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Points About Positioning
Here is a list of some particular points about positioning of patients. Click on each of the headings for more information.
Individual schedule
Based on the RA, an individualised schedule for positioning/repositioning should be developed for all ‘at risk’ patients. This should cover repositioning in the bed and/or chair.
Records
Records should be kept to ensure adherence to the schedule.
Evaluate
Skin should be inspected at each turn to evaluate the effectiveness of the repositioning schedule.
Time periods
As a general guide, patients should not be left in one position in a bed for any longer than two hours, or one hour in a chair. However, for higher risk patients, shorter periods may be required.
Lying positions
The general preferred lying positions are:
- < 30° angle on backrest
- elevate the foot of the bed no more than 10 - 20°
- 30° body tilt.
It is also important to protect bony prominences.
Importantly, never place a patient in a supine position.
Sitting positions
The following points include considerations for preferred sitting positions and preventing forward slide:
- curves of the spine should be maintained
- the hips and knees need to be at 90-100°
- feet should be supported; a footrest may be required.
Support devices
The patient will often require support devices (in both bed and chair) to assist them in maintaining the preferred position e.g. pillows, foam wedges, footrest.
Education
Educate the patients and carers about how they can assist with redistributing body weight.
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