Effectiveness of turning with unequal time intervals on the incidence of pressure ulcer lesions

Abstract

More frequent repositioning on a pressure-reducing mattress does not necessarily lead to fewer pressure ulcer lesions and consequently cannot be considered as a more effective preventive measure.

Assessing evidence supporting redistribution of pressure for pressure ulcer prevention: A review

“…A 6-hour turning sc hedule for patients lying on a viscoelastic mattress resulted in similar outcomes, but a 4-hour turning schedule for patie nts lying on a visc oelastic mattress signific antly reduced stage II PUs . Other research suggests that turning ma y need to occur more frequently than every 2 hours and that sufficient pressure reduction surfaces are needed in addition to turning [32,[34][35][36]. Recently, Vanderwee et al, using a pressu re-reducing mattress, found no difference between repositioning patient s every 4 hours and alternating between 2 hours in late ral and 4 h ours in supine [36].…”

“…Furthermore, in studies on turning, patients who are able will change posture between scheduled repositionings. As a result, these subjects are exposed to more position changes than offered by the intervention, which may mask a need for more frequent repositioning in those unable to reposition themselves [36]. The necessary repositioning frequency may be so high that implementation is impractical for immobile patients [32].…”

Incidência de úlcera por pressão e ações de enfermagem

“…The result observed in the variable Turning patients every two hours is similar to a study developed in the intensive care unit of a Brazilian teaching hospital, where, before educational intervention, of the 15 patients presenting PU only 13.3% were turned every 2 hours and, after intervention, none of the 15 patients who presented PU received this kind of preventive care (8) . Two studies conducted in geriatric units in Belgium demonstrated that in one of them, the group of patients with a 2-hour turning regimen and turning to supine position every 4 hours presented a 16.4%, PU levels II to IV incidence whereas the control groups who were turned every 4 hours presented a 21.2%, incidence with no statistically significant difference between the two groups (26) ; in another study, among the 14.3% patients who were turned every 2 hours, and the 3% who received this care every 4 hours presented statistically significant differences (27) . For the other care categories Clean and dry patients after incontinence episode, Prescribed and administered diet, Intake of fluid from 1500 to 2000 ml/day, Daily use of skin moisturizer and Use of adequate mattress, there were no studies in the literature whose methodologies enabled comparisons.…”

Investigation of the risk factors of pressure ulcers in intensive care unit patients: According to the Braden Scale

“…Furthermore, PUs are an indicator of the quality of the nurse-specific provided by health care organizations (8)(9)(10). In studies conducted before 2008-2009 reveal a reduction in the prevalence of PUs in hospitals (4%-20%), (4,(11)(12)(13)(14). However, the prevalence of PUs in intensive care units varies between 9% and 42% which is still frequent (15).…”