Repositioning and positioning in bed to prevent pressure ulcers

Relieving pressure rather than just repositioning: assessing risk, drawing up an individual movement plan, performing the 30° side position and micro-positioning correctly, floating the heels and using aids in a targeted way.

Content created with AI assistance from public clinical sources (RKI, AWMF) – may contain mistakes; if in doubt, your textbook is right

Translated from the German original, which is authoritative. The exam itself is in German.

Material

• Positioning cushions in various sizes, small towels or positioning rolls for micro-positioning if needed
• Slide sheet or slide mat, second person if needed
• Pressure-redistributing mattress (soft positioning or alternating pressure) according to assessment or prescription, set according to the manufacturer’s instructions
• Movement or positioning plan and documentation sheet
• Disposable gloves in case of incontinence or contact with excreta

Typical mistakes in the exam

• Rigidly repositioning every two hours without assessing the skin
• Positioning the person in a 90° side-lying position directly on the trochanter
• Pulling the person up the bed instead of moving them with a slide sheet or kinaesthetics
• Massaging reddened skin or rubbing it with Franzbranntwein (alcohol-based rubbing liniment)
• Letting the heels rest on the cushion instead of floating them
• Carrying out repositioning but not documenting it

What examiners ask afterwards

• How do you carry out the finger test, and what does a positive result mean?
• Why a 30° and not a 90° side-lying position?
• How do you set the interval for repositioning?
• What disadvantages can a soft positioning mattress have?
• What are shear forces, and how do you avoid them?

Sources

• Expertenstandard Dekubitusprophylaxe in der Pflege (DNQP)
• EPUAP/NPIAP/PPPIA: Prevention and Treatment of Pressure Ulcers/Injuries — International Guideline
• Expertenstandard Erhaltung und Förderung der Mobilität in der Pflege (nach § 113a SGB XI)
• Herstellerangaben zu druckverteilenden Matratzensystemen