Positioning, Mobility, Transfers, and Safe Handling
Positioning and pressure relief
Good alignment protects skin, breathing, and joints. Reposition at least every two hours and on the care plan schedule, using pillows to support the head, back, and limbs, and a 30-degree lateral rather than flat on the hip. Prevent foot drop with a footboard or boots, and prevent contractures by supporting joints in a neutral position. When moving a resident up in bed, use a draw sheet and two people, and lower the head of the bed first.
Transfers
Lock the wheelchair, raise the footrests, and position it on the resident's strong side, angled slightly. Apply a gait belt around the waist over clothing, not over bare skin or under the arms. Stand on the resident's weak side, slightly behind, holding the gait belt, and pivot toward the strong side. Use a mechanical lift, with trained staff as the plan directs, for anyone who cannot bear weight; one-person lifts and lifting by the arms or around the neck are never acceptable. Never pull on an affected arm.
Ambulation and equipment
Walk slightly behind and to the weak side, holding the gait belt, and follow the resident's pace. A cane goes on the strong side; with a walker, the resident steps into it rather than pushing it away. After any transfer, place the call light within reach, put the bed in the lowest position with wheels locked, and leave the resident with the items they need.
Rule of thumb
Raise the bed to your working height, then lower it when you finish: lock it, lower it, and hand over the call light.