Pre‐procedure

ActionRationale

1. 1.Show
   Introduce yourself to the patient, explain and discuss the procedure with them, and gain their consent to proceed.
   To ensure that the patient feels at ease, understands the procedure and gives their valid consent (NMC [91], C).
2. 2.Show
   Wash hands thoroughly or use an alcohol‐based handrub.
   To reduce the risk of contamination and cross‐infection (NHS England and NHSI [83], C).

Procedure

1. 3.Show
   Ensure the bed is at the optimum height for the handlers. If two handlers are required, try to match the handlers’ heights as far as possible.
   To minimize the risk of injury to the practitioners (Treadwell [123], E).
2. 4.Show
   Ask the patient to bend both knees and turn their head towards the direction they are moving. Ask the patient to reach towards the side of the bed with the uppermost arm and roll onto their side.

   Abdominal wounds should be supported by the patient's hands. Extra care should be taken with patients who have joint pathology, oedema, ascites or positional vertigo (dizziness or giddiness).
   To assist the patient to roll using their bodyweight. E
3. 5.Show
   Ask the patient to bend their knees and lower their feet over the edge of the bed (Action figure 7.4).

   Ask the patient to push through the underneath elbow and the upper arm on the bed to push up into a sitting position (Action figure 7.5). As the patient sits up, monitor changes in pain or dizziness, which could indicate postural hypotension or vertigo. Be aware that a patient with neurological symptoms or weakness may not have safe sitting balance and may be at risk of falling. Refer to Procedure guideline 7.10: Positioning the neurological patient with tonal problems in bed.
   To help to lever the patient into a sitting position using the weight of their legs. E
4. 6.Show
   Assist the patient to achieve an upright sitting position with appropriate alignment of the body parts.
   To ensure a safe sitting position. E

Post‐procedure

1. 7.Show
   Once the patient is on the edge of the bed, safely supported as required, continue to mobilize or transfer them to a wheelchair, commode or chair using local mobilizing policy.
   To ensure safe transfers. E
2. 8.Show
   Document the details of the procedure.
   To fulfil the legal requirements of the professional body and employing institution (NMC [91], C).