Orders of nursing plan of care

Orders of nursing plan of care
1. Review the physician’s orders and nursing plan of care for
patient activity. Identify any movement limitations and the
ability of the patient to assist with turning. Consult
patient-handling algorithm, if available, to plan appropri-
ate approach to moving the patient.
2. Gather any positioning aids or supports, if necessary.
3. Perform hand hygiene. Put on PPE, as indicated.
4. Identify the patient. Explain the procedure to the patient.
5. Close the room door or curtains. Position at least one
nurse on either side of the bed. Place pillows, wedges, or
any other support to be used for positioning within easy
reach. Place the bed at an appropriate and comfortable
working height, usually elbow height of the caregiver
(VISN 8, 2009). Lower both side rails.
6. If not already in place, position a friction-reducing sheet
under the patient.
7. Using the friction-reducing sheet, move the patient to the
edge of the bed, opposite the side to which he or she will
be turned. Raise the side rails.
8. If the patient is able, have the patient grasp the side rail on
the side of the bed toward which they are turning.
Alternately, place the patient’s arms across his or her chest
and cross his or her far leg over the leg nearest you.
9. If available, activate the bed mechanism to inflate the side
of the bed behind the patient’s back.
10. The nurse on the side of the bed toward which the patient
is turning should stand opposite the patient’s center with
his or her feet spread about shoulder width and with one
foot ahead of the other. Tighten your gluteal and abdomi-
nal muscles and flex your knees. Use your leg muscles to do
the pulling. The other nurse should position his or her
hands on the patient’s shoulder and hip, assisting to roll
the patient to the side. Instruct the patient to pull on the
bed rail at the same time. Use the friction-reducing sheet to
gently pull the patient over on his or her side

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