A Study to Assess the Effect of Therapeutic Positions on Hemodynamic Parameters among Critically Ill Patients in the Intensive Care Unit at Sri Ramachandra Medical Centre

Abstract

Positioning is one of the most frequently performed nursing activities in the critical care, often providing a central pivotal focus for planning other nursing activities. Currently, the concept of therapeutic positioning is emerging in trauma and critical care with the adaptation of research based positioning strategies designed to enhance or promote physiologic stability and tolerance of nursing and medical treatments. The study was aimed to determine the effect of therapeutic positions on hemodynamic parameters among critically ill patients. Experimental pre-test-post-test design was used. Samples were critically ill patients who got admitted in the C4 multidisciplinary intensive care unit of Sri Ramachandra Medical Centre. Simple random sampling was used to select 40 samples. Hemodynamic parameters such as heart rate, respiratory rate, systolic blood pressure, diastolic blood pressure, oxygen saturation, mean arterial pressure and the background variables of critically ill patients were studied together. Positioned the patients on various therapeutic positions for every two hours by following turning schedule such as left lateral, supine, right lateral, supine and semi fowler's position was carried out for the study group patients, whereas the control group received the routine care. Hemodynamic parameters were assessed before and after the positioning for both the groups for three days. There was a significant difference in systolic blood pressure in left lateral position at (t value 3.317) p<0.01 and oxygen saturation in semi fowler's position (t value 9.211) p<0.001. This study has attempted to identify the changes in hemodynamic parameters among critically ill patients while following turning schedule. The study shows that there was a significant difference in systolic blood pressure in left lateral position and oxygen saturation in semi fowler's position. Therapeutic positions based on turning schedule have a significant role in maintaining the hemodynamic parameters and preventing complications.