Two Methods for Turning and Positioning and the Effect on Pressure Ulcer Development: A Comparison Cohort Study

Area of Science:

• Critical Care Medicine
• Nursing Science
• Patient Safety

Background:

• Pressure ulcers are a significant concern in intensive care units, particularly for immobile, mechanically ventilated patients.
• Effective patient positioning and regular turning are crucial for preventing pressure ulcer development.
• Current standard of care (SOC) for positioning often relies on pillows, with varying effectiveness.

Purpose of the Study:

• To compare the effectiveness of a patient positioning system (PPS) versus standard of care (SOC) using pillows in preventing pressure ulcers.
• To evaluate differences in turning effectiveness, nursing resource utilization, and nurse injuries between the two positioning methods.

Main Methods:

• A nonrandomized comparison study was conducted with 60 immobile, mechanically ventilated patients in a trauma/neurointensive care unit.
• Patients were assigned to either the SOC (pillow) group or the PPS group.
• Data collected included daily pressure ulcer assessments, number of personnel for turning, turn angle, and nurse injuries.

Main Results:

• The PPS group had significantly fewer hospital-acquired pressure ulcers (1) compared to the SOC group (6) (P = .042).
• The PPS method required significantly fewer nurses for repositioning than the SOC method (P ≤ 0.001).
• The average turn angle achieved with PPS (31.03°) was greater than with SOC (22.39°).

Conclusions:

• Patient positioning systems (PPS) are effective in achieving optimal patient positioning to prevent pressure ulcer development.
• PPS can lead to more efficient nursing resource allocation and potentially safer patient handling.
• Implementing assistive devices like PPS can enhance pressure ulcer prevention strategies in critical care settings.