Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Force Management

  • Assess all surfaces upon which the client sits or lies in terms of pressure, friction and shear.
  • Assess all transfer and repositioning activities in terms of pressure, friction and shear.
  • Ensure that the client is comfortable on all surfaces
  • Ensure the equipment is in good working order and is not worn out.
  • Ensure the surfaces are positioned and used correctly.
  •  Check that the surface is not bottomed out:
    • Foam – should rebound to its original shape when the client’s weight is removed. If it does not rebound, it is considered bottomed out.
    • Air – slide your hand, palm down, between the client and the air surface at the lowest bony prominence. The client should be floating in the surface. If there is less than a half an inch of air between the client’s lowest bony prominence and the bottom of the surface, the surface has bottomed out.