Therapeutic positioning in CCU

Abstract

Repositioning is conceptualized as turning the patient from side to side when lying in bed or on a similar surface. Healthy individuals change positions, even during sleep, approximately every 12 min. A variety of sensory cues prompt a change in body position. These sensory cues prevent detrimental effects of prolonged periods of immobility. Individuals who have neurological impairments must rely on others to reposition them to prevent hazards of immobility. Nurses use clinical judgment based on physiological and scientific evidence to position critically ill patients to prevent complications of immobility and to achieve optimal patient outcomes. Therapeutic positioning in stationary positions is done to optimize ventilation and perfusion and to promote effective pulmonary gas exchange. In the critical care population, heart rate and rhythm, blood pressure, respiratory rate, and oxygen saturation are monitored continuously, providing immediate feedback regarding any changes in patient status. Hemodynamic instability is a term commonly used by clinicians to describe labile changes in cardiopulmonary status. The clinician's perception of hemodynamic instability may cause a delay or omission in turning, repositioning, and other interventions to advance patient mobility and may contribute to pressure ulcer formation. The exhaustive care unit's exercise culture and individual clinician insights concerning hemodynamic uncertainty may lead to staff not revolving patients out of anxiety that they are “too unbalanced to turn.” Critical care personnel determine the quality of patient care and patient outcomes. Interdisciplinary care is based on a comprehensive approach that includes standards and guidelines consistent with high quality evidenced based care.