Positioning Clients Performance Checklist

Positioning Clients

Check care plan for direction and client needs. Assess the client’s status before undertaking the activity. Consider the client’s preferences. Explain the procedure to the client. Perform hand hygiene.

Fowler’s Position

• Head of bed 45to 60⁰.
• Keep the spine straight; support the head with a pillow.
• Support the arms with pillows.

Supine Position– the back-lying position

• The bed is flat.
• The head and shoulders are supported on a pillow.
• Arms and hands are at the client’s sides.
• Pillows support the arms and hands.
• A small pillow is under the thighs.

Lateral Position– side-lying on the left or right side.

• A pillow is under the head and neck.
• The upper leg is placed in front of the lower leg.
• The upper leg and thigh are supported with pillows.
• The upper hand and arm and the back are supported by pillows.

Sims’ Position– a left side-lying position.

• The upper leg is flexed.
• The lower leg is not lying under the upper leg.
• The lower arm is behind the client.
• Pillows are used to support the head and shoulders, the upper leg and the upper arms and hand.

30◦ Lateral Position

• Place pillows under head, shoulder, and leg to lift up hip to avoid pressure on the hip.

Sitting Position

• The back and buttocks are against the back of the chair.
• The feet are flat on the floor or on wheelchair footrests.
• The backs of the knees and calves are slightly away from the edge of the seat.
• Paralyzed arms are supported on elevated armrests.

Repositioning in a chair or wheelchair

Clients are repositioned so that their back and buttocks are against the back of the chair. Follow the steps as outlined in the physiotherapist’s session. If the client can help:

• Lock the wheelchair wheels.
• Stand in front of the client and block their knees and feet with yours.
• Apply a transfer belt.
• Position the client’s feet flat on the floor.
• Position the client’s arms on the armrests. Grasp the transfer belt on each side while the client leans forward.
• Lift the client as they push with their arms and feet.
• If a transfer belt is not available, put your arms under the client’s arms and place hands around the client’s shoulder blades.
• Ask the client to push with his or her feet and arms on the count of three.
• As client pushes with arms and feet, push the client’s knees with your knees. The client will be naturally repositioned back into the wheelchair.

Infants

• Always lay babies on their backs for sleep.
• Do not lay the baby on soft bedding products such as pillows.

Perform hand hygiene. Ensure comfort and safety. Tidy area.