Expert Answer: What kind of sheet is recommended to reposition a resident in bed?

Over half of all caregiver injuries stem from overexertion, often during patient repositioning. Understanding what kind of sheet is recommended to reposition a resident in bed is crucial for caregiver safety and resident dignity.

Quick Summary

Low-friction slide sheets and traditional draw sheets are the recommended tools. They minimize the physical effort for caregivers and protect residents from skin shearing during repositioning.

Key Points

• Friction is the Enemy: Repositioning sheets are designed to minimize friction and shearing forces on a resident's skin, which cause injury.

• Slide vs. Draw: Slide sheets offer the lowest friction for maximum safety, while traditional draw sheets provide a grip but require much more force.

• Safety in Numbers: Always use at least two caregivers for repositioning tasks to prevent injury to both the resident and the staff.

• Technique Over Strength: Correct body mechanics (using body weight, not back strength) are just as important as using the right equipment.

• Pressure Ulcer Prevention: Using low-friction sheets is a key, evidence-based strategy in preventing painful and dangerous pressure ulcers.

• Remove When Done: Tubular slide sheets should be removed after repositioning to prevent the resident from sliding out of position unintentionally.

The Critical Role of Proper Repositioning in Senior Care

Moving a resident in bed is one of the most common tasks in caregiving, yet it's fraught with risk for both the resident and the caregiver. Improper techniques can lead to painful skin tears, pressure ulcers (bedsores), and musculoskeletal injuries for staff. The single most effective way to mitigate these risks is by using specialized equipment designed for the task. The question isn't just about moving someone; it's about doing so safely, comfortably, and efficiently. This guide explores the tools designed for this purpose, focusing on which sheets are best for the job.

What are Repositioning Sheets?

Repositioning sheets, often called patient transfer sheets, are purpose-built tools that reduce the friction between a resident and the bed surface. Unlike a standard bed sheet, which can bunch up and create friction, these sheets are engineered to make sliding easier and safer. Their primary goals are to:

• Reduce Caregiver Strain: By minimizing friction, the force required to move a person is dramatically reduced, protecting caregivers from back, shoulder, and neck injuries.
• Protect Resident's Skin: They help prevent shearing—an injury that occurs when skin layers rub against each other or a surface—which is a major cause of pressure ulcers.
• Improve Resident Comfort and Dignity: A smooth, controlled movement is more comfortable and less jarring for the resident than being dragged or awkwardly lifted.

Types of Repositioning Sheets: A Detailed Look

There are two main categories of sheets recommended for repositioning a resident. Each has distinct advantages depending on the care environment and resident needs.

1. The Traditional Draw Sheet

A draw sheet is a small sheet, typically made of cotton or a cotton/polyester blend, placed over the middle of the bottom sheet. It extends from a resident's shoulders to their knees. Caregivers grip the edges of the draw sheet to pull or 'draw' the resident up or over in bed.

• How it Works: It provides a secure layer to grip, preventing caregivers from having to pull on a resident's limbs or clothes. While it's better than nothing, it does not significantly reduce friction.
• Best For: Minor adjustments, residents who can provide some assistance, and as a tool for turning.
• Pros: Inexpensive, widely available, washable, can be left under the resident.
• Cons: Still requires significant physical force, does not eliminate friction and shearing risk.

2. The Modern Slide Sheet (or Glide Sheet)

Slide sheets are the gold standard for safe patient handling. They are made from robust, silicone-coated nylon or a similar low-friction fabric. They come in two primary forms: flat and tubular.

• How it Works: A tubular sheet is a fabric loop that allows the two layers to slide effortlessly against one another. A flat sheet system involves two separate sheets. The resident is moved on the top layer, which glides over the bottom layer with almost no resistance.
• Best For: Fully dependent residents, bariatric patients, and any situation where minimizing friction is the top priority.
• Pros: Extremely low friction, drastically reduces force needed, protects skin from shearing, promotes proper ergonomic technique.
• Cons: More expensive than draw sheets, must typically be removed after use (especially tubular models) to prevent the resident from sliding unintentionally.

Comparison Table: Draw Sheet vs. Slide Sheet

Feature	Draw Sheet	Slide Sheet
Friction Reduction	Low	Very High
Caregiver Effort	High	Very Low
Skin Protection	Moderate	Excellent
Ease of Use	Simple concept, physically demanding	Requires some training, physically easy
Versatility	Good for turning and small boosts	Excellent for all repositioning tasks
Cost	Low	Moderate to High

A Step-by-Step Guide to Using a Slide Sheet (Two-Person Team)

Using a slide sheet correctly is key to its effectiveness. Always use at least two caregivers.

1. Prepare the Space: Ensure the bed is at a comfortable working height (waist-level for the shorter caregiver) and that the brakes are locked. Lower any bed rails on the sides you are working from.
2. Position the Sheet: Briefly and gently roll the resident onto one side. Place the folded or rolled slide sheet against their back, tucking it underneath them.
3. Roll and Unfurl: Gently roll the resident back over the folded sheet and onto their other side. The second caregiver then pulls the sheet through so it lies flat underneath the resident, from shoulders to below the hips.
4. Get a Secure Grip: Each caregiver should grab the edge of the top layer of the slide sheet, using an underhand grip. Stand with a wide base, one foot forward.
5. Perform the Move: On a count of three, caregivers should shift their weight from their front foot to their back foot, using their body weight—not their arms or back—to slide the resident smoothly up or across the bed.
6. Remove the Sheet: Once the resident is in the desired position, remove the slide sheet by gently rolling the resident side-to-side and pulling it out. This prevents accidental sliding later.

Choosing the Right Sheet: Key Considerations

When selecting a repositioning sheet, consider these factors:

• Resident's Needs: Is the resident completely dependent or can they assist? Are they at high risk for skin breakdown?
• Care Setting: A hospital may have different infection control and laundering requirements than a home care setting.
• Material and Durability: Look for sheets with reinforced stitching and materials that can withstand frequent industrial laundering.
• Handles: Some sheets come with built-in handles, which can provide a more secure grip, though grabbing the sheet itself is also effective.

Preventing Pressure Ulcers: The Bigger Picture

Repositioning sheets are a cornerstone of any pressure ulcer prevention program. Pressure ulcers are caused by sustained pressure, friction, and shearing. By virtually eliminating friction and shearing during movement, slide sheets directly combat two of the three primary causes. This equipment, combined with a consistent turning schedule and proper skin care, creates a robust defense against these dangerous and costly wounds. For more in-depth clinical guidelines, caregivers can reference resources from health authorities. Learn more about prevention strategies from the National Institute on Aging.

Conclusion: Making the Safest Choice

So, what kind of sheet is recommended to reposition a resident in bed? While a traditional draw sheet is better than no tool at all, the clear clinical recommendation for safety and effectiveness is the slide sheet. Its ability to minimize friction protects residents from painful skin injuries and empowers caregivers to perform their duties without risking their own physical health. Investing in high-quality slide sheets and proper training is one of the most impactful decisions a facility or home caregiver can make to elevate the standard of care.

Frequently Asked Questions

Can I just use a regular bed sheet as a draw sheet?

While a folded regular sheet can be used in an emergency, it creates significantly more friction than a dedicated draw or slide sheet, increasing the risk of injury to both the resident and caregiver.

How often should a resident be repositioned?

The widely accepted standard of care is to reposition at-risk individuals at least every two hours. However, the frequency should be based on a personalized assessment of the resident's specific condition and risk factors.

What's the difference between a slide sheet and a glide sheet?

The terms 'slide sheet' and 'glide sheet' are generally used interchangeably to describe the same product: a sheet made of very low-friction material designed for repositioning patients.

Are repositioning sheets washable?

Yes, almost all repositioning sheets are machine washable. It is crucial to follow the manufacturer's specific laundering instructions to maintain their low-friction properties and ensure longevity.

Do repositioning sheets help with boosting a resident up in bed?

Absolutely. This is one of their primary functions. They allow caregivers to slide a resident up toward the headboard with minimal pulling and effort, which is a common and high-risk care task.

Can one person use a slide sheet to move a resident?

For very minor adjustments with a partially cooperative resident, it may be possible. However, the universal safety standard is that two or more people should always be used for repositioning tasks to ensure stability and prevent injury.

Do you leave the slide sheet under the resident after moving them?

Generally, no. Tubular slide sheets must be removed to prevent the resident from sliding unintentionally. Some flat bottom sheets in a two-sheet system may be designed to stay, but the top sliding layer is typically removed.