{"id":1716,"date":"2024-09-26T18:30:38","date_gmt":"2024-09-26T22:30:38","guid":{"rendered":"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/chapter\/positioning-clients-in-bed-2\/"},"modified":"2024-10-07T16:44:00","modified_gmt":"2024-10-07T20:44:00","slug":"positioning-clients-in-bed","status":"publish","type":"chapter","link":"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/chapter\/positioning-clients-in-bed\/","title":{"raw":"8.3 Positioning Clients in Bed","rendered":"8.3 Positioning Clients in Bed"},"content":{"raw":"Positioning a client in bed is important for maintaining alignment and preventing pressure injury, foot drop, and contractures (Perry et al., 2018). Proper positioning is also vital for providing comfort for clients who are bedridden or who have decreased mobility related to a medical condition or treatment. When positioning a client in bed, supportive devices such as pillows, rolls, wedges, and blankets, along with re-positioning, can aid in providing comfort and safety (Perry et al., 2018).\r\n\r\nPositioning a client in bed is a common procedure. There are various positions possible for clients in bed, which may be determined by their condition, preference, or treatment related to an illness. Table 8.3.1 identifies client positions in bed and a description for each.\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
Table 8.3.1 Client Positions in Bed[footnote]Data sources: Perry et al., 2018; Potter et al., 2017. Images retrieved from 3.5 Positioning Patients in Bed<\/a> in Clinical Procedures for Safer Patient Care<\/a> by Glynda Rees Doyle and Jodie Anita McCutcheon, CC BY 4.0<\/a>[\/footnote]<\/caption>\r\n
Position<\/th>\r\nDescription<\/th>\r\n<\/tr>\r\n<\/thead>\r\n
Supine position<\/td>\r\nClient lies flat on back. Additional supportive devices for under lower legs or head may be added for comfort.\r\n\r\n[caption id=\"attachment_1694\" align=\"aligncenter\" width=\"300\"]\"\" Figure 8.3.1<\/strong> Supine position[\/caption]<\/td>\r\n<\/tr>\r\n
Prone position<\/td>\r\nClient lies on stomach with head turned to the side.\r\n\r\n[caption id=\"attachment_1695\" align=\"aligncenter\" width=\"300\"]\"\" Figure 8.3.2<\/strong> Prone position[\/caption]<\/td>\r\n<\/tr>\r\n
Lateral (side lying) position<\/td>\r\nClient lies on the side of the body with the top leg over the bottom leg. This position helps relieve pressure on the coccyx.\r\n\r\n[caption id=\"attachment_1696\" align=\"aligncenter\" width=\"300\"]\"\" Figure 8.3.3 <\/strong>Lateral position[\/caption]<\/td>\r\n<\/tr>\r\n
Sim\u2019s position<\/td>\r\nClient lies between supine and prone positions with legs flexed in front of the client. Arms should be comfortably placed beside the client, not underneath.\r\n\r\n[caption id=\"attachment_1697\" align=\"aligncenter\" width=\"300\"]\"\" Figure 8.3.4<\/strong> Sim's position[\/caption]<\/td>\r\n<\/tr>\r\n
Fowler\u2019s position<\/td>\r\nClient\u2019s head of bed is placed at a 45-degree angle. Hips may or may not be flexed. This is a common position to provide client comfort and care.\r\n\r\n[caption id=\"attachment_1698\" align=\"aligncenter\" width=\"300\"]\"\" Figure 8.3.5<\/strong> Fowler\u2019s position[\/caption]\r\n
    \r\n \t
  • High Fowler\u2019s position is used to describe a client\u2019s position where the upper body is positioned approximately 60 and 90 degrees in relation to the lower body.<\/li>\r\n<\/ul>\r\n<\/td>\r\n<\/tr>\r\n
Semi-Fowler\u2019s position<\/td>\r\nClient\u2019s head of bed is placed at a 30-degree angle. This position is used for clients who have cardiac or respiratory conditions, and clients with a nasogastric tube and who have enteral nutrition.\r\n\r\n[caption id=\"attachment_1699\" align=\"aligncenter\" width=\"300\"]\"\" Figure 8.3.6<\/strong> Semi-Fowler\u2019s position[\/caption]<\/td>\r\n<\/tr>\r\n
[pb_glossary id=\"604\"]Orthopneic[\/pb_glossary] or\u00a0tripod position<\/td>\r\nClient sits at the side of the bed with head resting on an overbed table on top of several pillows. This position is used for clients with breathing difficulties.\r\n\r\n[caption id=\"attachment_1700\" align=\"aligncenter\" width=\"300\"]\"\" Figure 8.3.7<\/strong>\u00a0Tripod position \u2013 relieves restriction on rib cage and promotes lung expansion<\/span>[\/caption]<\/td>\r\n<\/tr>\r\n
Trendelenberg position<\/td>\r\nPlace the head of the bed lower than the feet. This position is used in situations such as hypotension and medical emergencies. It helps promote venous return to major organs such as the head and heart.\r\n\r\n[caption id=\"attachment_1701\" align=\"aligncenter\" width=\"300\"]\"\" Figure 8.3.8<\/strong> Trendelenburg position<\/span>[\/caption]<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n

Moving a Client Up in Bed<\/h1>\r\nWhen moving a client in bed, perform a point-of-care risk assessment prior to the procedure to determine the level of assistance required for optimal client care. If a client is unable to assist with repositioning in bed, follow the agency\u2019s [pb_glossary id=\"585\"]no-lifting policy[\/pb_glossary] regarding the use of mechanical lifts for complex and bariatric clients. See Checklist 8.3.1 for the steps to move a client up in bed.\r\n
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Checklist 8.3.1: Moving a Client Up in Bed<\/strong><\/p>\r\n

Disclaimer:\u00a0Always review and follow your agency policy regarding this specific skill.<\/i><\/b><\/p>\r\nSafety considerations:\u00a0<\/i><\/b>\r\n