Patient Positioning and Bedmaking Techniques

Patient Positioning Techniques

• Supine Position: Patient lies on their back.
• Prone Position: Patient lies face down with head turned to side.
• Lateral Position: Patient lies on their side; top arm and leg are flexed. Use a pillow to protect bony prominences.
• Dorsal Recumbent: Patient lies on their back with legs flexed.
• Sims Position: Patient is positioned ¾ over on their side.

Positioning Aids

• Used for procedures like enemas and colonoscopies.
• Includes pillows, trochanter rolls, positioning boots.
• Prevents pressure on greater trochanter.

Repositioning a Patient in Bed

• Assess whether assistance is needed.
• Determine if assistive devices, like pull or turn sheets, are necessary.
• Check for tubes or drains (IVs, urinary catheters).
• Instruct patient to flex hips and knees, using feet for push-off.
• Utilize a rocking motion with legs and arms to shift the patient smoothly.
• Implement pull sheets or pads to minimize friction during movement.

Making an Occupied Bed

• Remove top bedding, covering the patient with a bath blanket.
• Perform linen change using a log roll method.
• Fan fold dirty linen toward the center; place new linens accordingly.
• Assist the patient in rolling onto the clean side of the bed.
• Complete the linen change and reposition the patient centrally.

Making an Unoccupied Bed

• Gather clean linens, disinfect if necessary.
• Ensure bed height is comfortable for work.
• Apply bottom and top sheets, waterproof pads, and securely miter corners.
• Make one side of the bed completely before proceeding to the other side.

Bed Positions

• Flat: Bed frame parallel to the floor.
• Semi-Fowler: Head of bed raised to a 30° angle.
• Fowler: Head of bed elevated to 45-60° (semi-sitting); High-Fowler: 60-90°.
• Orthopneic Position: Head of bed at 90°, allowing patient to lean forward for chest expansion.
• Trendelenburg Position: Lower head of bed, raise foot; promotes venous circulation in emergencies only.

Principles of Body Mechanics

• Techniques aim to prevent musculoskeletal injuries, especially targeting the back.
• Encourage patient involvement when possible.
• Maintain a wide base of support with feet flat and one foot in front of the other.
• Keep knees slightly bent; align spine by tightening abdominal muscles and tucking buttocks.
• Keep head erect and adopt a firm stance.
• Weight should be kept close to the body during lifting.
• Utilize legs and arms for lifting, avoiding twisting of the back.

Unit Outcomes

• Ability to make both unoccupied and occupied beds.
• Demonstration of safe patient transfer and therapeutic positioning techniques.
• Focus on bed-to-chair and bed-to-cart methods.
• Understanding of proper body mechanics to prevent nurse injuries.

Hospital Bed Features

• Side rails for patient safety.
• Wheels with locking mechanisms for mobility.
• Adjustable elevations for head, foot, and entire bed.
• Bed exit alarms to alert staff when patients get out of bed.
• Weight capacity indicators and CPR functionality included.

Nurse Call System

• Patient-controlled system for alerting nurses.
• Includes features such as TV control for patient comfort.

Bedmaking General Principles

• Ensure linens are clean, dry, and wrinkle-free for patient comfort.
• Follow medical asepsis to prevent infections.
• Clean linens should not contact soiled items or other patients’ bedding.
• Wear gloves when handling soiled linen, if uncertain.

Bedmaking Supplies

• Essential items: linen bag, bottom sheet (flat or fitted), top sheet, bedspread.
• Optional items: waterproof pads, pillowcases, blankets, draw sheets.

Types of Bed Making

• Unoccupied Bed: Made when no patient is present; can be open or closed.
• Occupied Bed: Requires changing linens while patient remains in bed; demands attention to privacy and safety.

Procedure for Making an Occupied Bed

• Cover patient with a bath blanket before removing bedding.
• Log roll the patient to change bottom linens, using a fan fold technique for dirty sheets.
• Ensure patient is repositioned to the center after changing linens.

Bed Positions

• Flat: Entire frame horizontally aligned with the floor.
• Semi-Fowler: Head raised 30 degrees.
• Fowler: Head elevated to 45-60 degrees; high-Fowler varies from 60-90 degrees.
• Orthopneic: Head of bed at 90 degrees, assisting in breathing.
• Trendelenburg: Head lowered, foot raised, mainly for emergencies.

Patient Positioning

• Aimed at increasing comfort and maintaining alignment.
• Requires nursing judgment, physician orders, and assessment for potential assistance.

Body Mechanics Principles

• Techniques to avoid musculoskeletal injuries, with emphasis on back safety.
• Encourage patient involvement where possible.
• Maintain proper posture with a wide and stable base of support.
• Keep load close when lifting; avoid twisting motions.

Patient Positioning Techniques

• Supine: Lying on the back; Prone: Face down.
• Lateral: Side-lying with flexed top arm/leg for comfort.
• Dorsal Recumbent: Back with flexed legs; Sims: ¾ turned on side.
• Use of pillows and positioning aids to prevent pressure sores.

Repositioning a Patient in Bed

• Assess the need for assistance and identify any medical devices in use.
• Guide the patient on utilizing their legs and arms for pushing.
• Employ gentle rocking motions and pull sheets to minimize friction when moving the patient.

This quiz covers different patient positioning techniques as outlined in Pearson, Volume 3. You'll explore the supine, prone, lateral, dorsal recumbent, and Sims positions, along with positioning aids that help prevent pressure injuries. Test your knowledge on essential practices for safe patient care.