Hemiparetic positioning of patients with hemiplegia

Nature and scope of the project: Patients with hemiplegia may develop pain, decreased strength, sensation, and tone impacting functional ability of the affected arm when patients are not positioned correctly. The purpose of this quality improvement (QI) project was to evaluate improvements in the function of patients with hemiplegia in a rehabilitation hospital after implementing a hemiparetic positioning program. Project implementation: Education on hemiparetic positioning developed by an interdisciplinary team was offered to all nursing and therapy staff over a 1-month with follow-up and written materials. Evaluation criteria: The outcome measures for this project were Functional Independence Measurement (FIM) scores. Changes in FIM scores of patients hospitalized 3 months before the project were compared with a sample hospitalized after the project to see if outcomes improved. Outcomes: The sample consisted of 91 (pre-QI = 27, post-QI = 64) hospitalized patients with hemiplegia. All patients had significant improvements in FIM scores from admission to discharge. There were no significant differences observed between the groups on FIM change scores using Mann-Whitney U test: transfers from bed/chair/wheelchair (z = -.822, p = .411), upper body dressing (z = -.104, p = .917), lower body dressing (z = -1.120, p = .263), and toileting (z = -1.259, p = .208).