Sunday, 20 September 2015

Patient repositioning

Seamus Cowman, Associate Editor
Professor Seamus Cowman

Patient repositioning is a commonly implemented pressure injury prevention strategy in health care. The surprising thing is that there is little evidence on how frequently patients should be repositioned, there is also a lack of understanding of the frequency of movement among hospitalized patients with reduced mobility. A new study by Latimer et al 2015: ‘The repositioning of hospitalized patients with reduced mobility: a prospective study’ published in Nursing Open, provides new insights for health professionals in planning care for pressure ulcer, at risk patients. The problem of pressure ulcers represents a serious failing in the delivery of health services and it remains as an enigma to health service professionals and administrators alike, as this is largely a preventable problem.

This observational study incorporated two data collection methods: chart audits and semi-structured observations. Using a consecutive sampling plan, 241 participants were recruited from two large Australian hospitals with one of the inclusion criteria being reduced mobility. The results showed that patients were repositioned more frequently than might have been previously believed and were observed to be repositioned on average 15 times over a 24 hour period. A lack of patient understanding about proper positioning for prevention of pressure ulcers is an important finding. Interestingly older patients and males were repositioned less frequently, placing them at greater risk for pressure ulcer development. Patients were repositioned less at night than they were during the day.

The findings of this study should be of interest to health professionals in their efforts to tackle a mostly preventable health problem. The authors in their conclusion echo a recommendation that is a recurring theme from the literature on pressure ulcers: ‘Targeted and individualized pressure injury prevention management should be incorporated into clinical practice, however, this can only be achieved with nurse’s support and concurrent organizational support’.    

Latimer, S., Chaboyer, W. and Gillespie, B. M. (2015), The repositioning of hospitalized patients with reduced mobility: a prospective study. Nursing Open, 2: 85–93. doi: 10.1002/nop2.20

 July 2015

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