Does regular repositioning prevent pressure ulcers?

Area of Science:

• Healthcare research
• Clinical nursing
• Patient safety

Background:

• Prolonged pressure exposure is the main cause of pressure ulcers (PUs).
• Frequent patient repositioning is a standard intervention for PU prevention.
• Effective interventions must minimize or avoid pressure exposure.

Purpose of the Study:

• To review evidence on the effectiveness of repositioning for pressure ulcer (PU) prevention.
• To assess the efficacy of various repositioning frequencies and techniques.

Main Methods:

• Systematic review of MEDLINE and CINAHL databases (1960-2008).
• Included prospective randomized clinical trials and quasi-experimental studies.
• Focused on studies measuring pressure ulcer incidence.

Main Results:

• Repositioning every 4 hours with pressure redistribution surfaces is as effective as every 2 hours for preventing facility-acquired PUs.
• Limited evidence supports this 4-hour repositioning frequency.
• Insufficient evidence exists to compare the efficacy of 30-degree lateral, 90-degree lateral, or semi-Fowler's positions.

Conclusions:

• The optimal frequency and technique for patient repositioning to prevent pressure ulcers (PUs) lack definitive evidence.
• Clinical practice supports regular movement for immobilized patients.
• Regulatory focus on PU prevention highlights the need for evidence-based repositioning guidelines.