Patients can often spend more of the day in bed than out of it, therefore patient positioning in bed is vitally important.

This is to both prevent and treat pressure sores. Pressure sores are areas of damage to the skin and underlying tissue, caused by sitting or lying in one position for too long. They can be painful, slow to heal, and in some cases can lead to serious infections.

Incorrect patient positioning

Bad positing of a patient can cause various injuries. Shearing and friction are two of the main types of forces that can cause injury:

Shearing

Shearing happens when two layers of skin move in different directions. This can happen when a patient slides down in bed or when they are turned from one side to the other.

Friction

Friction occurs when two surfaces rub together, often causing a red, raw area of skin.

This can happen when a patient is dragged up the bed or when they are lifted without being supported properly. Both of these forces can cause pressure ulcers, as well as other types of injuries. To prevent these kinds of injuries, it is important to position patients correctly in bed.

When is positioning used?

Positioning is important for all patients that spend a significant portion of each day in bed. This could be due to a permanent condition or a temporary one, either way the patients condition requires them to spend long periods of time lying in bed.

Positioning is also important for patients that are at risk of falling out of bed. This could be due to a number of reasons, such as delirium, dementia, seizures, or weakness.

Positioning is important when:

  • Patient has limited or no mobility
  • Patient has pressure sores or is at risk of getting them
  • Patient is at risk of falling out of bed
  • Patient is uncomfortable when lying down
  • Patient receives hygiene or dressing procedures in bed

What are the benefits of proper positioning?

There are many benefits to positioning patients correctly, both for the patient and the staff.

Patient benefits:

  • Reduced risk of pressure sores
  • Reduced pain
  • Improved comfort
  • Improved circulation
  • Improved respiratory function
  • Easier access for hygiene and dressing procedures
  • Improved ability to communicate

Carer benefits:

  • Reduced time spent repositioning the patient
  • Reduced risk of back injuries
  • Improved efficiency
  • Improved communication with the patient

How to correctly position patients

There are many different ways to position patients, and the best way will depend on the individual patient and their needs. The most important thing is to make sure that the patient is comfortable and that their pressure areas are not being put under too much strain.

Here are some general guidelines for how to correctly position patients:

Head and shoulders

The head and shoulders should be elevated at 30 degrees. This prevents the patient from sliding down in bed and keeps their airway open.

Hips and knees

The hips and knees should be bent at a 90 degree angle. This takes pressure off of the lower back and pelvis and helps to prevent pressure sores.

Ankles

The ankles should be flexed at a 30 degree angle. This helps to improve circulation and prevent swelling.

Arms

The arms should be positioned so that they are not resting on anything or hanging off the bed. This prevents them from becoming numb and decreases the risk of pressure sores.

What to use to assist with positioning

Positioning pillow

A positioning pillow can be used to support the patients head, shoulders, and hips. This helps to keep them in the correct position and prevents them from sliding down in bed.

Turning schedule

Patients should be turned every 2 hours to prevent pressure sores. They should be turned from their back to their side and then to their stomach. This should be done slowly and with the help of at least two people.

Transfer boards

A transfer board can be used to help patients move from one position to another. This is especially helpful for patients that are unable to turn themselves.

Satin Slide Sheets

Satin Slide Sheets can be used to help patients move up in bed. They are placed under the patient and then slid up the bed. This is helpful for patients that are unable to sit up on their own.

With the right equipment, patient positioning becomes a lot easier. Positioning is important for the comfort and safety of patients. It is also important for the efficiency of carers. When positioning patients, always make sure that they are comfortable and that their pressure areas are not under too much strain.