clinical patient care
Patient Positioning for Examination
Positioning means placing a patient so the provider can examine or treat the right area while the patient stays safe, covered and as comfortable as possible.
15 steps4 criticalLimit 3 minAlways tested
Steps
- 1Critical stepPerform hand hygiene and confirm the patient's identity using two identifiers
- 2Find out which position the provider's order or the exam calls for
- 3Explain what will happen and why, and how the patient can help; ask them to empty their bladder and put on a gown if the exam needs it
- 4Give privacy while the patient changes, and keep them covered with a drape
- 5Raise the bed or table to a safe working height and make sure the brakes are locked
- 6Supine or horizontal position: help the patient lie flat on the back with legs extended
- 7Fowler's position: help the patient lie on the back with the head raised to the height the provider orders
- 8Prone position: help the patient lie on the abdomen with the head turned to one side; check first that they can lie this way
- 9Sims' position: help the patient lie on the left side with the left arm behind the body and the right knee bent up toward the abdomen
- 10Critical stepLithotomy position: help the patient lie on the back with legs well separated, knees bent and feet in the stirrups; for a pelvic exam, buttocks about one inch past the table end
- 11Trendelenburg position (feet higher than head): use it only when the provider orders it
- 12Adjust the drape each time the position changes so the patient stays covered
- 13Critical stepCheck alignment and comfort, use pillows to support limbs if needed, and ask how the patient feels
- 14Before stepping away, lower the bed or table, check that the brakes are locked, and put the call light within reach
- 15Document the position used per your facility's policy, and document or report any skin issues or other changes you observe
What graders are watching for
Tips
- Know the positions by description: supine is flat on the back, Fowler's has the head raised, prone is face down, Sims' is on the left side with the left arm behind, lithotomy is on the back with feet in stirrups, and Trendelenburg has the feet higher than the head.
- Some positions do not suit some patients: Sims' may not suit a patient with leg injuries or arthritis, and prone may not suit one with an abdominal incision or breathing difficulty. Ask the provider rather than forcing the position.
- Never leave a patient alone in the knee-chest position; they may become dizzy, faint and fall.
Common mistakes
- Choosing a position by habit rather than by the order.
- Putting a patient head-down on your own initiative.
- Placing a patient on the right side for Sims' or leaving the arm in front.
- Forgetting to re-drape after a position change.
Practice this skill
Practise the sequence with critical-step highlighting and a rationale for each step.
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Sources and how we check them: How we verify.