Turning a stroke patient in bed requires a gentle, systematic approach to ensure their safety, comfort, and proper body alignment, particularly considering potential weakness or paralysis on one side. This careful positioning helps prevent complications such as pressure sores and joint stiffness.
How to Turn a Stroke Patient in Bed?
Turning a stroke patient involves careful preparation, mindful execution, and proper post-turn positioning to support their affected limbs and maintain comfort.
Preparing for the Turn
Before you begin, ensure you have adequate space and necessary aids. Communication with the patient is key, even if their communication is limited; explain each step clearly and slowly.
- Gather Supplies: Have several pillows or wedges ready. These are crucial for supporting the patient's weak limbs and maintaining their new position.
- Adjust Bed Height: Raise the bed to a comfortable working height for you to prevent back strain. Lower the side rail on the side you are working from.
- Position Patient:
- Move Patient Closer: Gently slide the patient closer to the side of the bed you are working from (the side you will be turning them away from). This provides more room on the side they will be turned towards.
- Cross Limbs: Cross the patient's strong leg over their weak leg. Bring the patient's strong arm across their chest.
- Address Weak Arm (if patient is lying on weak side): If the patient is currently lying on their weak side, it's crucial to gently move their weak arm away from their body before turning. This prevents the arm from getting trapped or injured beneath their body during the roll.
Executing the Turn
Once the patient is prepared, perform the turn smoothly and with controlled movements.
- Initiate the Roll: Stand on the side of the bed towards which you will turn the patient. Place one hand on their hip and the other on their shoulder (or strong arm). Gently but firmly, roll the patient onto their side, moving them towards you.
- Support the Body: As you roll the patient, allow their body to gently rest on the pillows you will place to support them in their new side-lying position.
Post-Turn Positioning and Support
Proper positioning after the turn is vital for comfort and preventing complications.
- Pillow Under Weak Arm: Place a pillow under the patient's weak arm to support it. This helps prevent the arm from hanging unsupported, which can cause discomfort or nerve compression.
- Pillow Under Weak Leg: Follow this by placing another pillow under their weak leg. This helps maintain proper alignment of the hip and knee, preventing the leg from rotating inward or outward.
- Back Support: Place pillows or wedges behind the patient's back to help them maintain the side-lying position and prevent them from rolling back onto their back.
- Head and Neck: Ensure the patient's head and neck are supported with a comfortable pillow, maintaining a neutral alignment.
Key Considerations for Caregivers
- Body Mechanics: Always use good body mechanics to protect yourself from injury. Bend at your knees, not your waist, and use your leg muscles to help with the turn.
- Regular Turning: Stroke patients, especially those with limited mobility, should be turned every two hours (or as advised by a healthcare professional) to prevent pressure injuries and promote circulation.
- Patient Feedback: Continuously communicate with the patient and observe their facial expressions for any signs of discomfort or pain.
- Seek Assistance: If the patient is heavy or difficult to turn alone, always enlist the help of another person to ensure safety for both you and the patient.
- Skin Inspection: Each time you turn the patient, take a moment to inspect their skin for any signs of redness, open areas, or irritation, especially over bony prominences. Early detection of pressure points can prevent more severe pressure injuries.
By following these steps, you can safely and effectively turn a stroke patient, promoting their comfort and well-being. For more general information on safe patient handling, you can refer to resources like MedlinePlus from the National Library of Medicine.
