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Use of backrest elevation in critical care: a pilot study
Summary
Most patients in intensive care units remain in lower backrest positions, increasing the risk of ventilator-associated pneumonia. Higher backrest elevation is not linked to hemodynamic status or enteral feeding, suggesting convenience may drive current practices.
Area of Science:
- Critical Care Medicine
- Nursing Research
- Patient Safety
Background:
- Lower backrest positions are frequently used in intensive care units.
- This practice is associated with an increased risk of developing ventilator-associated pneumonia.
Purpose of the Study:
- To assess typical bed elevation and backrest positions in a medical intensive care unit.
- To investigate the relationship between backrest position, hemodynamic status, and enteral feeding.
Main Methods:
- Data collected over 2 months in a 12-bed medical respiratory intensive care unit.
- Head of bed elevation measured using a protractor.
- Hemodynamic status assessed via systolic, diastolic, and mean arterial blood pressure.
Main Results:
- Mean backrest elevation was 22.9 degrees; 86% of patients were in supine positions.
- Backrest position varied significantly by nursing shift (P = .005).
- No significant relationship found between backrest elevation and hemodynamic status or enteral feeding status.
Conclusions:
- Minimal use of higher backrest elevation (≥30 degrees) was observed.
- Higher backrest elevation was not associated with enteral feeding or hemodynamic status.
- The frequent use of lower backrest positions may stem from convenience or comfort, despite risks of aspiration and ventilator-associated pneumonia.