Assessment:
Determine assistive devices that will be required and encumbrances to movement, such as an IV or a heavy cast on one leg. Medications the client is receiving, as certain medications may hamper movement or alertness of the client. Assistance required from other health care personnel.
Planning/Implementation:
Explain to the client what you are going to do, why it is necessary, and how she can cooperate. Wash hands and observe other appropriate infection control procedures. Provide for client privacy. Position yourself and the client appropriately before performing the move. Stand on the same side of the bed, and assume a broader stance with one foot ahead of the other. Place the client’s arms across the chest. Lean your trunk, and flex your hips, knees, and ankles. Place your arms under the client. Tighten your gluteal, abdominal, leg, and arm muscle. Pull the client to the side of the bed. One nurse counts: One, two, three, go. Then, at the same time, all staff members pull the client to the side of the bed by shifting their weight to the back foot. Elevate the side rail on this side of the bed. Move to the other side of the bed, and place supportive devices for the client when turned. Place a pillow where it will support the client’s head after the turn. Place one or two pillows between the client’s leg to support the upper leg when the client is turned.
Roll and position the client in proper alignment. Use a turn sheet to facilitate logrolling. First, stand with another nurse on the same side of the bed. Assume a broad stance with one foot forward, and grasp half of the fanfolded or rolled edge of the turn sheet. On a signal, pull the client toward both of you. Before turning the client, place pillow supports for the head and legs. Then, go to the other side of the bed (farthest from the client), and assume a stable stance. Reaching over the client, grasp the far edges of the turn sheet, and roll the client toward you. The second nurse (behind the client) helps turn the client and provides pillow supports to ensure good alignment in the lateral position.
Evaluation:
Document all relevant information. Record the tine and change of position moved from and position moved to, any signs of pressure areas, use of support devices, ability of client to assist in moving and turning and response of client to moving and turning.
