TURNING A CLIENT TO A LATERAL OR PRONE POSITION IN BED

Ma. Pia Doromal Mirador, RN Head Nurse, ER OPD

Turning a Client to the Lateral or Prone Position in Bed

PURPOSES:
Movement to the lateral (side lying) position may be necessary when placing a bedpan beneath the client, when changing the clients bed linen, or when repositioning the client.

Turning a Client to the Lateral or Prone Position in Bed

ASSESSMENT: Before moving a client, assess the following: The clients physical abilities (muscle strength,presence of paralysis). Ability to understand instructions. Degree of comfort or discomfort when moving. Clients weight. Your own strength and ability to move the client.

Turning a Client to the Lateral or Prone Position in Bed

PREPERATION: Determine assistive devices that will be required. Determine the encumbrances to movement such as an IV or a heavy cast on one leg. Determine the medications the client is receiving because certain medications may hamper movement or alertness of the client. Determine if assistance is required from other health care personnel.

Turning a Client to the Lateral or Prone Position in Bed

IMPLEMENTATION:

Explain to the client what you are going to do, why is it necessary, and how he or she can cooperate. Listen to any suggestions made by the client or support people. Discuss how the results to be used in planning further care or treatments.
Wash hands and observe other appropriate infection control procedures. Provide for client privacy.

Position yourself and the client appropriately before performing the move.

Turning a Client to the Lateral or Prone Position in Bed

IMPLEMENTATION:

Move the client closer to the side of the bed opposite the side the client will face when turned. This ensures that the client will be positioned safely in the centre of the bed after turning. use the pull sheet beneath the clients trunk and thighs to pull the client to the side of the bed. Roll up the sheet as close as possible to the clients body and pull the client to the side of the bed. Adjust the clients head and reposition the legs appropriately. While standing on the side of bed nearest the client, place the clients near arm across the chest. Abduct the clients far shoulder slightly from the side of the body and externally rotate the shoulder.

Turning a Client to the Lateral or Prone Position in Bed

IMPLEMENTATION:

Pulling the other arm away from the body and externally rotating the shoulder prevents that arm from being caught beneath the clients body during the roll. Place the clients near ankle and foot across the far ankle and foot. This facilitates the turning motion. Making these preparations on the side of the bed closes the client helps prevent unnecessary reaching. Raise the side rail next to the client before going to the other side of the bed toward which the client will turn, directly in line with the clients waistline and as close to the bed as possible.

Turning a Client to the Lateral or Prone Position in Bed

IMPLEMENTATION: Lean your trunk forward from the hips. Flex your hips, knees, and ankles. Assume a broad stance with one foot forward and the weight placed on this forward foot. Pull or roll the client toward you to the lateral position. Place one hand on the clients far hip and the other hand on the clients far shoulder. This position of the hand supports the client at the two heaviest part of the body, providing greater control in movement during the roll. Tighten your gluteal, abdominal, leg, and arm muscles; rock backward, shifting your weight from the forward to the backward foot, and roll the client onto the side of the body to face you. Turning the client toward you
promotes the clients sense of security.

Turning a Client to the Lateral or Prone Position in Bed

IMPLEMENTATION:

Position the client on his/her side with arms and legs positioned and supported properly.

Turning a Client to the Lateral or Prone Position in Bed

TURNING THE CLIENT TO A PRONE POSITION:

To turn a client to the prone position, follow the preceding steps, with two exceptions:
Instead od abducting the far arm, keep the clients arm alongside the body for the client to roll over. Keeping the arm alongside the body prevents it from being pinned under the client when the client is rolled. Roll the client completely onto the abdomen. It is essential to move the client as close as possible to the edge of the bed before the turn so that the client will be lying on the center of the bed after rolling. Never pull a client across the bed while the client is in the prone position. Doing so can injure a womans breast or a mans genitals.

Turning a Client to the Lateral or Prone Position in Bed

Thank you!