Which action best maintains safety when positioning a resident in a side-lying position?

• A. Leave resident positioned on side with upper knee bent in front of the lower leg
• B. Keep the rest of the body completely flat on the bed
• C. Place pillow under the head only, not neck
• D. Place device/padding or pillow between legs so that the knees and ankles are separated

Answer: (D)

Safe side-lying relies on keeping the spine, hips, and legs properly aligned while distributing pressure to prevent skin breakdown. Placing a pillow or padding between the knees and ankles keeps the legs separated, which maintains hip alignment, prevents the upper leg from resting against the lower leg, and reduces friction and pressure on bony areas. This setup also helps protect nerves and circulation by avoiding crowding of the limbs and provides better overall stability in the position. Other approaches don’t offer the same level of alignment and support: letting the upper knee lie in front of the lower leg can twist the hip and create pressure or misalignment; keeping the rest of the body flat provides insufficient lateral support; and placing a pillow only under the head neglects support for the legs and hips. Therefore, using padding between the legs is the safest and most effective choice.