Tip of the Month: Offer elderly reclining chairs, not gurneys
Offer elderly reclining chairs, not gurneys
Would you like a simple way to reduce pain and increase satisfaction of elderly patients? Allow them to sit on reclining chairs instead of gurneys, suggests Scott Wilber, MD, FACEP, director of the emergency medicine research center at Summa Health System in Akron, OH.
Researchers placed 132 patients ages 65 or older in a reclining chair or gurney, and their pain levels and patient satisfaction were assessed one and two hours later using a 0-10 scale. "What we found was that even though more patients in the chair group reported pain at the onset, that group had a substantial drop in pain levels to almost zero at two hours, whereas the gurney group had a steady increase of pain levels," says Wilber.1
At the same time, patient satisfaction increased by 2 points for the chair group at the two-hour mark, with an average score of 8.1 compared with 6.0 for the gurney patients. "We decided to study this because we observed that a lot of older patients, as the ED stay gets longer and longer, complain of pain while in a gurney," he says.
While in a gurney, the patient’s hips are flexed between 45 and 90 degrees with legs fully extended, which can worsen pain from chronic back problems, Wilber explains. "Placing them in that position is bad, but you can’t lay them down flat looking at the ceiling, either."
The researchers were able to borrow the chairs needed for the study from hospital inpatient floors, closets, and storage areas, but the ED will purchase six new reclining chairs at a cost of $800 each (3-Position Deluxe Adult model, Invacare, Elyria, OH).
"We were able to demonstrate to administrators that this is something we can do to improve satisfaction in this population, which is cheaper than hiring an extra nurse or physician," says Wilber.
Reference
- Wilber ST, Burger B, Gerson LW, et al. Reclining chairs reduce pain from gurneys in older emergency department patients: A randomized controlled trial. Acad Emerg Med 2005; 12:119-123.
Source
For more information on reducing pain in elderly trauma patients, contact:
- Scott Wilber, MD, FACEP Director, Emergency Medicine Research Center, Summa Health System, 41 Arch St., Room 519, Akron, OH 44309. Telephone: (330) 375-7530. E-mail: [email protected].
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