Currently submitted to: JMIR Nursing
Date Submitted: May 27, 2026
Open Peer Review Period: Jun 1, 2026 - Jul 27, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Effectiveness of Nurse-Led Positioning Interventions: A Systematic Review and Meta-Analysis
ABSTRACT
Background:
Nurse-led positioning interventions are widely implemented in clinical settings; however, their effectiveness across diverse patient outcomes has not been sufficiently synthesized. This systematic review and meta-analysis evaluated the effects of nurse-led positioning protocols on cardiovascular risk factors, glycaemic control, mental health, cardiovascular outcomes, and dietary and fluid compliance.
Objective:
The purpose of this study was to provide an evidence-based synthesis that can inform clinical practice and guide future research. The significance of this study lies in consolidating a disparate body of literature into a coherent framework and clarifying the clinical utility of a common nursing intervention.
Methods:
A comprehensive literature search was conducted in accordance with PRISMA guidelines, and 16 eligible studies were identified for quantitative synthesis. Random-effects meta-analyses were performed for each outcome domain, with effect sizes expressed as standardized mean differences.
Results:
Nurse-led positioning showed a statistically significant, large beneficial effect on cardiovascular outcomes (d=0.86, 95% CI [0.59, 1.12], p<1e^(-9)). Significant improvement was also observed for dietary and fluid compliance (d=-1.26, 95% CI [-1.49, -1.03], p<1e^(-10)). However, no statistically significant effects were found for cardiovascular risk factors (d=0.07, 95% CI [-0.01, 0.15], p=0.08), glycaemic control (d=-0.05, 95% CI [-0.17, 0.08], p=0.45), or mental health outcomes (d=-0.11, 95% CI [-0.25, 0.03], p=0.11).
Conclusions:
These findings suggest that nurse-led positioning interventions may be particularly effective for improving cardiovascular endpoints and promoting adherence to dietary and fluid regimens, whereas their influence on metabolic and psychological parameters appears limited. Further high-quality trials are warranted to confirm these differential effects and clarify the underlying mechanisms. Clinical Trial: Not applicable
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