Effects of Patient Positioning on Post-Surgical Recovery

Diagnostic laparoscopy is the most common gynecologic procedure performed in an ambulatory surgical setting (Loffer, 1987). Women recovering from diagnostic laparoscopies have been reported to experience significantly more nausea and vomiting (Carroll et al. 1994; Chung, 1995) headaches, drowsiness, dizziness, and sore throat than other ambulatory procedure surgical patients (Chung, 1995). Although there are approximately 2000 diagnostic laparoscopies performed annually at Naval Hospitals (Gibbons, 1996), little is documented regarding post-operative nursing interventions which are more effective in decreasing post-operative recovery time, improving patient outcomes, and optimizing discharge readiness for these women. In addition, no literature has been published regarding effects of positioning on post-surgical diagnostic laparoscopy patients.

The purpose of this study is to (a) evaluate the effects of patient positioning on home readiness among ambulatory surgical patients following diagnostic laparoscopy, and (b) identify persistent symptoms which result in a delay in discharge. This research is intended to determine if patients who are recovered in "stretcher-chairs" reach home readiness sooner and experience greater comfort levels than patients who are recovered in traditional hospital beds. This study will also attempt to identify which persistent post-operative symptoms prolong patient recovery.

This is a randomized, comparative study evaluating two different methods of recovery positions for post-surgical diagnostic laparoscopy patients. The independent variable is patient positioning. Subjects will be randomly assigned to one of two position treatment groups: stretcher-chair or traditional hospital bed. The dependent variables are time to reach home readiness, home readiness scores at 15 minute intervals, persistent symptoms, and patient comfort.

Descriptive statistics will be calculated for the demographic and dependent variables. Independent t-tests will be used to test for significant differences between the two treatment groups (stretcher-chairs vs. traditional hospital beds) in time to reach home readiness, number of persistent symptoms, and patient comfort. A 2 X 4 analysis of variance with repeated measures on the second factor will be used to test for significant differences between the two treatment groups in home readiness scores at 15 minute intervals. The first factor will be treatment group (stretcher-chair vs. traditional hospital bed) and the repeated factor will be home readiness scores at 15 minute intervals.