Predictors of backrest elevation in critical care

Mary Jo Grap, Cindy Munro, Sandra Bryant, Brooke Ashtiani

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Low backrest and supine positions are associated with increased mortality and ventilator associated pneumonia (VAP). Data are not available across ICU settings about the level of backrest position used and its relationship to enteral feeding and hemodynamic status. The purpose of this descriptive study was to document the level of backrest elevation and position and identify factors associated with and predict positioning in a medical, surgical and neuroscience intensive care unit. Data were collected randomly in each unit over a 6-week period, resulting in 506 observations for 170 patients. Backrest elevation was determined by electronic bed read-out or bed frame elevation gauge. BP, HR and enteral feeding status were retrieved from the medical record. Results showed that mean backrest elevation was 19.2° and 70% of subjects were supine. No difference in backrest elevation among units was found. Significant correlations between backrest elevation and systolic BP (r= 0.15, P= 0.006); and backrest and diastolic BP (r= 0.13, P= 0.02) were found. There was no difference in backrest elevation between patients being fed and not being fed. Differences in backrest elevation for intubated versus nonintubated patients approached significance (P=0.07) with intubated patients at lower backrest elevations. In summary, use of higher backrest elevations (>30°) is minimal, is not related to feeding and minimally related to hemodynamic status. Strategies to meet published recommendations for backrest elevation (30-45°) must include repeated feedback about nurse's use of backrest elevation and estimates of elevation.

Original languageEnglish (US)
Pages (from-to)68-74
Number of pages7
JournalIntensive and Critical Care Nursing
Volume19
Issue number2
DOIs
StatePublished - Jan 1 2003
Externally publishedYes

Fingerprint

Critical Care
Enteral Nutrition
Hemodynamics
Ventilator-Associated Pneumonia
Supine Position
Neurosciences
Medical Records
Intensive Care Units
Nurses
Mortality

ASJC Scopus subject areas

  • Critical Care

Cite this

Predictors of backrest elevation in critical care. / Grap, Mary Jo; Munro, Cindy; Bryant, Sandra; Ashtiani, Brooke.

In: Intensive and Critical Care Nursing, Vol. 19, No. 2, 01.01.2003, p. 68-74.

Research output: Contribution to journalArticle

Grap, Mary Jo ; Munro, Cindy ; Bryant, Sandra ; Ashtiani, Brooke. / Predictors of backrest elevation in critical care. In: Intensive and Critical Care Nursing. 2003 ; Vol. 19, No. 2. pp. 68-74.
@article{ea1120aebb8844e08d76b52d09cae49f,
title = "Predictors of backrest elevation in critical care",
abstract = "Low backrest and supine positions are associated with increased mortality and ventilator associated pneumonia (VAP). Data are not available across ICU settings about the level of backrest position used and its relationship to enteral feeding and hemodynamic status. The purpose of this descriptive study was to document the level of backrest elevation and position and identify factors associated with and predict positioning in a medical, surgical and neuroscience intensive care unit. Data were collected randomly in each unit over a 6-week period, resulting in 506 observations for 170 patients. Backrest elevation was determined by electronic bed read-out or bed frame elevation gauge. BP, HR and enteral feeding status were retrieved from the medical record. Results showed that mean backrest elevation was 19.2° and 70{\%} of subjects were supine. No difference in backrest elevation among units was found. Significant correlations between backrest elevation and systolic BP (r= 0.15, P= 0.006); and backrest and diastolic BP (r= 0.13, P= 0.02) were found. There was no difference in backrest elevation between patients being fed and not being fed. Differences in backrest elevation for intubated versus nonintubated patients approached significance (P=0.07) with intubated patients at lower backrest elevations. In summary, use of higher backrest elevations (>30°) is minimal, is not related to feeding and minimally related to hemodynamic status. Strategies to meet published recommendations for backrest elevation (30-45°) must include repeated feedback about nurse's use of backrest elevation and estimates of elevation.",
author = "Grap, {Mary Jo} and Cindy Munro and Sandra Bryant and Brooke Ashtiani",
year = "2003",
month = "1",
day = "1",
doi = "10.1016/S0964-3397(03)00028-4",
language = "English (US)",
volume = "19",
pages = "68--74",
journal = "Intensive and Critical Care Nursing",
issn = "0964-3397",
publisher = "Churchill Livingstone",
number = "2",

}

TY - JOUR

T1 - Predictors of backrest elevation in critical care

AU - Grap, Mary Jo

AU - Munro, Cindy

AU - Bryant, Sandra

AU - Ashtiani, Brooke

PY - 2003/1/1

Y1 - 2003/1/1

N2 - Low backrest and supine positions are associated with increased mortality and ventilator associated pneumonia (VAP). Data are not available across ICU settings about the level of backrest position used and its relationship to enteral feeding and hemodynamic status. The purpose of this descriptive study was to document the level of backrest elevation and position and identify factors associated with and predict positioning in a medical, surgical and neuroscience intensive care unit. Data were collected randomly in each unit over a 6-week period, resulting in 506 observations for 170 patients. Backrest elevation was determined by electronic bed read-out or bed frame elevation gauge. BP, HR and enteral feeding status were retrieved from the medical record. Results showed that mean backrest elevation was 19.2° and 70% of subjects were supine. No difference in backrest elevation among units was found. Significant correlations between backrest elevation and systolic BP (r= 0.15, P= 0.006); and backrest and diastolic BP (r= 0.13, P= 0.02) were found. There was no difference in backrest elevation between patients being fed and not being fed. Differences in backrest elevation for intubated versus nonintubated patients approached significance (P=0.07) with intubated patients at lower backrest elevations. In summary, use of higher backrest elevations (>30°) is minimal, is not related to feeding and minimally related to hemodynamic status. Strategies to meet published recommendations for backrest elevation (30-45°) must include repeated feedback about nurse's use of backrest elevation and estimates of elevation.

AB - Low backrest and supine positions are associated with increased mortality and ventilator associated pneumonia (VAP). Data are not available across ICU settings about the level of backrest position used and its relationship to enteral feeding and hemodynamic status. The purpose of this descriptive study was to document the level of backrest elevation and position and identify factors associated with and predict positioning in a medical, surgical and neuroscience intensive care unit. Data were collected randomly in each unit over a 6-week period, resulting in 506 observations for 170 patients. Backrest elevation was determined by electronic bed read-out or bed frame elevation gauge. BP, HR and enteral feeding status were retrieved from the medical record. Results showed that mean backrest elevation was 19.2° and 70% of subjects were supine. No difference in backrest elevation among units was found. Significant correlations between backrest elevation and systolic BP (r= 0.15, P= 0.006); and backrest and diastolic BP (r= 0.13, P= 0.02) were found. There was no difference in backrest elevation between patients being fed and not being fed. Differences in backrest elevation for intubated versus nonintubated patients approached significance (P=0.07) with intubated patients at lower backrest elevations. In summary, use of higher backrest elevations (>30°) is minimal, is not related to feeding and minimally related to hemodynamic status. Strategies to meet published recommendations for backrest elevation (30-45°) must include repeated feedback about nurse's use of backrest elevation and estimates of elevation.

UR - http://www.scopus.com/inward/record.url?scp=0038742958&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0038742958&partnerID=8YFLogxK

U2 - 10.1016/S0964-3397(03)00028-4

DO - 10.1016/S0964-3397(03)00028-4

M3 - Article

C2 - 12706732

AN - SCOPUS:0038742958

VL - 19

SP - 68

EP - 74

JO - Intensive and Critical Care Nursing

JF - Intensive and Critical Care Nursing

SN - 0964-3397

IS - 2

ER -