Moving a person up and down in bed
How to control risks to employees from moving a person up and down in bed by using general OHS information and equipment recommended for best practice. This guidance is for employers at workplaces where people are moved, including in the healthcare and social assistance industries.
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First consider available equipment to prevent movement down the bed
A person might repeatedly move down the bed and be unable to independently reposition themselves. Equipment to prevent the person from repeatedly moving down the bed may include:
- the right-sized bed, where the hip and knee breaks fit the person’s dimensions
- using the knee break, where clinically appropriate.
Beds with knee and hip breaks might not remove the need to move a person up and down in bed. In this case, consider the following guidance.
Working environment
If the person cannot help themselves move, the task may require multiple employees and equipment. For the method chosen, each employee will need sufficient space for the tasks or tools involved.
Floors need to be:
- flat and have low friction if wheeled equipment is used
- free from spills and clutter.
Hard, smooth and slip-resistant flooring is preferred for safe and efficient movement. Surfaces that are irregular are not recommended in areas where wheeled equipment is used. For example, carpet and some tiles.
Carpet can make moving items like mobile hoists and beds more difficult and increase risks, especially when done manually. Risks increase in tight spaces or when equipment needs to be moved over long distances.
If considering carpet, do force measurements and equipment trials with a sample of the proposed carpet.
Systems of work
For each method, employees should have easy access to:
- information about which method to choose, based on the highest order of risk control
- equipment required
- the training to use the method.
When choosing a method, employees should:
- refer to the person’s care plan and manual handling information
- follow the organisation’s instructions and training
- always explain the move to the person being moved.
Tools to help with the move
For this task, consider the following commonly used pieces of equipment. Not all possible options are included.
Bed mechanics, air firming mattress:
Bed ladder or overhead bars (bars not shown):
Slide sheets:
Bed rails:
Air transfer device:
Wall-mounted or ceiling-mounted hoist with overhead tracking, or mobile hoist, used with sling
Multiple tools can be used together for the move. For example, using bed mechanics when moving a person with an overhead hoist with sling can help with smooth movement from point A to point B.
When the person can help with the move
The person being moved may be able to help with their move. In this case, the following methods should be considered and included in the care plan as applicable.
- Verbal instructions
Assessment of the person is required. Where it is clinically applicable, the care plan should direct employees to instruct and encourage the person in care to use their own body movements to help with the task as much as they can.
For more information, also see Preparing for safe moves.
- Bed mechanics
Consider the person’s clinical care requirements in the care plan. Where it will not cause harm, use the bed’s head-down function to help with the move. Slightly elevate the foot-end of the bed to help the person use their body mechanics to move up the bed.
If an air mattress is on the person’s bed, use the firming function to inflate and firm the surface before starting any move. This will make it easier for the person to help and minimise the chance of them sinking into the surface.
Use bed features such as the knee break or the bed’s tilt mechanism to prevent the person from slipping down the bed in future.
- Bed ladder or overhead bar with suitable anchor point
Bed ladders and overhead bars can help a person move and position themselves in bed. Remember that anchor points and equipment have a safe working load. Do not exceed the load limit.
A bed ladder is attached to the foot end of the bed or other suitable anchor points to improve the angle of pull. It can remain on the bed, in reach. The person can help themselves sit up by reaching forward, grabbing the ladder rungs and pulling themselves up, rung by rung. The equipment can easily removed and replaced as needed.
- Slide sheets
Placing 2 layers of a slide sheet between the surface and person’s body lowers the force a person needs to move themselves. When the move is complete, remove both slide sheets to prevent risks to the person, such as slipping, falling and pressure-related injuries.
A slide sheet is made of low-friction material. Slide sheets can vary in quality. They may have different coefficients of friction and promote slip in different directions. Provide the highest-quality slide sheets in various sizes to accommodate a variety of people moves.
Ensure slide sheets are functional. Replace slide sheets that do not slip. Refer to manufacturer’s guidelines on when to replace slide sheets.
- Bed rails
Fitted mobility rails are a half-bed rail fitted to the head end of a mechanical bed. They help a person move themselves when moving up the bed and when rolling from side to side. Mobility rails are not suitable as a barrier or restraint to getting in or out of the bed.
Side rails, formerly known as cot sides, provide a grip point for people to hold when moving in bed. Side rails also protect people from falling off the bed. Side rails can be raised and lowered as needed.
Unless the person’s care plan says otherwise, rails need to be lowered at the end of a task so they are not a barrier or restraint when getting into or out of the bed.
Mobility and side rails should have clearly labelled safe working loads.
When the person cannot help with the move
The person being moved may be unable to help with their move. In this case, the following methods should be considered and included in the care plan as applicable.
- Slide sheets
Placing 2 slide sheets completely under the full body of a person who cannot help with their move is more effective than using a single slide sheet. When the move is complete, remove both slide sheets to prevent risks to the person, such as slipping, falling and pressure-related injuries.
A slide sheet is made of low-friction material. Slide sheets can vary in quality. They may have different coefficients of friction and promote slip in different directions. Provide the highest-quality slide sheets in various sizes to accommodate a variety of people moves.
Ensure slide sheets are functional. Replace slide sheets that do not slip. Refer to manufacturer’s guidelines on when to replace slide sheets.
- Bed mechanics
Consider the person’s clinical care requirements in the care plan. Where it will not cause harm, combine the bed’s head-down function with other approved people-moving techniques. For example, position the person on 2 full-length slide sheets. Slightly elevate the foot-end of the bed and, using the top slide sheet, move the person to the head of the bed.
If an air mattress is on the person’s bed, use the firming function to inflate and firm the surface before starting any move. This will minimise the chance of them sinking into the surface.
Use bed features such as the knee break and tilt mechanism to prevent the person from slipping down the bed in future.
- Air transfer device
An air transfer device is an inflatable air cushioning device. It is more effective than slide sheets at reducing the friction of moving a person on a surface. Air transfer devices inflate using a pump to move a person across, up and down firm, flat surfaces.
Where possible, air transfer devices should be positioned on the surface before an immobilised person is placed there. Otherwise, employees should follow the appropriate information, instruction and training provided to safely place the device under the person being moved.
- Wall-mounted or ceiling-mounted hoist with overhead tracking
Wall-mounted and ceiling-mounted hoists are connected to ceiling tracks. They move people inside a sling from one point to another.
Hoists come with a variety of attachments, including:
- weighing devices
- spreader bars
- motorised tilt functions.
These attachments can make it easier and more comfortable to safely handle people. Suitable attachments should be available and conveniently stored for ease of access.
The safe working load for moving the person is the minimum safe working load of either:
- the hoist
- its attachments.
Ensure that wall-mounted and ceiling-mounted hoists and their attachments are inspected and tested before each use.
A detailed inspection should take place at least once a year or as specified in the manufacturer’s instructions. A suitably competent person should do the detailed inspection.
Damaged hoists or attachments should be reported and not used.
Floor-mounted hoists are also available but are less common.
- Mobile floor hoist
Mobile floor hoists lift, carry and reposition people inside a sling. The hoists have wheels and can travel across the floor.
Mobile hoists come with a variety of attachments, including:
- weighing devices
- spreader bars
- motorised lifting and tilt functions.
These functions can make it easier and more comfortable to safely handle people.
When mobile floor hoists are used, ensure there are systems or procedures in place so employees consider the:
- required elevation and position of the person in the sling
- suitability of the hoist attachments.
Suitable attachments should be available and conveniently stored for ease of access.
The safe working load for moving the person is the minimum safe working load of either:
- the hoist
- its attachments.
Ensure that mobile floor hoists and their attachments are inspected and tested before each use. A detailed inspection should take place once a year or as specified in the manufacturer’s instructions. A suitably qualified person should do the detailed inspection.
Damaged hoists or attachments should be reported and not used.
All floor hoists should be fully electric and eliminate the need for manual lifting by employees during transfers.
- Appropriate sling
Slings are fabric supports for lifting and carrying people while being moved with a hoist. There are different types of slings. Ensure the:
- chosen sling is endorsed for use on the lifting device
- weight and dimensions of the person being lifted do not exceed the sling’s size and safe weight limit, or the limit of the hoist, whichever is lower.
Ensure that slings are visually inspected before every lift. A detailed inspection should take place at least every 6 months or as specified in the manufacturer’s instructions. A suitably qualified person should do the detailed inspection. Replace damaged, worn-out and non-compliant slings immediately.
Slings are not ‘one size fits all’. Choose slings appropriate for the:
- task
- body, height, weight and shape of the person being lifted or transferred.
Where possible, slings should be positioned before a person is placed on the surface. Otherwise, employees should follow the appropriate information, instruction and training to safely place the sling under the person being moved.
For more information, also see ‘Using hoists and slings’ in Preparing for safe moves.
Related OHS information
Employers should also consider the occupational health and safety information outlined in the related guidance: