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Repositioning: Suggestions for repositioning patients in bed


I am currently in charge of the hospital's zero lift program. I have been asked to look for something to assist with repositioning residents or patients in bed. What do you recommend?

Loree Pauls
Lincoln Hospital


Dear Loree:

Repositioning is a potentially dangerous operation and is often repeated many times each day by nurses and caregivers worldwide.  Luckily, there are some aids that, if used properly, can make repositioning easier.

There are two basic types of repositioning aids available 'manual and mechanical' and you need to consider the features, advantages, and benefits of both in each individual situation. 

1) Manual Aids: There are a number of manual friction reducing devices on the market, often called transfer or repositioning sheets, and you need to carefully consider both patient and caregiver safety when selecting a product to use.  Their advantages are low cost and easy availability, while disadvantages are the need for multiple caregivers and the risk of caregiver injury.
   In 1993, a NIOSH Lifting Equation set the maximum recommended manual lifting limit at 51 lbs. This is for a vertical lift and does not take into account shearing and rotational forces applied to the human spine during repositioning tasks. The Patient Safety Center of Inquiry of the Veterans Administration, in its October 2001 publication of lifting algorithms, recommended the following for Repositioning in Bed: Side-to-Side, Up in Bed; If patient is >200 pounds: Use friction reducing device and 2-3 caregivers.  

2) Mechanical Aids: Many kinds of mechanical aids are available to assist you during repositioning operations.    Mechanical lifts can be either mobile floor based models or ceiling-mounted overhead systems.  When using a specially designed repositioning sheet together with a mechanical lift, the patient can easily be moved to a better position in the bed.  The patient can also be turned in the bed, with virtually no strain on the patient or the caregiver.  Turning is usually popular since it facilitates washing and dressing the patient as well as changing bed linens.  It can also help prevent bed sores. 

Remember to select only repositioning sheets designed to be used with mechanical lifts, and pay particular attention to recommended weight limitations when using them with heavy patients.  

Best Regards ,

The Lift Doctor