Document Detail


Does regular repositioning prevent pressure ulcers?
MedLine Citation:
PMID:  19018196     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Prolonged exposure to pressure is the primary etiologic factor of a pressure ulcer (PU) and effective preventive interventions must avoid or minimize this exposure. Therefore, frequent repositioning of the patient has long been recommended as a means of preventing PU. OBJECTIVES: To review the evidence on the efficacy of repositioning as a PU prevention intervention. SEARCH STRATEGY: A systematic review of electronic databases MEDLINE and CINAHL, from January 1960 to July 2008, was undertaken. Studies were limited to prospective randomized clinical trials or quasi-experimental studies that compared repositioning to any other preventive interventions or any study that compared various techniques of repositioning such as turning frequency. Only those studies that measured the primary outcome of interest, PU incidence, were included in our review. RESULTS: Limited evidence suggests that repositioning every 4 hours, when combined with an appropriate pressure redistribution surface, is just as effective for the prevention of facility- acquired PUs as a more frequent (every 2 hour) regimen. There is insufficient evidence to determine whether a 30 degrees lateral position is superior to a 90 degrees lateral position or a semi-Fowler's position. IMPLICATIONS FOR PRACTICE: The current regulatory and legal environment has focused increased attention on PU prevention. Pressure redistribution methods and the frequency of application are among the first factors scrutinized when a PU develops. Our clinical experience validates that regular movement of the immobilized patient is important, but evidence defining the optimal frequency of repositioning or optimal positioning is lacking.
Authors:
Lee Ann Krapfl; Mikel Gray
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society / WOCN     Volume:  35     ISSN:  1528-3976     ISO Abbreviation:  J Wound Ostomy Continence Nurs     Publication Date:    2008 Nov-Dec
Date Detail:
Created Date:  2008-11-21     Completed Date:  2009-02-13     Revised Date:  2009-05-21    
Medline Journal Info:
Nlm Unique ID:  9435679     Medline TA:  J Wound Ostomy Continence Nurs     Country:  United States    
Other Details:
Languages:  eng     Pagination:  571-7     Citation Subset:  N    
Affiliation:
Wound/Ostomy Department, Mercy Medical Center, Dubuque, Iowa, USA.
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MeSH Terms
Descriptor/Qualifier:
Humans
Movement*
Ostomy / nursing*
Posture*
Pressure
Pressure Ulcer / prevention & control*
Randomized Controlled Trials as Topic
Comments/Corrections
Erratum In:
J Wound Ostomy Continence Nurs. 2009 Jan-Feb;36(1):34

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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