Synthesis Table-4: Positioning

Practice Area: Positioning for Needlesticks/Procedures

Topic / Citation / Sample / Key Findings / Comments
Positioning / Sparks LA, Setlik, J Luhman, J
Parental Holding and Positioning to Decrease IV Distress in Young Children: A Randomized Controlled Trial
Journal of Pediatric Nursing 2007
22(6); 440-447 / 9 mos-4 yrs ED
N=118
Held upright by parent or lying flat
RCT / Distress was lower in parent held group in all 3 periods
IV attempts similar
RNs preferred lying flat
Parents had greater satisfaction in the held group. / Parents felt comfortable holding
Nurses needed to change their technique when child was supine
64 % of children did not receive topical even though it was a standard
Positioning / Lacey, CM, Finkelstein, M & Thygeson, MV
The Impact of Positioning on Fear During Immunizations: Supine Versus Sitting Up
Journal of Pediatric Nursing 2008, 23(3) :195_=220 / 4-6 yrs
108 patients
General ped clinic
Receiving immunizations
Excluded: children who had 4 or more procedures.
chronic illness, CI
Random- 2 group / Crying prior to injection more likely in supine position
Crying after injection was greater in supine position
(mean = 10 min vs 2 min) / Less fear when sitting up
Staff reluctant to use sitting up—if child showed signs of distress they would often tell child they had to lie down
Positioning / Megel, ME, Heser, R & Matthews, K
Parents’ Assistance to Children Having Immunizations
Issues in Comprehensive Pediatric Nursing, 2002 25:151-165 / 41 parents
40 children
Immunizations at clinic
Descriptive / Coded behaviors from audiotapes
Physical contact and explanations during immunization
Crying was not reprimanded, half indicated positive feedback. Physical contact and rewards given and promised
Learned from health care provider, just knew, read about what to do Strategies that parents used recommended in literature included: relaxation/deep breathing, distraction. / Negative parental coping behaviors were related to more distress. Positive coping behaviors were related to more positive coping