Nurses know that head-of-bed (HOB) elevation of 30° to 45° is associated with a decrease in ventilator-associated pneumonia. However, can clinicians accurately identify the correct HOB elevation by observation? Hiner and colleagues put 175 clinicians to the test. Clinicians viewed a simulated critically ill patient in a bed with the HOB elevated and the elevation gauge concealed. They found the following:

  • A little more than 50% of the nurses and respiratory therapists, and less than 50% of the medical assistants, accurately identified the correct elevation using observation alone.

  • Clinicians should not rely on observation to establish correct HOB elevation. The inclinometer gauge, usually provided on the bed, should be used to ensure accurate HOB elevation of 30° to 45°.

—Karen Johnson, RN, PhD

See Article, pp 164–167

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