Positioning
Original Editors - Naomi O'Reilly and Stacey Schiurring
Top Contributors - Naomi O'Reilly, Stacy Schiurring and Jess Bell
Introduction[edit | edit source]
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 positioning is a good starting point to maximise 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. Positioning involves placing the patient into a specific static alignment, which can involve their entire body, or just a single body part or limb. Positioning can be achieved either actively by the patient, meaning they are able to move under their own volition, or passively, where the patient is placed into a specific position by another person. Patients in this second category require assistance with their mobility or have altered consciousness.
A major challenge to proper positioning is placing a dynamic body into a prolonged static position. The human body was made for movement, it does not tolerate prolonged periods of immobilisation well. This means the positioning must be comfortable and allow the patient to reposition as needed while maintaining the purpose behind the positioning. 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[edit | edit source]
- 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[edit | edit source]
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[edit | edit source]
There are no general contraindications for positioning; however, some clinical conditions may require special considerations, preparation and specialist assistance
Principles of Positioning[edit | edit source]
When approaching any therapeutic intervention, it is important to fully assess your patient before proceeding with therapeutic positioning. A patient should never be placed in a static position which will cause them harm or pain. The main principles underpinning all interventions involving patient positioning should focus on their 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.
Conclusion[edit | edit source]
Positioning is a useful therapeutic tool that can be individualized to a patient’s unique needs and limitations. It is a natural continuation of the assessment skills you have reviewed in previous courses. While positioning can appear simple and straightforward at the surface, I hope this course has provided some insight into the skill and mindfulness that goes into effective and safe positioning.
Resources[edit | edit source]
References [edit | edit source]
