Nursing & Healthcare Programs

Prone Position

Written by Hollie Finders, RN
Hollie Finders is a registered nurse with years of experience working in the health care field. She has degrees in both biochemistry and nursing. After working with patients of all ages, Hollie now specializes in pediatric intensive care nursing. Hollie’s LinkedIn

Procedure

Equipment needed: pillow.

  1. Perform hand hygiene.
  2. Explain the procedure to the patient and ask for his or her assistance in following directions.
  3. Lock the bed wheels and raise the bed to a comfortable working height.
  4. Lower the side rail on the working side. Ensure the opposite side rail is raised.
  5. Lower the head of the bed until the bed is completely flat.
  6. If the patient is in the supine position, move the patient to the side of bed and turn the patient onto his or her side.
  7. Once the patient is side lying, decide if there is enough room to complete the roll onto the patient’s stomach.
  8. If there is not enough room, move the patient to the side of the bed while he or she remains in a side lying position.
  9. When there is adequate room, complete the roll by assisting the patient onto his or her stomach.
  10. Ensure the patient’s head is turned onto its side. Place a pillow under the head for comfort. Pillows or rolled towels can also optionally be placed under the abdomen and the shins to help maintain proper body alignment.
  11. Position the hands at the patient’s sides or flex the arms and allow the hands to rest next to the patient’s face.
  12. Ensure the patient is comfortable, return the side rails to their original position, lower the bed, and make sure the call light is within the patient’s reach.
  13. Perform hand hygiene.
  14. Document the procedure in the patient’s chart and report any changes in the patient’s condition to the nurse.

Important Information About the Prone Position

Prone position is not used as commonly as other patient positions. This position allows for full extension of the hips and the knees and gives many bony prominences a break from continuous pressure. However, placing patients in prone position does not come without the risks of pressure ulcers. In the prone position, there is excess pressure placed on areas of the forehead, chin, clavicles, chest, pelvis, knees, and feet [1]. For this reason, it is important to continue to reposition patients at least every two hours.

In the prone position, many patients can experience adverse effects if the body is not properly aligned and supported. Patients who suffer from hyperextension of the back in the prone position can benefit from a pillow or towel roll placed under the abdomen. This helps reduce extreme curvature of the back, and ultimately, reduces pain. A pillow placed under the patient’s shins will help support the legs and ankles and prevent foot drop. Depending on the patient’s condition, prone position may not be recommended. Always consult with the nurse before turning the patient prone.

References

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4390897/

More Resources

Performing Ostomy Care

Residents who have had a portion of their intestines removed due to illness or trauma may have a temporary or permanent ostomy, which is an opening in the abdomen that is created for the elimination of urine or feces. The portion of the intestine that is connected to the abdominal wall and is visible is called the stoma. A pouch is placed over the stoma to collect feces.

Removing Personal Protective Equipment

It is important to follow the correct procedure while removing personal protective equipment to avoid contaminating your skin or clothing. The most common source of contamination in this process stems from improper removal of gloves. Gloves are often the most soiled piece of equipment. To avoid contaminating your skin or the other equipment worn, gloves should always be removed first. Then remove the goggles, gown, and mask, in that order.

Orthopneic Position

Patients with respiratory illnesses such as chronic obstructive pulmonary disease (COPD) find ways to help themselves breathe more easily. This can include sleeping with extra pillows to keep them propped up or leaning forward to ease the work of breathing. The orthopneic position is one forward-leaning position used to help patients breathe comfortably when they are having difficulty.

Measuring the Radial Pulse

The radial artery, located in the wrist, is easy to feel and an efficient location to measure heart rate. Changes to the rhythm or strength of the radial pulse can indicate heart disease, damage to the arm, or body fluid status. It is important to remember to check the radial pulse on both sides as differences between left and right can indicate injury or disease processes.

Transferring the Resident from a Bed with a Mechanical Lift

A mechanical lift is used to transfer residents who cannot support their own weight. When used properly, mechanical lifts prevent injuries for both residents and health care workers. It is important that a nurse’s assistant be trained to use the mechanical lift before attempting to operate it. Most facilities require at least two health care workers to assist when using a mechanical lift.

Moving the Resident from a Bed to a Stretcher or Gurney

Moving a patient from a bed to a stretcher can pose huge safety risks to both the patient and to the health care workers completing the transfer. Always use the appropriate amount of people to complete a transfer, which may vary according to the patient’s weight and/or the facility’s policy. In some cases, a mechanical lift may be needed.