The Effects of a Positioning Program for Pressure Ulcer and Peripheral Nerve Injury Prevention during Surgery among the Older Patients Undergoing Urological Surgery

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Nalinthip Niruntaweechai
Usavadee Asdornwised
Rattima Sirihorachai
Patkawat Ramart


Purpose: The aim of this study was to compare the pressure ulcer scores and the incidence of peripheral nerve injury among those who received the positioning program for pressure ulcer and peripheral nerve injury prevention with routine care and those who received only routine positioning and care among the older patients during urological surgery in a lithotomy position.

Design: Two groups experimental research with pre- and post-test design.

Methods: Participants were randomized into intervention and control groups. Forty-two elders in the intervention group were assigned to participate in the positioning program with routine care and forty-two elders in the control group received only routine positioning and care. Data were collected using a demographic data questionnaire, the Bates-Jensen Wound Assessment tool (Thai version), peripheral nerve injury assessment form. The positioning program consisted of the guideline for lithotomy positioning together with the use of warm gel cushions on the arm boards and sacrum area and intermittent pneumatic compression. Data were analyzed using independent t-test, the Mann-Whitney U test, the chi-square test and Fisher’s exact test.

Main findings: The intervention group had statistically lower pressure ulcer scores, compared to the control group (p < .05). In addition, the incidence of peripheral nerve injury of the intervention group was significantly lower than that of the control group (p < .05).

Conclusion and recommendations: The outcomes of intervention program based on the guideline for positioning and equipment used including warm gel and intermittent pneumatic compression showed lower scores for pressure ulcers and incidences of peripheral nerve injury than those in the control group. Thus, using the positioning program is recommended as a routine practice for pressure ulcer and peripheral nerve injury prevention in urological surgery patients.

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Niruntaweechai, N., Asdornwised, U., Sirihorachai, R., & Ramart, P. (2023). The Effects of a Positioning Program for Pressure Ulcer and Peripheral Nerve Injury Prevention during Surgery among the Older Patients Undergoing Urological Surgery. Nursing Science Journal of Thailand, 41(4), 101–114. Retrieved from
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