University of Perpetual Help System

Isabela Campus
Minante I, Cauayan City

PERFORMANCE EVALUATION TOOL FOR POSITIONING

Name: _______________________________________________ Rating: ______________________

Year/ Section: ________________ Group: ________________ Date: ______________________

Direction: Please rate the learner based on the competencies listed below
0 - NOT OBSERVED ( task was not demonstrated by the student)
1 - UNACCEPTABLE (performance was ineffective and inefficient)
2 - NEEDS IMPROVEMENT ( task was performed with some deficiency)
3 - ACCEPTABLE (student performed the task well enough)
4 - COMPETENT (student performed the task quickly, thoroughly & precisely)

PROCEDURE SCORE Remark

4 3 2 1 0
BODY MECHANICS and NPI
 Observe proper body mechanics

 Assemble equipment and supplies

 Check doctor’s order, verify client’s identity, greet the client,

explain the procedure and instruct the patient properly.

POSITIONING
1. SUPINE

 Flat on bed

 Pillow under the head (no pillow for post-operative

clients)

 Place a trochanter roll along the hips

 Support the feet to prevent foot drop

2. LATERAL

 Turn patient to either side as one unit (logrolling)

 Pillow under the head and at the back for support

 Arm on the lying side is flexed so that it is resting in front

of face and the hand facing up

 The other can be extended or slightly flexed and rest it on

patient's hip or bring it forward and place it on a pillow.

 The top leg will be flexed forward with pillow support

3. SIMS

 Patient on either side with pillows under the head

 The arm on the lying side is extended and positioned

behind the patient.

 Flex the other arm and bring it forward. Support with a

pillow.

 The leg is flexed forward and supported with a pillow

  Chest and abdomen is partially lying on bed

 Ensure privacy

4. PRONE

 Patient is flat and lying on abdomen

 Turn patient to face on either side

 Place a small pillow under the head

 Place a small pillow on the abdomen to reduce pressure

on breasts (OPTIONAL)

 Position arms in the way most comfortable for the patient

 Place small pillow under the lower legs to prevent

pressure on the toes

5. KNEE-CHEST

 From prone position raise the patient's buttocks so that

the body is flexed upward

 The patient rests on the knees and upper part of the chest

 Ensure privacy

6. DORSAL RECUMBENT

 Patient is on his back with knees flexed and soles of feet

flat on the bed.

 Fold sheet once across the chest.

 Fold a second sheet crosswise over the thighs and legs so

that genital area is easily exposed.

 Ensure privacy

7. LITHOTOMY

 Patient is laid on the back with knees bent, positioned

above the hips, and spread apart through the use of
stirrups

 Ensure privacy

8. FOWLER'S

 High fowlers – elevate head of bed to 90 degrees

 Semi fowlers – elevate head of bed 30-45 degrees

9. Assisting patient to sit on bed (dangling position)

10. Assisting the patient from bed to a bed side chair

Evaluated by: _______________________________

Checklist prepared by:
H. Cortez, RN, MAN -UPHS
Clinical Instructor