Wound, Ostomy and Continence Nurses Society (WOCN) Practice Exam

What is one way to reduce shear in patients?

1. By increasing head of the bed elevation

2. By using a lift sheet

3. By allowing the legs to hang freely

4. By avoiding chair positioning

The correct answer is: By using a lift sheet

Using a lift sheet is an effective way to reduce shear in patients because it minimizes skin friction against the underlying surface when moving or repositioning a patient. Shear occurs when the skin moves in one direction while the underlying tissues remain stationary, which can cause damage to the skin and deeper tissues, especially in vulnerable individuals. Lift sheets allow for a smoother movement, as they can be used to slide or lift the patient without dragging the skin against bed linen or the surface. This technique is especially critical for patients who are immobile or have limited mobility, helping to prevent pressure ulcers and other complications associated with shear forces. In contrast, increasing the head of the bed can potentially increase shear on the patient's back when they slide down due to gravity. Allowing the legs to hang freely may not address the issue of shear effectively, as it could result in more movement of the body and potentially increase shear forces at the sacral area. Avoiding chair positioning may reduce shear in some cases, but it does not directly address the mechanisms of shear that occur during repositioning in a bed. Therefore, using a lift sheet is a clear method to mitigate shear forces effectively.