For patients with reduced mobility, changing position in their chair throughout the day is the best way to prevent pressure injuries and keep the blood flowing. But how often should we be looking to move a patient in their chair, and what range of positions should we be aiming for?
Official NICE guidelines state that a patient should be moved every two hours. However, like all guidelines, these need to be interpreted with our individual patient in mind as some may require much more frequent movement depending on their condition. Factors such as their mobility and the condition of their skin should be considered.
For fully mobile patients, encourage them to rise from their chair every two hours. This helps oxygenate the blood vessels in areas that have been under pressure. When they sit down, you may want to consider altering their position by reorganising support around their back and legs. If patients are able to do so, you should also encourage them to reposition themselves in their chair as often as every 15 minutes. However, it’s important to make sure that they are able to do this safely, without increasing the risk of pressure injuries, or sitting in a position that might cause them muscular discomfort.
For less mobile patients, altering the position of the chair can also help get their blood flowing around the areas at risk from pressure injury. Use the Tilt in Space Feature to lift the legs and encourage blood flow through the pelvic areas, or raise the footrest to take pressure of the backs of the thighs. You can also place cushions behind their back to encourage the patient to sit forwards. If any of these positions are uncomfortable for your patients to hold for a long period of time, it is worth noting that just five to ten minutes in a tilted posture are enough to get the blood flowing through the tissue.
You may need to move the patient out of their chair as you adjust the configuration of the cushions. Read more about the best way to do that here.
As with everything, you should record and monitor the changes in position you make to your patient. Observe which alterations have the most positive effect for that individual, and note whether the frequency should be increased. By working with your patient in this way you will find the optimal frequency with which they should be moved and the range of positions into which it is possible for them to do so.