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Advances in Skin & Wound Care:
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Quick Tips: Pointers for Patient Positioning

Section Editor(s): Hess, Cathy Thomas BSN, RN, CWOCN

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Pointers on Patient Positioning

Although the clinical practice guideline on preventing pressure ulcers is over 10 years old, the recommendations on patient positioning are still valid. To help prevent pressure ulcers, keep these pointers in mind:

* Keep the patient’s heels protected and elevated off the surface of the bed.

* Maintain the elevation of the head of the bed at 30 degrees or less, if medical status permits.

* Turn or reposition the patient’s body at least every 2 hours; the turning schedule should be individualized to the patient’s status.

* Note that the use of pressure-reducing surfaces does not replace turning schedules.

* Limit the patient’s lateral rotation to 30 degrees from the supine or prone position to avoid direct loading of the greater trochanter.FIGURE

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* Position the patient’s body to avoid loading over an existing pressure ulcer or wound.

* Eliminate the use of donut-type devices.

* Use pillows or wedges to separate bony prominences.

Sources: Panel on the Prediction and Prevention of Pressure Ulcers in Adults. Pressure Ulcers in Adults: Prediction and Prevention. Clinical Practice Guideline, No. 3. AHCPR Publication No. 92-0047. Rockville, MD: Agency for Health Care Policy and Research; May 1992; Brienza DM, Geyer MJ, Sprigle S. Seating, positioning, and support surfaces. In: Baranoski S, and Ayello EA. Wound Care Essentials: Practice Principles. Springhouse, PA: Lippincott Williams & Wilkins; 2004. p 187–216.

© 2004 Lippincott Williams & Wilkins, Inc.

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