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AACN clinical issues · Apr 2005
ReviewQuality improvement in backrest elevation: improving outcomes in critical care.
- Mary Jo Grap and Cindy L Munro.
- Department of Adult Health, School of Nursing, Virginia Commonwealth University, Richmond, VA 23298-0567, USA. mjgrap@vcu.edu
- AACN Clin Issues. 2005 Apr 1;16(2):133-9.
AbstractThe positioning of critically ill patients is an independent nursing decision, often has multiple rationales, and may significantly affect morbidity and mortality. Recent evidence suggests that backrest elevation in critically ill patients may reduce ventilator-associated pneumonia. However, use of recommended levels of backrest elevation is infrequent in the critical care environment. In addition, published guidelines for backrest elevation to reduce pneumonia conflict with those for protecting skin integrity. This article reviews the benefits and complications of backrest elevation, data related to current positioning practices, and recommendations for backrest elevation. A quality improvement process to guide evidence-based care related to backrest positioning is also described.
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