Overview

People sometimes have to stay in bed for long periods of time. And they may not be able to move themselves into different positions. It's very important that a person changes positions. Lying in one position for a long time can cause pressure injuries (also called pressure sores).

Pressure injuries are damage to the skin. They can range from red areas on the surface of the skin to severe tissue damage that goes deep into muscle and bone. These problems are hard to treat and slow to heal. When pressure injuries don't heal well, they can cause problems such as bone, blood, and skin infections.

Pressure injuries usually occur over bony areas, such as the hips, lower back, elbows, heels, and shoulders. They can also occur in places where the skin folds over on itself.

You can help a person avoid pressure injuries by helping them turn and change position in bed. Using a drawsheet can help.

Making a drawsheet

A drawsheet makes it easier to "roll" a person into another position. You can buy a drawsheet, or you can make one with a sheet. You then make the bed using the drawsheet.

To make a drawsheet:

1. Fold a sheet in half lengthwise.
2. Place the sheet on top of the fitted bottom sheet so that the top and bottom of the drawsheet go across the bed (perpendicular to the bed). Position the drawsheet so that it will be between the person's head and knees.
3. Tuck in the drawsheet tightly on both sides. Smooth out any wrinkles to reduce possible skin irritation.

Turning a person in bed

Turning someone in bed is best as a two-person job. If the person can help, you may be able to do it yourself. If the person cannot help, have a family member or friend help you. It is easier for two people to turn someone, and it can be dangerous for one person to do it.

It is best to turn the person every 2 hours. Before getting started, tell the person that you want them to roll into another position. If they have any drains, tubes, or other medical equipment, adjust these so they don't get in the way.

If the person can help

• Have the person scoot toward the opposite side of the bed so that they will have room to roll. Help them, if needed.
• Go to the side of the bed you want them to roll toward.
• Ask them to lie on their back with their knees bent. Have them place their arms across their body.
• Ask them to roll toward you while keeping their knees bent. If you have a rail on the bed, have them reach toward the rail.
• Help them as needed. Gently place your hands on the shoulders and hips, and guide the person toward you.

If the person can't help

Get someone to help you. You will be using a drawsheet, so learn how to make and position a drawsheet.

Follow these steps to turn the person in bed.

1. Stand on opposite sides of the bed. Your assistant will be on one side, and you will be on the other side. If the person you are turning is in a hospital bed, lower the height of the bed. This will make it easier to turn the person.
2. Untuck the drawsheet on both sides of the bed.
3. Make sure the person is high enough up in the bed. If not, you can use the drawsheet to lift them toward the head of the bed. To do this,
   • You and your assistant each will gather up one side of the drawsheet so you both have a "handle" to grab.
   • Be sure that you and your assistant have your feet shoulder-width apart. This will help you avoid straining your back.
   • Agree on a count, and then lift and move them up and to the side of the bed they will be rolling away from.
4. Tuck in the drawsheet on the side of the bed that the person will roll toward.
5. Position the person. Help them lie on their back with their knees bent. If they can't bend their knees, cross one ankle over the other in the direction of the turn. Position their arms across their body.
6. Start to roll the person onto their side. One of you will pull, and the other will push. Be sure that you and your assistant have your feet shoulder-width apart to help avoid straining your backs.
   • If you're pulling the person toward you, lean from your hips (don't bend your back), reach over the person, and grab the drawsheet at their hip and shoulder areas. Slowly pull the drawsheet toward you to roll the person over.
   • If you're rolling them away from you, slowly push at the hip and shoulder areas.
7. Smooth out the drawsheet and tuck it in.

Making the person comfortable

You can use pillows to help the person get comfortable and avoid pressure injuries.

If the person is on their side:

• Place pillows in front of them, at chest level, with the top arm draped over a pillow.
• If needed, tuck one edge of a pillow under the buttock, lengthwise. Then fold the pillow under and tuck the other edge under the first edge. That creates a "roll" that stays in place better and helps keep the person from rolling back.
• Place a pillow between the person's knees, with the legs slightly bent.
• Put the top leg a little in front of the bottom leg. This takes pressure off the bottom leg.
• Put a pillow under the bottom leg so that the bottom ankle is off the bed.

If the person is on their back:

• Put a pillow under their legs between the knees and ankles.
• Do not put anything under the heels.
• If you have a hospital bed, don't adjust the top end above 30 degrees. This helps prevent the person from sliding down.

When you are finished, smooth out the drawsheet in its original position and tuck it in.