Preventing pressure ulcers with proper patient turning and positioning

Healthcare professionals see patients with hospital acquired pressure ulcers (HAPUs) and staff with debilitating back injuries all too often.

Chenel Trevellini, MSN, RN, CWOCN, a Registered Nurse from New York who is passionate about sharing best practices, found that implementing a proper system for turning and positioning patients could lower both of these rates significantly. The knock-on effect was substantial savings for the care facility.   

She was working at St Francis Hospital in Roslyn, New York when some new upcoming healthcare laws prompted the hospital to look at innovative ways for pressure ulcer care. “Although we had a very low HAPU rate, we noticed that staff had been getting injured when using draw sheets for turning and positioning patients,” she explained in an interview with MedTech Views.

The hospital had heard about a type of system for turning and positioning patients that sounded like it could address this. “We decided to implement this new system throughout the entire 315-bed hospital with hopes that we could reduce injuries to nursing staff,” said Chenel.

The system’s two components work in tandem to benefit both patients and nursing staff. There’s a low-friction positioning mat with reinforced handles aimed at reducing caregiver back injuries. It also has a low-pressure air chamber designed to adapt to the patient by positive air displacement and redistribute pressure around the sacrum and buttocks, where pressure ulcers often occur. The second component is a fluidised positioner that allows the patient’s body to be supported in a comfortable therapeutic position until it’s time to be repositioned again.

“The design forces the caregiver to use the correct ergonomic position, using their body weight to move the patient,” said Chenel. “It’s also very intuitive, with labels as well as a clear head and tail end,” she added. “Unlike regular cushions, the special positioner guarantees that the patient will stay in the same place. The system helps prevent the patient from sliding down, which decreases friction and shear injuries.”

Over the course of a year, there was a notable reduction in staff injuries directly related to boosting, lifting and turning patients. “The year before we implemented the new system, we had 85 reported incidents, 31 of which resulted in formal claims. After we implemented the system, we had 38 incidents and just 14 claims for the year,” Chenel pointed out. “In monetary terms, this translated into a savings of $269,000.”

There were also some unanticipated outcomes. Special needs bed rentals dropped, with spending on them falling from $85,000 before implementation to $27,000 in the year afterwards. Moreover, patients’ pressure ulcer rates decreased from around 2.5% to 1.9%. “Implementation of the whole system only cost $42,500, so it basically paid for itself,” she commented.

Aside from the clear economic advantages, Chenel emphasised the human benefit. “It addresses both the safety of the caregiver and the patient. Both patients and staff love it. As you can send the system home, family members are able to care for the patient there. This improves the patient’s quality of life because they don’t have to go into rehab or a long-term care facility. And staff appreciate that we’re doing something to look after them, too.” 

Author: Karen Finn