A Nurse's Critical Role in Seating and Positioning

In this post:

Nurses have a significant impact on implementing correct seating & positioning for residents.
Correct positioning can prevent pressure injuries, abnormal postures, and other painful problems.
Proper equipment and nursing education are critical to achieving positive patient outcomes.
Broda wheelchairs make it easier for nurses to follow best practices with no lifting required.

Proper positioning of patients is crucial in skilled nursing facilities. Nurses play a vital role in ensuring that patients are positioned correctly.

Nurses understand the importance of maintaining good postural alignment and how improper or ill-fitting equipment can impact a person’s health. If a mobility device does not fit, it can create abnormal postures, increasing the risk of falls and pressure injury.

Improper seating and positioning can directly oppose three of the five quality measures of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014.¹

Skin integrity
Change in functional status
Incidence of major falls

The Problem with Standard Sling-Seat Wheelchairs

Pressure Injuries and Skin Breakdown

Prolonged sitting in the standard wheelchair configuration requires the body to sit at a 90 x 90-degree angle. This configuration can lead to the user sliding into abnormal postures. Abnormal postures cause increased pressure on the bony prominences, which may develop into pressure injuries.

Postural Issues

Sling seats offer no stability at the pelvis. The vinyl seat and back will stretch, causing a hammock effect. When the seat and back supports fail, the lack of stability at the pelvis can lead to abnormal postures. This can result in discomfort and increased fall risk. Poor postural alignment can lead to digestive and swallowing difficulties, increasing the risk of choking or aspiration of food. Poor posture can also limit the optimal lung expansion necessary to support proper respiratory function. Needless to say, a nurse’s attention to proper seating and positioning could make a world of difference for the patient’s overall health.

Reduced Mobility

Older adults with mobility impairments may have difficulty repositioning themselves independently. In many cases, residents rely on nurses to help them reposition and offload pressure from bony prominences. Standard sling seats typically do not offer adjustability, making it difficult for wheelchair users and nurses to change their position to relieve pressure or to achieve a more comfortable posture.

Most standard wheelchairs also do not offer seat surface height adjustability to allow for an effective heel strike for self-propulsion. When a resident cannot effectively self-propel, nurses and nursing assistants are responsible for moving the patient throughout the facility.

Adequate Seating Reduces Care Burden on Nurses

Without proper equipment, the nursing staff’s time is consumed with repositioning, transporting, and keeping an eye on residents with a high fall risk. New seating equipment from Broda could help a nursing team regain control of their day, especially when short-staffed.

Instead of…	Try…
Helping patients with weight shifting in a standard wheelchair	Using Broda wheelchairs with a tilt feature for quick & easy repositioning with no lifting required.
Worrying about high fall risks	Using a Broda wheelchair with proper positioning. Correct posture lowers fall risk!
Wheeling residents around the facility	Conducting a seating evaluation to see if an ergonomic pedal wheelchair from Broda could help them regain their ability to self-propel.
Constantly treating new pressure injuries	Investing in Broda wheelchairs with built-in pressure injury prevention measures, like our proprietary Comfort Tension Seating®.

Nurse maneuvering a patient — A nurse maneuvering a patient seated in a Synthesis Positioning Wheelchair with the WC19 Transport Package.

Abnormal postures, discomfort, or poor positioning indicate the need for a referral to therapy for a seating and positioning evaluation. Nurses know that a seating assessment helps achieve the proper fit between the wheelchair user and the seating system to ensure optimal pressure redistribution and comfort, increasing engagement, mobility, and independence.

Is your nursing team stressed and overwhelmed? See if Broda wheelchairs are a worthwhile investment for your facility.