Bedsores are a common sign of neglect for nursing home patients. Caregivers need to reposition immobile patients every two hours to keep their blood flowing, their skin healthy, and to prevent bedsores.
Can Bedsores Be Prevented?
Almost 2.5 million patients suffer from bedsores each year. Some of these pressure injuries are unavoidable, but most can be prevented. The most effective way to prevent a bedsore is by frequently changing a patient’s position. Currently, the accepted guideline for care recommends that patients be turned every two hours. However, there is more to individualizing a patient’s care plan to determine the proper positions and how often turns should occur to prevent dangerous sores from developing.
Factors for determining a plan for a patient includes examining the following factors, such as the patient’s:
- Tissue tolerance over bony prominences
- Activity and mobility levels
- General medical condition
- Treatment objectives
- Condition of skin
- Comfort level
Testing a Patient’s Tissue Tolerance
While two hours is the rule of thumb for most patients, it may not be appropriate for all. Caregivers must test a patient’s tissue tolerance by determining the time it takes for skin to redden over bony prominences. Determining the frequency of turn involves moving and repositioning the patient using recommended techniques. The amount of time a patient is left in the same position until skin redness needs to be determined. Once that time is established, the caregiver should set the turn frequency to 30 minutes less than that time.
Parepositioning Patients in Bed Using Proper Technique
When repositioning bed-bound patients, the caregiver must make sure that the pressure is redistributed or relieved. They should also avoid positioning the patient on bony prominences that are already reddened because this could be an early sign that the skin is breaking down. The caregiver must lift the patient instead of dragging him or her during repositioning. This reduces skin damaged caused by friction and shear.
Seated Patients Require More Frequent Repositioning
Patients in wheelchairs need to be turned more often than bed-bound patients. Caregivers should teach chair-bound patients to shift their weight every 15 minutes. When patients are unable to reposition on their own, caregivers should move them each hour. A pressure redistribution cushion should be used to help distribute the patient’s weight without increasing the potential for skin damage.