[Less frequent turning intervals and yet less pressure ulcers]

Area of Science:

• Gerontology
• Nursing Science
• Preventive Medicine

Background:

• Pressure ulcers (PUs) are a significant concern in long-term care.
• Effective prevention strategies are crucial for improving patient outcomes and reducing healthcare costs.
• Current turning protocols and support surfaces vary, necessitating evidence-based optimization.

Purpose of the Study:

• To investigate the efficacy of different turning intervals for pressure ulcer prevention.
• To optimize turning protocols by comparing various schemes in a high-risk population.
• To evaluate the combined effect of turning frequency and support surfaces on PU development.

Main Methods:

• A randomized controlled trial was conducted involving 838 high-risk nursing home residents.
• Four distinct turning schemes were compared.
• Pre-studies assessed the pressure-reducing effects of various mattresses, cushions, and positions.

Main Results:

• Turning every 4 hours combined with a pressure-reducing viscoelastic mattress significantly decreased pressure ulcer incidence.
• This optimal scheme outperformed turning every 6 hours on a viscoelastic mattress.
• It was also superior to turning every 2 or 4 hours on a non-pressure-reducing mattress.

Conclusions:

• Optimized turning schedules, particularly turning every 4 hours, are vital for pressure ulcer prevention.
• The use of pressure-reducing viscoelastic mattresses is a critical component of effective prevention strategies.
• Combining frequent repositioning with appropriate support surfaces offers the best protection against pressure ulcers in high-risk residents.