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Turning for Ulcer ReductioN: a multisite randomized clinical trial in nursing homes
Nancy Bergstrom1, Susan D Horn, Mary Pat Rapp
1School of Nursing, University of Texas Health Science Center at, Houston, Houston, Texas.
Journal of the American Geriatrics Society
|September 21, 2013
Summary
Repositioning nursing home residents at risk for pressure ulcers (PrUs) every 2, 3, or 4 hours on high-density foam mattresses showed no difference in PrU incidence. Consistent repositioning and skin monitoring are key for preventing pressure ulcers.
Area of Science:
- Gerontology
- Nursing Science
- Clinical Trial Research
Background:
- Pressure ulcers (PrUs) are a significant concern for nursing home residents, particularly those at moderate to high risk.
- High-density foam mattresses are commonly used, but optimal repositioning frequency for preventing PrUs on these surfaces is not well-established.
Purpose of the Study:
- To determine the optimal repositioning frequency for nursing home residents at risk for pressure ulcers (PrUs) when using high-density foam mattresses.
Main Methods:
- A multisite randomized clinical trial (TURN Study) involving 942 residents (aged 65+) at moderate or high risk for PrUs.
- Participants were stratified by risk and randomly assigned to 2-, 3-, or 4-hour repositioning schedules for 3 weeks.
- Skin assessments were conducted weekly by blinded assessors to determine PrU incidence.
Main Results:
- No statistically significant difference in PrU incidence was observed across the 2-, 3-, or 4-hour repositioning groups (P = .68).
- There was no significant difference in PrU incidence between high-risk and moderate-risk groups (P = .79).
- Superficial PrUs developed in only 2.0% of participants.
Conclusions:
- Consistent repositioning and skin monitoring are crucial for preventing pressure ulcers in at-risk nursing home residents on high-density foam mattresses.
- Repositioning frequency (2, 3, or 4 hours) did not significantly impact PrU incidence in this study population.
- These findings have significant implications for optimizing nursing staff utilization and reducing healthcare costs in nursing homes.
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