Assisting a Patient With Turning in Bed

Goal: The activity takes place without injury to patient or nurse.

1. Review the physician’s orders and nursing plan of care for patient activity. Identify any movement limitations and the ability of the patient to assist with turning. Consult patient handling algorithm, if available, to plan appropriate approach to moving the patient.

2. Gather any positioning aids or supports, if necessary.

3. Perform hand hygiene. Put on PPE, as indicated.

4. Identify the patient. Explain the procedure to the patient.

5. Close the curtains around bed and close the door to the room, if possible. Position at least one nurse on either side of the bed. Place pillows, wedges, or any other support to be used for positioning within easy reach. Place the bed at an appropriate and comfortable working height, usually elbow height of the caregiver (VISN 8 Patient Safety Center, 2009). Lower both side rails.

6. If not already in place, position a friction-reducing sheet under the patient.

7. Using the friction-reducing sheet, move the patient to the edge of the bed, opposite the side to which he or she will be turned. Raise the side rails.

8. If the patient is able, have the patient grasp the side rail on the side of the bed toward which he or she is turning. Alternately, place the patient’s arms across his or her chest and cross his or her far leg over the leg nearest you.

9. If available, activate the bed mechanism to inflate the side of the bed behind the patient’s back.

10. The nurse on the side of the bed toward which the patient is turning should stand opposite the patient’s center with his or her feet spread about shoulder width and with one foot ahead of the other. Tighten your gluteal and abdominal muscles and flex your knees. Use your leg muscles to do the pulling. The other nurse should position his or her hands on the patient’s shoulder and hip, assisting to roll the patient to the side. Instruct the patient to pull on the bed rail at the same time. Use the friction-reducing sheet to gently pull the patient over on his or her side.

11. Use a pillow or other support behind the patient’s back. Pull the shoulder blade forward and out from under the patient.

12. Make the patient comfortable and position in proper alignment, using pillows or other supports under the leg and arm, as needed. Readjust the pillow under the
patient’s head. Elevate the head of the bed as needed for comfort.

13. Place the bed in the lowest position, with the side rails up. Make sure the call bell and other necessary items are within easy reach.

14. Clean transfer aids, per facility policy, if not indicated for single patient use. Remove gloves and other PPE, if used. Perform hand hygiene.