Study of the ability of ICU staff to set a bed to the semi-recumbent position
© Keane and Kapoor; licensee BioMed Central Ltd. 2009
Published: 13 March 2009
The aim of this study was to assess the accuracy of setting the angle of the head of a bed to the semi-recumbent position. Ventilator-acquired pneumonias (VAPs) account for 31% of all ICU infections. Aetiology appears to be aspiration of contaminated oropharyngeal and gastric secretions around the endotracheal tube. The semi-recumbent position compared with the supine position is known to significantly reduce the incidence of VAP (8% vs. 34%) . Hence the National Institute for Clinical Excellence in the UK publishing a recommendation that ventilated patients be nursed at an angle of 30° to 45°.
Fifty-five members of ICU staff were asked to set the angle of the head of a standard ICU bed to 30° and 45°. The estimated bed angle was then measured accurately using a Mathey Dearman protractor.
Evidence suggests patients should be nursed in the semi-recumbent position to prevent VAP. However, we have found estimating the angle of a bed by eye is difficult and often inaccurate. Simple aids that highlight the angle of the bed have been shown to improve compliance to the semi-recumbent position by up to 71.5% compared with 21% in one study . Such aids to set the angle of the bed should be introduced in common practice to improve compliance with VAP guidelines.
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