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Two-hour turns may no longer be the standard, study finds

For years, the traditional protocol to preventing pressure ulcers was to turn the at-risk nursing home resident every two hours. Researchers at the University of Texas initiated the Turning for Ulcer ReductioN (TURN) study to determine if nursing homes using high-density foam mattresses could turn at-risk residents less frequently, while protecting them against pressure ulcers.

This randomized, controlled study of moderate to high-risk seniors age 65 and older were put on either 2-, 3- or 4-hour repositioning schedules, using high-density mattresses, for three weeks and received weekly skin assessments. A nurse, uninformed of the randomized turn schedule, checked each participant’s for pressure ulcers each week. No serious pressure ulcers were found during the study.

“We hope using high-density foam mattresses and being very much aware of resident’s skin at every turn will decrease the necessity of turning residents every two hours to prevent pressure ulcers and allow residents to sleep more, improving quality of life, said lead investigator Nancy Bergstrom, PhD, associate dean at the UT Health Science Center. However, she cautions: “Of course clinical judgment is necessary when implementing the results of this study; these findings do not mean that turning is unnecessary.”   


Topics: Clinical