Are you repositioning enough?
This week we will look at the importance of repositioning.
The National Institute of Clinical Guidelines (NICE 2015) for Prevention and Management of Pressure Ulcers advises:
‘A lack of mobility and sensation are risk factors for developing pressure ulcers. If a person is unable to reposition themselves, health and social care professionals should help them to change their position, to prevent the development of pressure ulcers. For some people, repositioning equipment may be needed.’
A 30% tilt is advised for those in bed unable to turn themselves. We can support this with pillows, wedges or decubitus cushions. Turns are currently recommend, 2,4 and 6 hourly, dependent on the assessment and risk. However, from the research we can see that *those at risk of tissue hypoxia, can begin to suffer early stage damage within the 2 hour window.
Where care is provided by social domiciliary cares, the amount of repositioning is almost entirely dependent on how many times the carers visit (unless there is a 24hr live in carer). For example, In most local authorities this could be be a maximum of only 4 times a day. So, If the last visit is 10pm and first 8am the patient has gone 10 hours with out a reposition. Way over the recommended amount.
Although there are limited devices that can offer a 30% tilt safely independent to carers or nurses assistance, there are increasing devices that can offer a 10-20% ‘tilt’ mode for in-between the manual turns. This allows a degree of offloading particularly if in the spine position, form the sacrum and coccyx, scapula.
Further research is being conducted on the degree required to gain adequate circulation
- see here.
The OSKA Series5-V4L mattress is the ideal solution to help with lateral rotation as well as providing exceptional comfort and support. It gives an alternating air and foam combination which and is suitable as an aid in the prevention oand treatment of pressure damage up to and including category 4.
The mattress can be switched from alternating therapy to lateral rotation therapy which gently tilts the patient from side to side every 20 minutes to alternate the pressure. This is ideal for palliative care or situations where manual turning is difficult.
It is important to remember this does NOT replace a manual turn from care staff as per the reposition chart but offers a great solution to support tissue reperfusion in between turns.
If you need clinical advice feel free to contact me here at OSKA™.