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Pulling a patient up in bed

Moving a patient in bed

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Description

A patient's body may slowly slide when they are in bed for a long time. The patient may ask to be moved up higher for comfort or may need to be moved up so a health care provider can do an exam.

Avoiding Injury

You must move or pull someone up in bed the right way to avoid injuring the patient's shoulders and skin. Using the right method will also help protect your back.

It takes at least 2 people to safely move a patient up in bed.

Friction from rubbing can scrape or tear the patient's skin. Common areas at risk for friction are the shoulders, back, buttocks, elbows, and heels.

Never move patients up by grabbing them under their arms and pulling. This can injure their shoulders.

Preparing to Move the Patient

A slide sheet is the best way to prevent friction. If you do not have one, you can make a draw sheet out of a bed sheet folded in half. Follow these steps to prepare the patient:

• Tell the patient what you are doing.
• If you can, raise the bed to a level that reduces the strain on your back.
• Make the bed flat.
• Roll the patient to one side, then place a half rolled-up slide sheet or draw sheet against their back.
• Roll the patient back onto the sheet and spread the sheet out flat under them.
• Make sure the head, shoulders, and hips are on the sheet.

Pulling up

The goal is to pull, not lift, the patient toward the head of the bed. The 2 people moving the patient should stand on opposite sides of the bed. To pull the patient up both people should:

• Grab the slide sheet or draw sheet at the patient's upper back and hips on the side of the bed closest to you.
• Put one foot forward in the direction you are preparing to move the patient. Put your weight on your back leg.
• On the count of three, move the patient by shifting your weight to your front leg and pulling the sheet toward the head of the bed.
• You may need to do this more than once to get the patient in the right position.

If using a slide sheet, make sure to remove it when you are done.

If the patient can help you, ask the patient to:

• Bring the chin up to the chest and bend the knees. The patient's heels should remain on the bed.
• Have the patient push with the heels while you pull up.

References

De Jong MR. Essentials of patient care for the sonographer. In: Hagen-Ansert S, ed. Textbook of Diagnostic Sonography. 9th ed. St Louis, MO: Elsevier; 2023:chap 2.

Smith SF, Duell DJ, Martin BC, Gonzalez L, Aebersold M. Body mechanics and positioning. In: Smith SF, Duell DJ, Martin BC, Gonzalez L, Aebersold M, eds. Clinical Nursing Skills: Basic to Advanced Skills. 9th ed. New York, NY: Pearson; 2016:chap 12.

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Review Date: 10/28/2023  

Reviewed By: Jennifer K. Mannheim, ARNP, Medical Staff, Department of Psychiatry and Behavioral Health, Seattle Children's Hospital, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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