Definition
Turning a patient to the lateral (side-lying) position is a fundamental nursing skill used to promote comfort, prevent pressure injuries, and assist with procedures like bedpan use or back care.
Purposes
- To perform procedures, such as changing linen and giving bedpan.
- To offer relief on pressure points in supine position.
- To facilitate hygiene, skin inspection, or procedures
- To relieve pressure on bony prominences (e.g., sacrum, heels)
- Prone maneuver or positioning the patient in prone position improves hypoxemia in patients with acute respiratory distress syndrome.
Procedure
| Nursing action | Rationale | |
| 1 | Before procedure Explain to patient what will be done and how it would help. In case of patients with tubing’s and medical devices attached, ensure that they are either disconnected or loosened as appropriate. Assess any chances of dislodgement of the tubing due to change in position. Before touching the patient sanitize the hand or wash hand as per hospital policy. | Knowledge of what to expect would reduce anxiety. A proper assessment of the attachments will prevent risk of injury, dislodgement Proper hand washing or sanitization prevents spread of infection. |
| 2 | During procedure Turning the patient in lateral position: Position yourself and the patient appropriately before the procedure. Move the patient to the side of bed where the nurse stands so as to have the patient face the opposite side when turned. While standing on the side of the bed nearest the patient, place the patients near arm across chest. Abduct the far arm –flexing at the elbow. Flex the knees of the leg near to you and place patient’s nearest ankle across the far ankle and foot. Raise the side rails next to patient. Go to the other side of the bed. Position yourself on the side of the bed towards which will turn directly in line with the patient’s waistline. Incline your trunk forward from the hips. Flex your hips, knees and ankles. Assume a broad stance with weight place on the forward foot. | This ensures that the patient will be positioned safely in the center of bed when turned. Pulling one arm forward facilitates turning motion. Pulling the other arm away from body prevents that arm from being caught beneath the body. Facilitates turning motion. |
| 3 | Pull/roll the patient to a lateral position. Two-heaviest parts of the body are supported: Place one hand on the patient’s far hip and one hand on the patient’s far shoulder. Tighten your gluteal muscles, rock back shifting your weight and abdominal muscles from forward to backward foot. Roll patient to side of the bed to face the nurse into a side-lying or lateral position. |
Special Considerations
Never pull the patient across the bed when the patient is in a prone position as it may injure a woman’s breast or man’s genitals.
- Avoid lying on the arm underneath
- Use friction-reducing devices if needed
- Monitor for skin redness, discomfort, or respiratory changes
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwer’s, ISBN-13:978-9388313285
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