Bed Positioning21. Use bed positioning devices and techniques that are compatible with the bed type and the individual's health status.Avoid positioning individuals directly on pressure ulcers regardless of the pressure ulcer anatomical location (trochanter, ischium, sacrum, and heel) unless such position is necessanry for performance of ADLs, such as eating or hygiene.Use pillows, cushions, and positioning aids to reduce pressure on existing pressure ulcers or vulnerable skin areas by elevating them away from the support surface.Avoid closed cutouts or donut-type cushions.Prevent contact between bony prominences.Elevate the head of the bed no higher than 30 degrees unless medically necessary.Reposition individuals in bed at least every 2 hours. Sources: Sackett, D.L. Rules of evidence and clinical recommendations on the use of antithrombotic agents. Chest 95 (2 Suppl) (1989): 25-45; and the U.S. Preventive Health Services Task Force. Guide to clinical preventive services: An assessment of the effectiveness of 169 interventions. Baltimore, MD: Williams and Wilkins, 1996.