Adjusting stroke patients' poor position: an observational study

Although nurses' role in rehabilitation has been generally ill-defined and consistently undervalued, of all professional groups, nurses working with stroke patients have potentially the greatest contribution to make. Stroke patients are believed to benefit from good posture yet they can spend long periods in inappropriate positions. This study examined the positioning, handling and mobilizing of stroke patients in hospital. Non-participant observation was used to gather data on stroke patients' position and nurses' activities. This paper addresses two basic questions--what causes the adjustment of patients from poor to good position and who is involved in achieving this adjustment. Poor position was observed to end 158 times in 380 'patient hours' of observation. The most frequent causes of positional improvement were activities whose primary intention was unrelated to position correction. The deliberate adjustment of patients' position by nurses was a rare event which occupied a small part of nurses' time. The potential for a more considered and consistent nursing approach appears to be great.