Turning, rolling or repositioning a person in bed

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.

It might be helpful to tap the side of the bed the person is to turn to.

For more information, also see Preparing for safe moves.

Where appropriate, use the electric bed functions to help with the task. A powered patient turning and repositioning system can help, if available and included in the person’s care plan.

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.

Bed sticks are devices that slide under the mattress or clamp on to the bed frame. They can help people reposition themselves and roll over.

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 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 bed.

Position a double layer of slide sheets under the person’s hips and shoulders. This will:

• help to reduce friction between their body and the surface
• reduce the force required for the person to roll themselves.

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.

Where appropriate, use the electric bed and mattress functions to help with the task.

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.

A powered patient turning and repositioning system can help, if available and included in the person’s care plan.

Placing 2 slide sheets under the full body of a person who cannot help with their move works best for turning, rolling and repositioning. 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 the slide sheet is functional. Replace slide sheets that do not slip. Refer to manufacturer’s guidelines on when to replace slide sheets.

Wall-mounted and ceiling-mounted hoists are connected to ceiling tracks. They move people inside a sling from one point to another. They can be used to help people roll in bed.

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 and ceiling 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 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 attachments 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.

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.

All floor hoists should be fully electric and eliminate the need for manual lifting by employees during transfers.

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 provided to safely place the sling under the person being moved.

For more information, also see ‘Using hoists and slings’ in Preparing for safe moves.