Moving a Patient Up in Bed With the Assistance of Another Nurse

Goal: The patient remains free from injury and maintainsproper body alignment.

1. Review the medical record and nursing plan of care for conditions that may influence the patient’s ability to move or to be positioned. Assess for tubes, IV lines, incisions, or equipment that may alter the positioning procedure. Identify any movement limitations. Consult patient handling algorithm, if available, to plan appropriate approach to moving the patient.

2. Perform hand hygiene and put on PPE, if indicated.

3. Identify the patient. Explain the procedure to the patient.

4. Close curtains around bed and close the door to the room, if possible. Place the bed at an appropriate and comfortable working height, usually elbow height of the caregiver (VISN 8 Patient Safety Center, 2009). Adjust the head of the bed to a flat position or as low as the patient can tolerate. Placing the bed in slight Trendelenburg position aids movement, if the patient is able to tolerate it.

5. Remove all pillows from under the patient. Leave one at the head of the bed, leaning upright against the headboard.

6. Position at least one nurse on either side of the bed, and lower both side rails.

7. If a friction-reducing sheet (or device) is not in place under the patient, place one under the patient’s midsection.

8. Ask the patient (if able) to bend his or her legs and put his or her feet flat on the bed to assist with the movement.

9. Have the patient fold the arms across the chest. Have the patient (if able) lift the head with chin on chest.

10. One nurse should be positioned on each side of the bed, at the patient’s midsection with feet spread shoulder width apart and one foot slightly in front of the other.

11. If available on bed, engage mechanism to make the bed surface firmer for repositioning.

12. Grasp the friction-reducing sheet securely, close to the patient’s body.

13. Flex your knees and hips. Tighten your abdominal and gluteal muscles and keep your back straight.

14. Shift your weight back and forth from your back leg to your front leg and count to three. On the count of three, move the patient up in bed. If possible, the patient can assist with the move by pushing with the legs. Repeat the process, if necessary, to get the patient to the right position.

15. Assist the patient to a comfortable position and readjust the pillows and supports, as needed. Return bed surface to normal setting, if necessary. Raise the side rails. Place the bed in the lowest position.

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