398 Unit 4 Healthcare Skills Copyright Goodheart-Willcox Co., Inc. Rationale Proper positioning and repositioning provides good body alignment, helps to prevent decubitus ulcer formation, and promotes comfort. Preparation 1. Assemble the necessary equipment based on how the patient will be positioned. 2. Be aware of all pressure points and natural curves of the body that may need care and support. 3. Wash your hands to ensure infection control. 4. Explain in simple terms what you are going to do before positioning. Do this even if the patient is unable to communicate or is disoriented. The Procedure 5. Provide privacy by drawing the bed curtains or putting a screen around the bed. 6. Ask the patient how he would be most comfortable, if there are any pressure concerns, and about personal preferences. 7. Use proper body mechanics when positioning the patient. Raise or lower the bed to a comfortable level for working and lower the bed rails. Lock the wheels of the bed, if needed. 8. Depending on the position desired, place pillows, soft rolled towels, or blankets under various body areas, such as • the head, shoulders, and small of the back • the arms and elbows • the thighs (tucking under to prevent external hip rotation) and • the ankles, calves, and knees (to raise the heels off the bed). Be sure to support the knees and calves when raising the ankles. 9. The knees may be fl exed and supported with a small pillow or blanket roll. 10. A small pillow or blanket roll may be added at the feet to prevent foot drop. (Use a foot board only if approved by the appropriate provider.) 11. Position or reposition the patient so the body is properly aligned. Then straighten the bed linens. 12. Raise the head of the bed to a level that is appropriate for the position. Lower the bed and raise the bed rails, if needed. 13. Ensure that any tubing the patient may have is carefully handled and reattached, if needed. If there is an IV catheter, be sure it remains intact during the positioning. If there is any concern, ask the appropriate provider to assist by checking that the IV or other tubing is functioning properly after the positioning is completed. If the patient has a foley catheter, which is used to drain urine from the bladder, be sure it is secured below the bladder. Follow-up 14. Make sure the patient is safe and comfortable. Place the call light and personal items within easy reach. 15. Wash your hands to ensure infection control. Reporting and Documentation 16. Communicate any specifi c observations, complications, or unusual responses to the appropriate provider. Also record this information in the patient’s chart or EMR. Procedure 13.5 Positioning a Patient in Bed Turning a Patient You may be asked to help turn patients for a variety of reasons such as to position the patient, to prepare the patient for transfer to a stretcher, or to provide hygiene care such as washing the patient’s back. Always practice safety by asking for assistance from others if the patient is frail, overweight, or has equipment or devices attached to his body, such as tubes or an IV catheter.