Repositioning clients

Most clients will reposition themselves when they get uncomfortable from staying in the same position for too long.

However some people, like those in a coma, in a hip or full body cast, or recovering from surgery, will need your assistance. In addition, many clients will need to be repositioned for procedures or other activities.

Now, you’ll need to know the different procedures when moving a client into different positions, but there are a few things to keep in mind for all of them.

If the person is large, confused, or non-cooperative, you might need to ask for assistance. Be sure to check for tubes and drains, so you don’t accidently pull them out.

Make sure the wheels on the bed or wheelchair are locked and hand rails on the bed are lowered. Check to see if the client is properly covered for their modesty.

Be sure to use good body mechanics. Stand with your feet spread shoulder-width apart and knees slightly bent to protect your back.

Be gentle and do not lift them by their limbs. When moving someone with a cast that’s still wet, try to use only the palms of your hands.

This will help spread the force over a larger area and prevent deforming the cast before it can dry.

For immobile clients resting in the supine position, first reposition them to a lateral position, then back to the supine position, and finally the lateral position on the other side.

Remember everyone needs to reposition at least once every two hours to prevent complications, like pressure ulcers and contractures, and some will need to be moved more frequently.

When you’re done, check that their clothing and the bedsheets are not tangled and replace any pillows you moved.

When moving someone towards one side of the bed for easier access during a procedure, first make sure the bed is raised to a height that’s comfortable for you to work with.

Make sure the head of the bed is flat. Slide your hands under their head and shoulders to move their upper body gently towards you.

Next, slide your hands under the person's chest and move the torso towards you. Finally, slide your hands under the hip and legs and move the lower body towards you.

If they need two people to move them, place a moving sheet, or slide sheet, under them and make sure it reaches from the shoulders to the hips.

You and your co-worker should be standing directly opposite each other. Roll the edges of the sheets towards the client to provide better grip.

On the count of 3, slowly lift the client and move them towards the side of the bed. The slide sheet method is preferred because it decreases the risk of shearing.

You might need to move someone up in bed because, if the head of the bed is elevated, they’ll eventually slide down.

To do this, lower the head of the bed to be flat to make the process easier, especially for larger people.

Next, place one hand behind the person’s head and shoulder. Use your other hand to hold their arm: the one that’s closest to you.

Ask them to bend their knees and, on the count of 3, lift their buttocks and push with their legs slowly to move themself up the bed as you support their head and torso.

Some hospital beds will have a trapeze bar above the clients; others may have a side rail or assist bar next to the bed.