Bed Positioning

Proper turning and repositioning is a method used to reduce the chance of tissue breakdown and wound development. It is important that wounds are avoided (whenever possible), as it may provide an opportunity for infection to set in.

Steps To Prevent Tissue Breakdown

• Educate the patient and family on the need to reposition.
• Encourage patients who can reposition independently to do so, but monitor their compliance.
• Turn and reposition the patient every 2 hours.
• Encourage food and fluids within the patient’s diet.
• Provide frequent hygiene and skin care to keep the patient’s skin clean and dry.
• Manage moisture caused by incontinence or perspiration; it can cause the skin to be more susceptible to breakdown.
• Provide a range of motion exercises with repositioning and encourage mobilization as able/tolerable.
• Avoid friction when moving the patient. Friction is caused by the skin rubbing across sheets or clothes.
  Use a slide sheet.
• Avoid shearing of the skin. Shearing is cause by downward pressure of gravity pulling the patient to the foot of the bed.
  This often occurs when the head of the bed is elevated.

Correct Positioning and Pressure Points Most Vulnerable to Breakdown

Supine Position: Pillow placed underneath head and knees; feet floating. Hands can be placed across or on sides of body.

Right Side Lying: Pillows to be placed in-between knees and under the arm; towel rolled and placed behind back. Patient should not be lying directly on bony prominences (shoulder blade and trochanter/hip).

Left Side Lying: Pillows to be placed in-between knees and under the arm; towel rolled and placed behind back. Patient should not be lying directly on bony prominences (shoulder blade and trochanter/hip).