Safe Patient Handling
Assisting with Moving a Patient in Bed
Select a Skill:
- » Assisting with Moving a Patient in Bed
- » Assisting with Positioning a Patient in Bed
- » Transferring from a Bed to a Wheelchair Using a Transfer Belt
- » Transferring from a Bed to a Stretcher
- » Performing Passive Range-of-Motion Exercises
- » Applying Elastic Stockings
- » Assisting with Ambulation Using a Gait Belt
- » Using a Sequential Compression Device
- » Using a Hydraulic Lift
Take the Review Test:
Safety
- Determine if the patient is able to fully or partially assist.
- Assess the amount of weight to be lifted and how much assistance, if any, you will need.
For your safety when moving a patient:
- Raise the level of the bed to a comfortable working height.
- Keep back, neck, pelvis, and feet aligned, and avoid twisting.
- Tighten the stomach muscles and tuck the pelvis to protect your back.
- Bend at the knees and let the strong muscles of the legs do the lifting.
- The person with the heaviest load coordinates the efforts of the personnel involved in transferring.
For patient safety when moving:
- Verify the patient’s range of motion (ROM).
- Keep the patient’s neck and spinal column in alignment to prevent further injury.
- Before flattening the bed, account for all tubing, drains, and equipment, in order to avoid dislodgement and spills.
- Increase the frequency of position changes if the patient reports discomfort.
- Protect the patient’s heels from shearing force by having another caregiver lift the heels while moving the patient up in bed.
Equipment
(Roll cursor over items to see labels)
Drawsheet
Friction-reducing device
PrintableDelegation
The skill of moving a patient up in bed can be delegated to nursing assistive personnel (NAP). Be sure to inform NAP of the following:
- Explain any moving restrictions, such as those that might apply to a patient with one-sided weakness.
- Review any information regarding the patient’s individual needs for body alignment, such as specific instructions for a patient with spinal cord injury.
- Specify times throughout the shift at which the patient must be moved.
- Outline any special safety precautions to be followed.
- Specify when to report changes to you, such as alterations in the patient's ability to assist with moving.
Preparation
- Assess the patient’s range of motion, body alignment, and comfort level while the patient is lying down.
- Assess for factors that contribute to complications of immobility, including loss of sensation, mobility restrictions, impaired circulation, and age.
- Assess the patient's level of consciousness.
- Assess the condition of the patient’s skin.
- Assess the patient’s physical ability to help with moving, which may be affected by age, level of consciousness, disease processes, strength, range of motion, and coordination.
- Assess for the presence of tubes, incisions, and equipment, such as traction.
- Assess the patient’s motivation to move.
- Check physician’s or other health care provider’s orders before moving the patient.
- Raise the level of the bed to a comfortable working height.
- Remove all pillows and devices that may be present.
- Get extra help as needed.
- Explain the procedure to the patient.
Follow-up
- Assess the patient’s body alignment, position, and comfort level.
- Report the patient’s ability to assist with moving.
Documentation
- Record the procedure and your observations regarding the patient’s ability to assist with moving.
- Report your observations at change of shift. Record each position change made throughout your shift and the time at which it occurred.
Review Questions
1. When preparing to move a patient in bed, what will the nurse do first?
Assemble adequate help to move the patient.
Assess the patient’s ability to help with moving.- Determine the patient’s weight.
- Decide on the most effective means of moving the patient.
INCORRECT. The amount of help needed will be unknown until after the nurse determines whether or how much the patient is able to help.
CORRECT. Assessing the patient’s ability to help is the first thing the nurse must do, since the answer determines how much help is needed with the move.
INCORRECT. The patient’s weight is important to know, but it is not the first action the nurse must take.
INCORRECT. The most effective means of moving the patient will be determined in part by whether the patient is able to help.
2. When preparing to move a patient in bed with the help of an assistant, which posture will both caregivers use to ensure their own safety?
- Stand with the knees locked.
- Stand with the feet together.
- Flex the hips and knees.
- Shift the body weight from the back leg to the front leg.
INCORRECT. When moving a patient in bed, standing with the knees locked could injure the legs or the back.
INCORRECT. When moving a patient in bed, standing with the feet together could injure the legs or the back.
CORRECT. Flexing the hips and knees is the safest posture for both caregivers to assume when moving a patient in bed.
INCORRECT. When moving a patient in bed, the body weight should be shifted from the front leg to the back leg.
3. A patient who weighs 200 lbs. needs to be moved up in bed with the aid of a friction-reducing device. The nurse will prepare for this move by assembling how many caregivers?
- A minimum of two
- None, since the device does all the lifting during the move.
- At least three
- The nurse can carry out this move without assistance.
INCORRECT. Since a friction-reducing device will be used and the client weighs more than 157 lbs., three or more people are needed to move this patient safely.
INCORRECT. The device does not function independently, and the nurse cannot use it without the help of other caregivers.
CORRECT. Since a friction-reducing device will be used and the client weighs more than 157 lbs., a minimum of three to four people are needed to move this patient safely.
INCORRECT. The nurse cannot carry out this move by himself or herself. Since a friction-reducing device will be used and the client weighs more than 157 lbs., a minimum of three to four people are needed to move this patient safely.
4. In which position will the nurse place the patient to move him or her up in bed?
- Supine with the head of the bed at a 30-degree angle
- Sitting in the bed
- Supine with the head of the bed flat
- Prone with the head of the bed flat
INCORRECT. This is not the recommended position to use to move a patient up in bed.
INCORRECT. This is not the recommended position to use to move a patient up in bed.
CORRECT. Placing the patient in the supine position with the head of the bed flat is the recommended position to use to move a patient up in bed.
INCORRECT. The patient should not be prone when being moved up in bed.
5. A patient will be moved up in bed with the use of a friction-reducing device. How will the nurse place this device under the patient?
- Lift the patient to place the device directly under him or her.
- Remove the draw sheet, and replace it with the device.
- Roll the patient from side to side, and place the device under the draw sheet.
- Sit the patient up in the bed, and place the device behind the shoulders.
INCORRECT. The patient is not lifted in order to place the device under him or her.
INCORRECT. The device must be placed under the draw sheet.
CORRECT. The patient will be rolled from side to side and the device placed under the draw sheet.
INCORRECT. The device must be behind the entire length of the patient, and not just placed at the level of the shoulders.
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