Assisting the Resident to Move Up in Bed 

Purpose: 

• To reposition the resident for comfort. 

• To prevent pressure areas. 

• To improve circulation. 

Procedure: 

1. Preparation: 

• Raise the bed to a comfortable working height. 

• Lower the headrest. 

• Stabilize the bed to ensure it does not move during the procedure. 

2. Positioning Yourself: 

• Stand next to the bed with your feet about 12 inches apart. The foot closer to the head of the bed should be pointed in that direction. 

• Place one hand under the resident’s shoulder and one under the buttocks. 

3. Resident Preparation: 

• Ask the resident to bend their knees and brace their feet firmly against the mattress. 

• If not using a trapeze, instruct the resident to place their hands about hip level with elbows bent. 

4. Moving the Resident: 

• On the signal "one, two, three," have the resident push toward the head of the bed with their hands and feet against the mattress. 

• Simultaneously, slide the resident toward the head of the bed, keeping your back straight and knees bent. 

• If the resident is unable to push with their feet, a second CNA should assist with the process. 

5. Final Steps: 

• Replace the pillow under the resident's head. 

• Position the resident comfortably. 

• Lower the bed to its lowest position. 

• Place the call signal within reach of the resident. 

Compliance and Documentation: 

• Adhere to CMS guidelines and Requirements of Participation for Long-Term Care Facilities. 

• Document the repositioning procedure, including the resident’s response, in their medical record. 

• Note any observations related to comfort, skin integrity, and circulation. 

• Regularly review and update techniques for repositioning residents according to the latest clinical best practices and regulatory standards. 

• Provide training to staff on proper techniques for moving residents up in bed to ensure safety and comfort. 

• Conduct regular audits to ensure compliance with this policy and address any gaps in practice or documentation. 

References: 

• Centers for Medicare & Medicaid Services (CMS). State Operations Manual (SOM), Appendix PP - Guidance to Surveyors for Long-Term Care Facilities. 

• CMS Requirements of Participation for Nursing Homes.