The effects of different positions on saturation and vital signs in patients

Abstract

Background Patient positioning is an independent nursing intervention and may increase peripheral oxygenation for patients with lung disease. Few studies have been conducted on the effect of body positions on oxygenation in patients with lung disease. Aims and objectives To investigate the effects of five different positions on peripheral oxygen saturation (SpO2) and vital signs in patients with lung disease. Design A semi‐experimental study was conducted. Methods Consecutive samples were recorded from critical care patients followed in the chest clinic of a university hospital. A total of 109 patients with lung disease were recruited. Patients who were able to lie in all positions, and who had unilateral or bilateral lung disease documented by a medical diagnosis by a physician were included in this study. The SpO2 and vital signs were measured at each position three times. Results For patients with right, left, and bilateral lung disease, lying on the right side of the body at 45 in bed, the SpO2 was higher, but this difference was not statistically significant. There was a significant difference at 40 minutes between the pulse rate in patients with left and bilateral lung disease, but not in patients with right lung disease. No significant differences were found between respiratory rates and body temperature in patients in any of the three groups at 10, 25, and 40 minutes. Conclusions Although this difference was not statistically significant, lying on the right side of the body at 45 in bed can be an effective position for improving oxygenation in all patients with lung disease. Relevance to Clinical Practice As there is insufficient evidence to suggest a specific position, further studies are needed. This study provides evidence that the best oxygenation in patients with unilateral and bilateral lung disease can be obtained by determining the appropriate position for critical care nurses.

The effect of different bed head angles on the hemodynamic parameters of intensive care patients lying in the supine position: A quasi‐experimental study

“…Changing a patient's lying position to increase patient comfort and to ease pulmonary secretions is among the independent interventions carried out by nurses (Abd El‐Moaty et al, 2017). Despite its importance in patients with cardiovascular or cardiopulmonary dysfunction and oxygenation problems, there is insufficient evidence to recommend a particular position (Alan & Khorshid, 2021). Placing intensive care patients in a lying position at different angles can have an effect on the results of hemodynamic parameter measurements (Guérin et al, 2020; Hassan & Baraka, 2021; Rodríguez‐Huerta et al, 2022).…”

“…Putting patients confined to bed into position in the bed and changing this position at regular intervals is among the interventions which nurses can perform independently (Alan & Khorshid, 2021). However, putting the patient in the wrong position can have negative consequences for the patient, and for this reason care must be taken (Alan & Khorshid, 2021; Elamoudy et al, 2022; Hassan & Baraka, 2021).…”

“…Putting patients confined to bed into position in the bed and changing this position at regular intervals is among the interventions which nurses can perform independently (Alan & Khorshid, 2021). However, putting the patient in the wrong position can have negative consequences for the patient, and for this reason care must be taken (Alan & Khorshid, 2021; Elamoudy et al, 2022; Hassan & Baraka, 2021). It is reported that just as positioning makes an important contribution to the treatment and care of patients who are confined to bed in the intensive care unit, it may also have a negative effect or cause damage to patients' body functioning and systems (Binda et al, 2021; Lucchini et al, 2020).…”

“…It is reported that just as positioning makes an important contribution to the treatment and care of patients who are confined to bed in the intensive care unit, it may also have a negative effect or cause damage to patients' body functioning and systems (Binda et al, 2021; Lucchini et al, 2020). Wrong positioning of intensive care patients may have such results as disruption of ventilation rates, changes in cardiac functions, reductions in cerebral perfusion, an increase in intracranial pressure, and aspiration of stomach contents (Alan & Khorshid, 2021; De Cassai et al, 2022; Lucchini et al, 2020). For these reasons, the nurse must assess the intensive care patient as a whole before positioning, the position to be given to the patient must provide benefit, and it should provide a solution to problems arising from being confined to bed and help to prevent problems rather than increasing the patient's existing problems (Alan & Khorshid, 2021; Tor et al, 2019).…”

What's in our first online‐only issue?

“…Alan and Khorshid 5 investigated the effect on the respiratory and haemodynamic status of nursing patients with lung disease in five different positions: on the right and left side of the body at 45°; in the semi Fowler position at 45° and 60°; and sitting upright in bed at 90°. The paper presents a detailed summary of the changes in peripheral oxygen saturation, respiratory rate, pulse, temperature, and systolic and diastolic blood pressure from baseline to 40 minutes after the position change, and discusses the findings in the context of previous empirical and theoretical work on ventilation and perfusion.…”