Review of Current Early Bed Positioning Practice by Occupational Therapists With Patients Post-Acute Stroke

Abstract

Abstract Background Many patients experience varied degrees of physical impairments post stroke, which can impact their ability to adjust their posture and position independently. National guidelines state that positioning should be assessed promptly and within 4 hours of arrival to hospital (National Clinical Guideline for Stroke for the UK and Ireland, 2023). Therefore, occupational therapists (OTs) working in stroke should prioritise positioning as early as possible within the intervention process. Aim: To highlight current practice and appraise in line with clinical standards to promote the importance of early bed positioning for acute stroke patients. Methods A two-month audit on positioning intervention by OTs was completed locally. Data was collated on a secure logbook. Results 59 patients were admitted with a stroke between January and February of 2024. 15 patients required bed positioning. Only 2 patients received bed positioning on initial assessment. Documented reasons for not completing bed positioning included time constraints, pain, and resources. Conclusion OTs are not meeting current standards in relation to bed positioning in SVUH. Time constraints, referral times and staffing were highlighted as contributing factors. A service development opportunity was identified and rolled out during the completion of this audit. Implications for practice: Ward based education and an information resource booklet on bed positioning was provided to the staff on the stroke ward. This has prompted a review of the OT initial assessment form to include bed positioning as part of the assessment, and the development of a positioning guidelines hand-out for the stroke interdisciplinary team to implement upon admission.