Operating room nurses' positioning of anesthetized surgical patients

Abstract

Aims and objectives: To describe the incidence of problems associated with the positioning of anaesthetised surgical patients.

Background: The positioning of the anaesthetised surgical patient is a complex task. The interdisciplinary nature with several professional groups in a surgical team may lead to conflict between the positioning standards and individual consideration for the patient. Existing knowledge of the relationship between the different positioning forms, surgical team competences and the applicability and availability of positioning equipment is sparse.

Design: A descriptive cross-sectional study.

Method: An electronic questionnaire was sent to 833 OR nurses employed at four public university hospitals. With 481 responses, a response rate of 57·7% was achieved. Descriptive statistical analyses were performed using the spss software package (version 19.00).

Results: Positioning of the patient was found to be particularly difficult for the prone (43·8%), lithotomy (53·4%) and lateral (65·5%) positions. Lack of positioning competences and equipment for arm support, standardised equipment for leg support and standard sizes of OR beds seemed to complicate positioning.

Conclusion: Lack of appropriate positioning equipment and positioning competences in surgical teams, combined with the poor availability of positioning equipment in ORs were found to cause problems.

Relevance to clinical practice: There is a need for innovative solutions to develop modern forms of positioning equipment allowing individual consideration of the patient. Further research is required on positioning equipment, optimisation of continuity and the establishment of permanent surgical teams.

Keywords: electronic questionnaire; operative surgical procedures; patient positioning; perioperative nursing; surgery.