Movement, repositioning and avoiding friction or shear

Movement protects skin because it relieves pressure. NICE quality standards say people at risk should receive advice on the benefits and frequency of repositioning, and people who cannot reposition themselves should be helped to change position. For carers, the practical rule is to follow the resident's current repositioning or mobility plan, not to guess or leave the person too long because the shift is busy.

NICE quality statements describe at least every 6 hours for adults at risk and at least every 4 hours for adults at high risk as a safety basis for repositioning advice and plans, but the individual's live care plan and clinical advice come first. Carers should also avoid dragging or sliding people across sheets or chairs, because friction and shear can damage skin even when there is no obvious wound at the time.

What safer repositioning looks like

• Follow the current plan: use the agreed position changes, support level and timing.
• Encourage independent movement where possible: even small weight shifts can help if the resident can do them safely.
• Use approved methods and equipment: move and handle in line with training and the moving-and-handling plan.
• Avoid dragging and bunching: creased bedding, sliding and pulling can increase skin stress.
• Watch comfort and pain: if a position cannot be tolerated, do not ignore it.

Repositioning is not just about turning. It is also about how the person is moved, supported and kept from sliding into skin damage.