A prospective observational study of ICU patient position and frequency of turning

Abstract

SummaryPositioning and turning critically ill patients may be beneficial but there are little data on current practice. We prospectively recorded patient position every hour over two separate days in 40 British intensive care units and analysed 393 sets of observation. Five patients were prone at any time and 3.8% (day 1) and 5% (day 2) were on rotating beds. Patients were on their back for 46.1% of observations, turned left for 28.4% and right for 25.5%, and head up for 97.4%. A turn was defined as a change between on back, turned left or turned right. The average time (SD) between turns was 4.85 (3.3) h. There was no significant association between the average time between turns and age, weight, height, gender, respiratory diagnosis, intubated and ventilated, sedation score, day of week or nurse:patient ratio. There was a significant difference between hospitals in the frequency with which patients were turned.

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“…In this study, researcher found that most of the nurses were mobilizing their mechanically ventilated patient 3 times or more per shift work which was consistent to other studies [36,37]. It means that in one shift work of 7 h, they are practicing 2 hourly mobilization according to protocol.…”

“…In this survey, researcher could not find any association between nurses' demographic data and nurses' EM practice which was consistent with one of the studies [36], no association between nurse to patient ratio and nurses' practice. It was difference compare to others study as some studies showed that nurses' education level, mobilization training [41], nurses experience associate with EM practices.…”

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“…Close to 50% of patients during that same period had no change in body position. 27 In a study 28 of the positioning of critically ill patients in a 2-day period in 40 ICUs in the United Kingdom, the average time between manual turns was 4.85 hours, with a standard deviation of 3.3 hours.…”