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50 Years of Fighting Pressure Ulcers Called Into Question

Alexandra Wilson Pecci, for HealthLeaders Media, November 26, 2013

"When you do it, you need to pay attention and make sure it's working for you," Bergstrom says.

Considerations for less-frequent patient turning:

1. Residents "need to have a high density foam mattress on the bed," Bergstrom says, not an overlay or pad on top of another type of mattress.

2. Use a safety checklist. Bergstrom's team developed a safety checklist, "which was almost an unintended consequence" of the study, she says.

The checklist took one minute for nurses to complete; they did it every time they turned a patient. It asked: What time was the patient was turned, and what position was he/she put in?; Were the patient's heels up (yes or no)?; Was the skin normal, red, bruised, or open?; Were the patient's briefs dry, wet, or soiled?; What was the brief care: washed, barrier cream, clean briefs? (check all that apply).

"It goes back to one of the first things I know; if you're going to turn people it's wise to look at the skin at every turn," Bergstrom says. "Everybody was rated on this checklist every time, and we believe this became a major safety factor in the study."

3. Be systematic. Facilities "need to teach the nurses to do these observations; they need to monitor."

Alexandra Wilson Pecci is a managing editor for HealthLeaders Media.

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