practical skill:

• simulated patient (patient manikin)
• hospital bed with bedding
• chair
• foot support
• low pillow - 2 pcs. 
• pillow (15-20x30-35x10-12) - 2-3 pcs. 
• roller (length 80-100, diameter 15-20 cm) 
• roller (length 10-40 cm, diameter - 6-8 cm) - 2-8 pcs. 
• anti-decubitus circle - 3 pcs.

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 lateral position. Place the patient in the back position.

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.
• Call an assistant if necessary
• 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
• 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:

• Position yourself as close to the patient's bed as possible

• Remove the pillow from under the patient's head, remove the blanket, make sure that nothing is in the way to move the patient

• Place a low pillow under the patient's upper shoulders, neck and head

• Place a small roller under the patient's lower back
• Place an anti-decubitus circle under the patient's sacrum

• Slightly spread the patient's hips (to avoid compression in the area of the knee and ankle joints) and place the rollers along the outer surface of the thighs, starting from the area of the trochanter of the femur

• Place small pillows under the patient's thighs

• Put rollers under the knee joints 

• Place anti-decubitus circles under the heels (put on shin holders)

• Place your arms parallel to your body, place small pads under your forearms
• Trn the patient's hands palms down and place rollers in the patient's hands
• Place the footrest at a 90 degree angle

• Make sure the patient is comfortable

• Straighten wrinkles in the patient's bed linen and clothing (if necessary)
• Cover the patient with a blanket
• Return the bed side rails to their initial position.

Final stage:

• Remove gloves, place in appropriate container for disinfection
• Perform hygienic hand washing