Vera Meeusen, PhD, MA, RN, FACPAN, AFACHSM, is Clinical Nurse Consultant, Endoscopy Unit, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.
Nick Kim, RN, is Clinical Nurse, Endoscopy Unit, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.
Gastroenterol Nurs. 2021;44(3):185-191. doi: 10.1097/SGA.0000000000000534.
Patient positioning during gastrointestinal endoscopic procedures has received minimal attention compared with surgical procedures performed in the surgical setting. However, prolonged endoscopic interventions on patients and the increasing requirement for general anesthesia have changed to need for patient positioning guidelines. The objective of this study was to test whether patient positioning guidelines for surgical procedures in surgical suites are suitable for gastrointestinal endoscopic procedures without negatively impacting safety and procedure duration. This was an observational feasibility study with volunteers of different body mass index categories. Volunteers were positioned in supine, lateral, and prone positions on an operating table and thereafter on an endoscopy stretcher and asked for comfort levels. Except for arm and head positioning in lateral and prone positions, it was possible to replicate the patient positioning guidelines. Alternative options were explored for the positioning of arms and head to optimize oral access. Besides minor adjustments, we were able to replicate the positioning guidelines and adhere to pressure and nerve injury prevention guidelines. Concept endoscopic patient positioning guidelines were developed. It is recommended to review the "swimmer's" position. Endoscopic patient positioning guidelines should become part of the National Practice Standards and education curriculum of endoscopy nurses.
与在外科环境中进行的手术程序相比,胃肠道内窥镜检查期间的患者体位问题几乎没有得到关注。然而,对患者进行长时间的内窥镜介入以及对全身麻醉的需求增加,使得有必要制定患者体位指南。本研究的目的是检验手术室手术程序的患者体位指南是否适用于胃肠道内窥镜检查程序,而不会对安全性和手术持续时间产生负面影响。这是一项针对不同体重指数类别的志愿者进行的观察性可行性研究。志愿者在手术台上仰卧、侧卧和俯卧,然后在胃镜担架上,并就舒适度进行评估。除了侧卧和俯卧时手臂和头部的位置外,其他位置都可以复制患者体位指南。我们还探讨了替代方案,以优化口腔通道的手臂和头部的位置。除了进行一些细微的调整,我们还可以复制定位指南,并遵守压力和神经损伤预防指南。制定了概念性的内镜患者体位指南。建议重新审查“游泳者”体位。内镜患者体位指南应成为内镜护士国家实践标准和教育课程的一部分。