Learning Objective #1: Discuss the patient and financial benefits of continuous lateral rotational therapy for patients subject to the hazards of immobility, including nosocomial pneumonia

Learning Objective #2: Discuss the use of a research based protocol by nurses to improve patient outcomes

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Continuous Lateral Rotational Therapy (CLRT) can be very beneficial to certain patient populations to help decrease the risk of nosocomial pneumonia. One lung over the other in a slow, continuous turn provides for improved mobilization and removal of secretions. Patients experiencing conditions that render them immobile are at risk for nosocomial pneumonia and other hazards, and therefore, are able to benefit from CLRT.

Research is very beneficial in that it adds to the body of nursing knowledge, which helps strengthen nursing practice, and improves patient outcomes. It also helps to validate nursing practice by using interventions based in scientific evidence. The intent of this program is to present the results of this CLRT study conducted in our facility, using it as a vehicle to demonstrate the research process, and the positive impact nurses can have on patient outcomes, while also affecting a positive financial impact for healthcare.

Completed in January 2004, this study revealed the following results when patients were appropriately placed on CLRT:

Appropriately placed Mean ventilator days = 13.79 Mean ICU LOS = 15.20 Mean ICU cost = $34,901.67 Mean hospital cost = $34,145

Not appropriately placed Mean ventilator days = 17.39 Mean ICU LOS = 19.18 Mean ICU cost = $44,526.21 Mean hospital cost = $48,280

Acuity and pneumonia risk scores were analyzed to determine their influence on patient outcomes. Regression analysis determined that the acuity level explained 7.5% of the ICU costs and that increased acuity led to increased ICU costs. There was a significant improvement in appropriate use of CLRT, exposing more patients to the benefits of the therapy. Due to the small sample size (total 58), these findings are not statistically significant, but the overall cost savings of $18,908, more efficient use, and the reduced lengths of stay are clinically significant.