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Clinicians' perception of head-of-bed elevation
Chad Hiner1, Tomoyo Kasuya, Christine Cottingham
1Harborview Medical Center, Seattle, Washington 98125, USA. Chiner@u.washington.edu
Summary
Clinicians
Area of Science:
- Critical care medicine
- Patient safety
- Infection prevention
Background:
- Head-of-bed elevation (30-45 degrees) is crucial for preventing ventilator-associated pneumonia (VAP).
- Accurate perception and determination of head-of-bed elevation by clinicians are not well-documented.
- Understanding these factors is key to improving VAP prevention strategies.
Purpose of the Study:
- To evaluate clinicians' accuracy in perceiving head-of-bed elevation.
- To identify methods used by clinicians to determine head-of-bed angles.
- To assess clinicians' knowledge of recommended head-of-bed elevation for VAP prevention.
Main Methods:
- 175 clinicians viewed a simulated patient with a 30-degree head-of-bed elevation (gauge concealed).
- Participants answered questions on perceived elevation, recommended angle for VAP prevention, and routine determination methods.
- Data collected from registered nurses, physicians, respiratory therapists, medical assistants, and physical/occupational therapists.
Main Results:
- Perception accuracy varied: 50-86% correct depending on clinician type (nurses 50%, physicians 53%, respiratory therapists 86%).
- Knowledge of the VAP-reducing angle was high (46-95%), with nurses and respiratory therapists demonstrating the best understanding.
- Elevation gauges were the most common method for determining the angle (58%).
Conclusions:
- Clinician perception of head-of-bed elevation accuracy ranges from 50% to 86%.
- Nurses tended to underestimate, while other clinicians tended to overestimate the angle.
- Nurses, respiratory therapists, and physical/occupational therapists showed superior knowledge regarding the optimal angle for VAP prevention.
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