Positioning

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Introduction

In medical terms, ‘position’ relates to body position or posture. Moving and positioning lie within the broader context of manual handling. Positioning is a key aspect of patient care. Optimum pos itioning is a good starting point to maximize the benefit of other interventions, such as bed exercises and breathing exercises; it can also assist rest and mobility, thereby facilitating recovery and enhancing function. However, although it is important, it must not be seen in isolation and is just one aspect of patient management where the overall goal is to optimize independence.

It is essential to frequently evaluate the effect that positioning is having on the individual to ensure that the intervention is helping to achieve the desired result or goal. Consider whether the positioning procedure is being clinically effective and, where possible, is evidence based.

Purpose of Positioning

• Provide Comfort and Safety
• Provide Pain Relief
• Support & Stabilise Body Segments
• Facilitate Normal Activity
• Increase Sensory Input and Spatial Awareness
• Prevent further damage to Affected Limbs
• Prevent or Manage Contracture
• Prevent or Manage Pressure Area
• Prevent or Manage Oedema
• Improve Circulation
• Improve Respiratory Function
• Modify Muscle Tone
• Reference Point For Movement
• Support hygiene procedures or examinations

Indications

Patients should always be encouraged to move themselves. Assistance in positioning is indicated for patients who have difficulty moving or require periods of rest when normal function is impaired.

Contraindications

There are no general contraindications for positioning; however, some clinical conditions may require special considerations, preparation and specialist assistance.

Principles of Positioning

The main principles underpinning all interventions regarding patient positioning focus on the short‐ and long‐term goals of rehabilitation and management for each specific patient. It is imperative that a thorough assessment is carried out prior to any intervention in order to plan appropriate goals of treatment. Wherever possible, goal setting should be a joint patient and healthcare professional discussion. It may be necessary to compromise on one principle, depending on the overall goal.

Regular reassessment is necessary to allow for modification of plans to reflect changes in status. Communication and involvement of the multidisciplinary team will assist rehabilitation interventions as treatment can be incorporated during positional changes. This potentially allows an opportunity for multiprofessional working and allows many individuals to act with a common purpose and with co‐ordinated activity.

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