A draw sheet is a small, rectangular piece of linen placed horizontally across a bed, typically positioned under the middle section of a non-ambulatory patient. Its primary function is to minimize the mechanical forces of friction and shear that occur when a patient’s skin rubs against the bed linens during transfers and repositioning. By reducing these forces, the sheet helps prevent skin breakdown and pressure injuries, while also decreasing the physical strain placed on caregivers.
Preparing the Draw Sheet and Patient
Proper setup begins by ensuring the bed is flat and the patient’s head is lowered to a near-horizontal position. Communicate the procedure to the patient beforehand, explaining how they can assist or what sensations they might feel. The draw sheet must extend from the patient’s shoulders down to their mid-thighs or knees, covering the heaviest parts of the body.
To place the sheet, gently roll the patient onto their side away from you, tucking the rolled portion of the sheet firmly against their back. Roll the patient back onto their spine, then pull the sheet through and unroll it on the opposite side of the bed. The sides of the sheet should then be tightly rolled up close to the patient’s body to create secure handles for the caregivers to grip. This firm rolling maintains a strong, non-slip hold during the transfer.
Technique for Moving the Patient Up in Bed
Moving a patient toward the head of the bed should always be a coordinated, two-person procedure to distribute the weight evenly. Caregivers stand on opposite sides of the bed, near the patient’s hips and shoulders, grasping the rolled edges of the draw sheet. Instruct the patient to cross their arms over their chest to prevent limb injury during the movement.
Both caregivers must use proper body mechanics by bending their knees, keeping their backs straight, and positioning one foot forward in a lunge stance. The leader coordinates the movement with a clear count, such as “one, two, three, move.” On the count, the caregivers simultaneously shift their weight backward and upward, lifting the patient slightly off the bed surface and gliding them toward the headboard. This slight lift suspends the patient like a hammock, which effectively eliminates friction with the mattress.
Technique for Turning the Patient
Turning a patient onto their side relies on the draw sheet to control the movement. The first step involves using the draw sheet to move the patient closer to the side of the bed opposite the intended turn. This creates space and prevents the patient from rolling out of bed during the maneuver.
To achieve this lateral shift, both caregivers grasp the rolled sheet and gently slide the patient toward the far side of the bed. Next, the caregiver on the side toward the turn positions themselves to control the roll, ensuring the bed rails are lowered on that side. The draw sheet is then used to gently roll the patient onto their side, providing a stable anchor point. Once the patient is turned, immediately place pillows or foam wedges behind the patient’s back and between their knees to maintain the side-lying position and support alignment.
Essential Safety Guidelines
Before initiating any transfer, the bed wheels must be securely locked to prevent the bed from shifting. For any dependent patient or one who exceeds a moderate weight, a minimum of two trained caregivers should be involved in the move. After the patient is safely repositioned, the bed rails on the side opposite the caregivers should be immediately raised to prevent accidental falls.
Caregivers must employ proper body mechanics throughout the process, using the large muscles in their legs rather than straining their back muscles. Following the transfer, a skin assessment is necessary to check for any new areas of redness, blanching, or skin tears caused by the movement. Utilizing the draw sheet correctly protects the patient from skin shear and reduces the risk of musculoskeletal injury for the person providing care.