Adjusting stroke patients' poor position: an observational study

Although nurses' role in rehabilitation has been generally ill-defined and consistently undervalued, of all professional groups, nurses working with s troke patients have potentially the greatest contribution to make. Stroke p atients are believed to benefit from good posture yet they can spend long p eriods in inappropriate positions. This study examined the positioning, han dling and mobilizing of stroke patients in hospital. Non-participant observ ation was used to gather data on stroke patients' position and nurses' acti vities. This paper addresses two basic questions - what causes the adjustme nt of patients from poor to good position and who is involved in achieving this adjustment. Poor position was observed to end 158 times in 380 'patien t hours' of observation. The most frequent causes of positional improvement were activities whose primary intention was unrelated to position correcti on. The deliberate adjustment of patients' position by nurses was a rare ev ent which occupied a small part of nurses' time. The potential for a more c onsidered and consistent nursing approach appears to be great.