Mosby's Nursing Assistant Video Skills

Purpose

Move the person to the side of the bed before turning or for repositioning and care.
Sometimes you can move the person in segments by yourself. Use at least one co-worker and a mechanical lift or assist device for:
- Older persons.
- Persons with arthritis.
- Persons recovering from spinal cord injuries or spinal cord surgery.
Using an assist device helps prevent pain, skin damage, and injuries.
Turn the person onto his or her side to help prevent complications of bedrest and for certain procedures and care measures. Turn the person toward you or away from you, depending on his or her condition and the situation.
After turning, position the person in good alignment, using pillows for support.
Turn and re-position persons who cannot do this for themselves in bed.
Logrolling is turning the person as a unit, in alignment, with one motion. This procedure keeps the spine straight and is less painful. Use it to turn:
- Older persons with arthritic spines, hips, or knees
- Persons recovering from hip fractures or spinal surgery
- Persons with spinal cord injuries.

Equipment

Roll cursor over items to see labels. For the purposes of clearly depicting the equipment, a barrier is not shown in this photo. When providing care, a barrier should always be placed on the surface before placing the equipment.

Drawsheet (lift sheet)

Folded flat sheet

Blue waterproof pad

Printable
Equipment
List

Delegation

Follow delegation guidelines. Before positioning a person in bed, obtain this information from the nurse and care plan:

The person’s dependency level
How much help the person needs
How many staff members are needed to safely complete the procedure
The person’s comfort level and what body parts are painful
Which procedure to use
What assist devices to use
What support devices are needed for positioning
Where to place pillows
What observations to report and record
What patient or resident concerns to report at once

Preparation

Observe quality-of-life measures.
Review the information under Delegation and Safety and Comfort.
Ask one or two co-workers to help you, as appropriate.
Practice hand hygiene.
Identify the person. Check the ID bracelet against the assignment sheet. Also call the person by name.
Provide for privacy.
Lock the bed wheels.
Raise the bed for body mechanics. Raise the bed rails, if used.

Safety

Use the method and equipment that are best for the person. The wrong method could seriously injure a person.
Be sure to lock the bed wheels before positioning the person.
When using an assist device, have at least one co-worker help you. If the person is tall or heavy, ask two co-workers to help. Do the same thing to logroll a person.
To use a slide sheet, place it under the person. After moving the person, remove the slide sheet.
To move the person in segments, move the person toward you, not away from you.
Use good body mechanics when turning a person in bed.
Keep the person in good alignment to help prevent injuries or skin breakdown.
Do not turn a person away from you with the far bed rail down. Raise the bed rail on the side near you. Then go to the other side of the bed. Lower that bed rail if up. Turn the person toward you.

Comfort

After moving the person to the side of the bed, move the pillow too. Position it under the person’s head and shoulders.
After turning, position the person in good alignment. Use pillows to support the person in the side-lying position. Make sure the person’s face, nose, and mouth are not obstructed by a pillow or other device.
After spinal cord injury or surgery, keep the person’s spine and neck straight. Usually, a pillow is not allowed under the head and neck. Follow the nurse’s directions and the care plan for positioning and pillow use.