Describe the step-by-step procedure for moving a person up in bed with two nursing assistants, including the positioning and the count.

Two nursing assistants stand on opposite sides of the bed with the head of the bed as flat as possible. Each places one arm under the person's shoulders and one under the thighs, and they grasp each other's forearms beneath the person. The person grasps a trapeze and flexes both knees. On the count of '1, 2, 3,' the move is made on '3,' as the assistants shift their weight from their rear leg to their front leg while the person pushes with the feet and pulls on the trapeze.

Before moving the person, two nursing assistants should complete pre-procedure steps: follow delegation and safety guidelines, ask a coworker to help, perform hand hygiene, identify the person, provide privacy, lock the bed wheels, and raise the bed for good body mechanics with bed rails up if used. In the procedure, lower the head of the bed to as flat a level as the person can tolerate. One assistant stands on each side of the bed and lowers the bed rails if they are up. Pillows are removed as directed by the nurse; a pillow may be placed upright against the headboard if the person can be without it. Each assistant stands with a wide base of support, pointing the foot nearest the head of the bed toward the head of the bed, and faces the head of the bed. Each bends the hips and knees while keeping the back straight. Each assistant places one arm under the person's shoulders and the other under the thighs, and the two assistants grasp each other's forearms under the person. The person is asked to grasp the trapeze and to flex both knees. The assistants explain that they will count '1, 2, 3,' the move will be on '3,' and on '3' the person pushes against the bed with the feet if able and pulls up with the trapeze. On the count of '3,' both assistants move the person toward the head of the bed by shifting their weight from their rear leg to their front leg. The steps are repeated if necessary. Afterward, the pillow is replaced under the head and shoulders, linens are straightened, the person is positioned in good alignment, the head of the bed is raised appropriately, and comfort and safety measures are completed, including placing the call light within reach, lowering the bed, adjusting rails per the care plan, unscreening, performing a safety check, decontaminating hands, and reporting observations. This two-person technique is recommended for moving heavy, weak, or very old persons up in bed, and it is best done with at least two staff members even when the person can assist.