Supported Fowlers Position

Raised bed to comfortable working height and

  1. put bed in flat position.
  2. Perform hand hygiene.
  3. Close door to room or close bedside curtains.
  4. Realign patient in correct body alignment, based on patient’s level of hemiplegia.

Positioning a nonhemiplegic patient in supported Fowler position

  1. Elevate head of bed 45 to 60 degrees.
  2. Rest head against mattress or on small pillow.
  3. Use pillows to support arms and hands if patient does not have voluntary control or use of hands and arms.
  4. Position pillow at lower back.
  5. Place small pillow or roll under thigh.
  6. Place small pillow or roll under ankles.
  7. To keep feet in proper alignment, place footboard at bottom of patient’s feet, apply high-top sneakers on patient’s feet, or use other devices to maintain dorsiflexion.
  8. Return bed to lowest position and replace side rails.
  9. Perform hand hygiene.

Positioning a hemiplegic patient in supported Fowler position

  1. Elevate head of bed 45 to 60 degrees.
  2. Position patient in sitting position as straight as possible.
  3. Position head on small pillow with chin slightly forward. If patient is totally unable to control head movement, hyperextension of the neck must be avoided.
  4. Provide support for involved arm and hand by placing arm away from patient’s side and supporting elbow with pillow.
  5. Position flaccid hand in normal resting position with wrist slightly extended, arches of hand maintained, and fingers partially flexed; may use section of rubber ball cut in half; clasp patient’s hands together. Position spastic hand with wrist in neutral position or slightly extended; fingers should be extended with palm down or may be left in relaxed position with palm up.
  6. Flex knees and hips by using pillow or folded blanket under knees.
  7. Support feet in dorsiflexion with firm pillow, footboard, or high-top sneakers.
  8. Return bed to lowest position and replace side rails.
  9. Perform hand hygiene.

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