NURSING CARE THROUGH THE APPLICATION OF COMBINED SEMI-FOWLER AND RIGHT LATERAL POSITIONS TO IMPROVE OXYGEN SATURATION IN PATIENTS WITH CONGESTIVE HEART FAILURE AT THE CARDIOVASCULAR CARE UNIT OF ARIFIN ACHMAD REGIONAL GENERAL HOSPITAL, RIAU PROVINCE

Abstrak

Congestive Heart Failure (CHF) is one of the leading causes of morbidity and mortality worldwide, including in Indonesia. CHF patients often experience ineffective breathing patterns due to the heart’s inability to pump blood efficiently, resulting in decreased oxygen saturation. Non-pharmacological interventions such as body positioning have been proven effective in improving oxygenation. The combination of semi-Fowler and right lateral positions can enhance lung expansion, reduce cardiac workload, and improve pulmonary ventilation and perfusion. This study aims to determine the effect of combining the semi-Fowler and right lateral positions on improving oxygen saturation in CHF patients in the CVCU Room of Arifin Achmad General Hospital, Riau Province. This research used a case study approach based on Evidence-Based Nursing Practice (EBNP). Data were collected through interviews and observations over three consecutive days (August 14–16, 2025) involving two CHF patients. The intervention was conducted by applying a combination of semi-Fowler and right lateral positions, and oxygen saturation (SpO₂) values before and after the intervention were compared based on indicators from the Indonesian Nursing Outcome Standards (SLKI). The results showed an increase in SpO₂ levels after the combined positioning intervention, along with clinical improvements such as decreased respiratory rate, reduced use of accessory respiratory muscles, and more balanced chest expansion. Patients also reported feeling more relieved and comfortable when breathing after the intervention. The combination of semi-Fowler and right lateral positions is proven effective in increasing oxygen saturation among CHF patients. This intervention can be recommended as a safe, simple, and evidence-based non-pharmacological nursing measure that supports improved quality of care in the CVCU setting