The effect of various combinations of turning and pressure reducing devices on the incidence of pressure ulcers.

Background: Turning is considered to be an effective way of preventing pressure ulcers, however almost no research has been undertaken on this method.

Aim: The aim of the study was to investigate the effect of four different preventative regimes involving either frequent turning (2, 3 hourly) or the use of a pressure-reducing mattress in combination with less frequent turning (4, 6 hourly).

Subjects: 838 geriatric nursing home patients participated in the study.

Methods: During 28 days, four different turning schemes were used: turning every 2 h on a standard institutional (SI) mattress (n = 65), turning every 3 h on a SI mattress (n = 65), turning every 4 h on a viscoelastic foam (VE) mattress (n = 67), and turning every 6h on a VE mattress (n = 65). The remaining patients (n = 576) received standard preventive care.

Main Results: The incidence of non-blanchable erythema (34.8-38.1%) was not different between the groups. The incidence of grade II and higher pressure ulcers in the 4h interval group was 3.0%, compared with incidence figures in the other groups varying between 14.3% and 24.1%.

Conclusions: Turning every 4 h on a VE mattress resulted in a significant reduction in the number of pressure ulcer lesions and makes turning a feasible preventive method in terms of effort and cost.