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¶ … Patient Turning Every Two Hours and Positioning Decreases the Development of New Pressure Ulcers
The objective of this study is to determine whether turning and positioning of a patient every two hours decreases in the development of new pressure ulcers. Toward this end, this study will conduct a review of the literature in this area of inquiry.
The work of Rich, et al. (2011) entitled "Frequent Manual Repositioning and Incident of Pressure Ulcers Among Fracture Patients" reports that frequent manual repositioning "is an established part of pressure ulcer (PU) prevention, but there is little evidence for its effectiveness." (p.1) The study reported by Rich, et al. conducted an examination of the link between repositioning and incidence of pressure ulcers among elderly patients that were bedbound fracture patients. The study findings indicate that there was no link between patient repositioning and incidence of pressure ulcers. However, the work of Ostadabbas, et al. (2011) reports "the most common prevention method is still periodic repositioning by the nursing staff. Some patients are at higher risk than others, and therefore should be repositioned...
159) Rich, et al. reports a scheduling algorithm that is successful in reducing the labor and time required to turn and position patients for the prevention of the development of pressure ulcers. The National Clearinghouse conducted a synthesis of guidelines on prevention of pressure ulcers and reports that there is an agreement that chair or wheelchair bound patients should be repositioned every hour if possible and where the patient is capable that they should be encouraged to perform small weight shifts every fifteen minutes. In addition agreement was discovered on regular scheduling of repositioning and turning for bed bound patients although no specific interval is stated. Specifically stated is "Currently there is limited evidence to suggest that repositioning every four hours when combined with any pressure redistributing mattress is just as effective for prevention of pressure ulcers as more frequent (every two hours) repositioning or turning. Evidence for the optimal frequency of repositioning is lacking." (National Clearing House, 2006, p. 1) The National Institutes of Health, National Institute of Nursing Research, National…
References
Baldwin, C. (nd) New Turning and Positioning System Facilitates Patient Repositioning to Aid in Pressure Ulcer Healing. Kindred Healthcare. Retrieved from: http://www.sageproducts.com/documents/pdf/education/case_studies/sacral/21495.pdf
National Institutes of Health, National Institute of Nursing Research, National Institute on Aging, et al. (2008) Pressure Ulcer Prevention: Turning for Ulcer Reduction (TURN) Clinical Trials Gov. Retrieved from: http://clinicaltrials.gov/ct2/show/NCT00665535
Prevention of Pressure Ulcers (2011) National Guideline Clearinghouse. Retrieved from: http://www.guideline.gov/syntheses/printView.aspx?id=47794
Rich, SE (2011) Frequent manual repositioning and incidence of pressure ulcers among bedbound elderly hip fracture patients. Wound Repair Regen, Jan 2011; 19(1): 10-18. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3059225/
Ostadabbas. S. et al. (2011) Pressure Ulcer Prevention: An Efficient Turning Schedule for Bed-Bound Patients. IEEE. Retrieved from: http://ecs.utdallas.edu/research/researchlabs/QoLT/files/pdfs/lissa11_ulcer.pdf
Pressure Ulcers in the Elderly During Hospital Stays Pressure ulcers are potentially fatal skin lesions that develop especially in frail, elderly patients on bony or cartilaginous areas such as the sacrum, elbows, and ankles. Within acute care in the United States, the incidence of pressure ulcers lies between 0.4% and 38%. The incidence within long-term and home care is significantly lower while intensive care units report that 8% to 40% of
Otherwise, the resources are either short or unavailable. These situations tend to make gains in pressure ulcer care quickly vanish (Cuddigan et al.). Lastly, national records on pressure ulcer rates have remained incomplete and unreliable (Cuddigan et al. 2001). Hospital discharge records do not all reflect or include pressure ulcer cases even if the patients reach Stage III or IV. In addition, these records are unable to recognize and tally
Pressure Ulcers in the Elderly Gifty Appiah Dr. Judi Kuric DNP Project Final Premise DNP Project Question Will Every Two Hourly Turning and Positioning Decrease Pressure Ulcers in the Elderly Bed Bound Population in Nursing Home. Will Every Two Hourly Turning and Positioning Decrease the Pressure Ulcers in the Elderly Bed Bound Population in Nursing Homes. Pressure ulcers are a common cause of immobility among the elderly, which results in immense pain, suffering, and substantial costs with charges
Summary of Common and Conflicting Findings Hart, Bergquist, Gajewski & Dunton (2006); Gunningberg (2005); Wipke-Tevis, Williams, Rantz, Popejoy, Madsen, Petroski & Vogelsmeier (2004); and Vanderwee, Grypdonck, DeBacquer & Defloor (2006) all indicate that pressure ulcers are unnecessarily common among patients in nursing care facilities. Pressure ulcers are generally defined as "lesions caused by unrelieved pressure, resulting in damage of underlying tissue," (Hart et al. 2006, p. 257). They occur mainly along
Evidence-based studies that delineate how to manage and treat pressure ulcers have determined that the most effective approaches include keeping the wound moist, appropriate repositioning, using support surfaces, and proper nutrition. Non-traditional approaches, including electrical stimulation, hyperbaric oxygen, growth factors and skin equivalents, and negative pressure wound therapy, are also showing promising results (Resources for Managing Hospital-Acquired Conditions, 2008). Organizational level activities for dealing with hospital-acquired pressure ulcers include: developing and adhering
Role of Staff Education in Pressure Ulcer Incidence in Long-Term Care Residents Pressure ulcers (PUs), also known as bed sores, decubitus ulcers, or pressure sores, are formed where skin and tissue are squeezed between bone and an outside surface for long periods of time, often due to immobility ("Pressure Ulcer," 2002). The development of PUs is a common problem in long-term care of the elderly. A recent report by a national