M3 · Cannot turn or change position in bed
Actual Movement and self-care
Definition
The person cannot reposition without help.- Weakness
- pain
- sedation
- paralysis
- heavy casts
- Cannot roll
- slides down the bed
- needs help to sit up
📋 Scenario
A man in traction cannot turn without two nurses.
Subjective (S): "I can't turn myself."
Objective (O): In traction; needs two nurses to turn; slides down in bed.
Assessment tools for this scenario: CP-MOVE Movement & Self-Care Score
Validated scales to consider: Barthel Index, Katz ADL
**CarePath diagnosis:** Cannot turn or change position in bed related to weakness, as evidenced by cannot roll and slides down the bed.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Use turning aids. | Slide sheets and other aids reduce friction and force, making turns easier for the patient and safer for staff. |
| Assist safely. | Safe assistance, with enough people and the correct technique, protects both the patient and the nurses from injury during turning. |
| Reposition regularly. | Regular repositioning relieves pressure on the skin and lowers the chance of pressure injuries in someone who cannot turn alone. |
| Check skin. | Skin checks find early redness or damage from pressure, which is a risk when someone cannot move himself. |
| Teach use of bed handles. | Using bed handles lets him take part in moving, which builds strength, confidence and independence. |
**Expected outcomes**
- Turned every 2 hours safely.
- Skin stays intact.
- Patient uses the bed handle to help.
- No strain injuries to staff.
**Linking the data to the diagnosis**
A man in traction says, "I can't turn myself." He needs two nurses to turn him and slides down in the bed, so he cannot roll or change position without help. This is an actual problem, not a risk, because the inability to turn is already present. The plan aims to turn him safely every 2 hours with aids so that his skin stays intact and staff are not strained. It also aims to teach him to use the bed handle so that he can help with his own movement.
CarePath diagnosis
Cannot turn or change position in bed related to weakness, as evidenced by cannot roll and slides down the bed.
Interventions and rationale
Listed in priority order.
| Intervention | Rationale |
|---|---|
| 1. Use turning aids. | Slide sheets and other aids reduce friction and force, making turns easier for the patient and safer for staff. |
| 2. Assist safely. | Safe assistance, with enough people and the correct technique, protects both the patient and the nurses from injury during turning. |
| 3. Reposition regularly. | Regular repositioning relieves pressure on the skin and lowers the chance of pressure injuries in someone who cannot turn alone. |
| 4. Check skin. | Skin checks find early redness or damage from pressure, which is a risk when someone cannot move himself. |
| 5. Teach use of bed handles. | Using bed handles lets him take part in moving, which builds strength, confidence and independence. |
Expected outcomes
- Turned every 2 hours safely.
- Skin stays intact.
- Patient uses the bed handle to help.
- No strain injuries to staff.
Linking the data to the diagnosis
A man in traction says, "I can't turn myself." He needs two nurses to turn him and slides down in the bed, so he cannot roll or change position without help. This is an actual problem, not a risk, because the inability to turn is already present. The plan aims to turn him safely every 2 hours with aids so that his skin stays intact and staff are not strained. It also aims to teach him to use the bed handle so that he can help with his own movement.