Patient repositioning and pressure ulcer risk

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Patient repositioning and pressure ulcer
riskMonitoring interface pressures of at-risk
patients

• Matthew J. Peterson, PhD Nikolaus Gravenstein,
  MD Wilhelm K. Schwab, PhD Johannes H. van
  Oostrom, PhD Lawrence J. Caruso, MD

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• Aim
• Examine the effect of routine repositioning over
  an extended time period on the interface
  pressures of the perisacral skin area of
  bedridden patients at risk for pressure ulcer
  formation using interface pressure mapping.
• Relevance
• Several recent studies in which repositioning was
  used as the primary intervention strategy failed
  to reduce the incidence of pressure ulcer
  formation .

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Method

• Used interface pressure mapping to assess how
  effectively routine repositioning relieves
  at-risk tissue of perisacral area.
• Recorded perisacral skin-bed interface pressures
  of bedridden patients at risk for pressure ulcer
  formation every 30 s during routine repositioning
  care for 46 h.

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Results

• At-risk patients have skin areas that are likely
  always at risk throughout their hospital stay
  despite repositioning.
• Skin areas that exceeded elevated pressure
  thresholds for gt95 of observation period
• All participants (23) 206 182 cm2.
• Participants observed in supine, turned left,
  turned right positions (13) 166 184 cm2.

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Conclusion

• Healthcare providers are unaware of actual
  tissue-relieving effectiveness (or lack thereof)
  of repositioning interventions.
• May partially explain why pressure ulcer
  mitigation strategies are not always successful.
• Relieving at-risk tissue is necessary part of
  pressure ulcer prevention, but repositioning
  practice itself needs improvement.