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Turning patients over in bed

Roll patients in bed

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Description

Changing a patient's position in bed every 2 hours helps keep blood flowing. This helps the skin stay healthy and prevents bedsores.

Turning a patient is a good time to check the skin for redness and sores.

Getting a Patient Ready

The following steps should be followed when turning a patient from their back to their side or stomach:

• Explain to the patient what you are planning to do so the person knows what to expect. Encourage the person to help you if possible.
• Stand on the opposite side of the bed the patient will be turning towards, and lower the bed rail. Move the patient towards you, then put the side rail back up.
• Step around to the other side of the bed and lower the side rail. Ask the patient to look towards you. This will be the direction in which the person is turning.
• The patient's bottom arm should be stretched towards you. Place the person's top arm across the chest.
• Cross the patient's upper ankle over the bottom ankle.

If you are turning the patient onto the stomach, make sure the person's bottom hand is above the head first.

Turning a Patient

The following steps should be followed when turning a patient:

• If you can, raise the bed to a level that reduces back strain for you. Make the bed flat.
• Get as close to the person as you can. You may need to put a knee on the bed to get close enough to the patient.
• Place one of your hands on the patient's shoulder and your other hand on the hip.
• Standing with one foot ahead of the other, shift your weight to your front foot (or knee if you put your knee on the bed) as you gently pull the patient's shoulder toward you.
• Then shift your weight to your back foot as you gently pull the person's hip toward you.

You may need to repeat steps 4 and 5 until the patient is in the right position.

When the Patient is in the Right Position

The following steps should be followed to make sure the patient is in the right position:

• Make sure the patient's ankles, knees, and elbows are not resting on top of each other.
• Make sure the head and neck are in line with the spine, not stretched forward, back, or to the side.
• Make sure the arms are not under the weight of the body.
• Return the bed to a comfortable position with the side rails up. Check with the patient to make sure the patient is comfortable. Use pillows as needed.

References

American Red Cross. Assisting with positioning and transferring. In: American Red Cross. American Red Cross Nurse Assistant Training Textbook. 4th ed. American National Red Cross; 2018:chap.11.

De Jong MR. Essentials of patient care for the sonographer. In: Hagen-Ansert S, ed. Textbook of Diagnostic Sonography. 9th ed. St Louis, MO: Elsevier; 2023:chap 2.

Qaseem A, Mir TP, Starkey M, Denberg TD; Clinical Guidelines Committee of the American College of Physicians. Risk assessment and prevention of pressure ulcers: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2015;162(5):359-369. PMID: 25732278 pubmed.ncbi.nlm.nih.gov/25732278/.

Review Date: 10/28/2023  

Reviewed By: Jennifer K. Mannheim, ARNP, Medical Staff, Department of Psychiatry and Behavioral Health, Seattle Children's Hospital, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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