Increasing frequency of critically ill patient turns is associated with a reduction in pressure injuries
Critical Care and Resuscitation, ISSN: 1441-2772, Vol: 20, Issue: 3, Page: 217-222
2018
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Article Description
Objective: Pressure injuries are a significant problem for critically ill patients; they increase morbidity, cost, and duration of hospitalisation. Prolonged immobility is a major risk factor, but evidence guiding how frequently patients should be turned to prevent this complication is limited. We aimed to determine the impact of changing from 5-hourly to 3-hourly turns on pressure injury incidence in critically ill patients. Design: We conducted a pre–post intervention evaluation study, comparing a 6-month period during which patient turns were 5-hourly (1 July 2015 – 31 December 2015) with a 6-month period during which turns were 3-hourly (1 February 2016 – 31 August 2016). These periods were separated by a 3-week wash-in period. Setting: Intensive care unit in a metropolitan tertiary referral hospital. Participants: All patients admitted during the pre-intervention and post-intervention periods were included. Intervention: A change in turn frequency for critically ill patients from 5-hourly to 3-hourly. Main outcome measures: The primary outcome was the number of patients diagnosed with a pressure injury. Secondary outcomes were the total number of pressure injuries, and the number of decubitus injuries. Results: In the pre-intervention period, 1094 patients were admitted; in the post-intervention period, 1165 were admitted. Thirty-eight pre-intervention patients (3.5%) and 23 post-intervention patients (2.0%) developed a pressure injury ( P = 0.028). The incidence of decubitus injuries was markedly reduced in the post-intervention period (36 v 8 injuries, P < 0.001). After adjusting for Acute Physiology and Chronic Health Evaluation (APACHE) III score, duration of intubation and age, the odds ratio for developing a pressure injury in the post-intervention period was 0.51 (95% CI, 0.27–0.97) ( P = 0.041). For mechanically ventilated patients, the adjusted odds ratio for developing a decubitus pressure injury in the post-intervention period was 0.22 (95% CI, 0.06–0.85) ( P = 0.029). Conclusions: A change in turn frequency from 5-hourly to 3-hourly was associated with a halved incidence of pressure injuries. Critically ill patients may benefit from more frequent turns.
Bibliographic Details
http://www.sciencedirect.com/science/article/pii/S1441277223006932; http://dx.doi.org/10.1016/s1441-2772(23)00693-2; http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85054415538&origin=inward; https://linkinghub.elsevier.com/retrieve/pii/S1441277223006932; http://dx.doi.org/10.1016/s1441-2772%2823%2900693-2; https://dx.doi.org/10.1016/s1441-2772%2823%2900693-2
Elsevier BV
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