Movement and Pressure Injury Prevention Care for Nursing Home Residents: Addressing the Nescience

Area of Science:

• Gerontology
• Nursing Science
• Biomechanics

Background:

• Nursing home residents are often assumed to be inactive, increasing pressure injury risk.
• Prolonged static postures are a concern for immobility and skin breakdown.

Purpose of the Study:

• To compare movement frequency in nursing home residents in lying versus upright positions.
• To examine movement patterns in residents with obesity, dementia, or neither condition.
• To analyze transient movements during prolonged static periods.

Main Methods:

• Descriptive exploratory study utilizing secondary data (N=934) from the TEAM-UP clinical trial.
• Analysis of transient movements (<60 seconds) during prolonged periods (2-5 hours) without repositioning.
• Comparison of movement rates across resident subgroups and repositioning intervals.

Main Results:

• Significantly more episodic transient movements occurred when residents were upright compared to lying.
• Residents with obesity or dementia showed similar movement frequencies to those without these conditions.
• Movement frequency was higher in residents with obesity compared to those without, particularly during 2-4 hour intervals.
• Episodic transient movements were significantly higher for repositioning intervals up to 3 hours across all subgroups.

Conclusions:

• Findings challenge the assumption of inactivity in nursing home residents.
• A standard 3-hour repositioning interval may be appropriate, especially with high-density mattresses, without increasing pressure injury risk.
• Caution is advised for repositioning intervals exceeding 3 hours; further research on protective movement effects is needed.