Transcript

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There are a couple. Staffing can play a role in us, guaranteed, but I think there are some strategies we can do to help that. So let me bring the real world in. If you are still repositioning with a draw sheet and pillows in 2026, the turn is an evidence-based practice. you're turning them because the evidence shows that we have to offload. But if you're turning with a draw sheet, in other words, you're moving the patient with a draw sheet, that's not evidence. If you're supporting them with a pillow, that's not evidence-based practice because you will lose the position with the pillow. 

So one of the biggest challenges I find is staffing comes up as “We don't have enough people.” But interesting enough, if you have the right tools, the right evidence-based practice tools, resources—so not just the practice, but the resources—then it makes it easier for the staff to do. 

So let me just give you an example of this. Probably in the last 10 years, there's been a proliferation of turn and position systems for the bed for a mobile patient. Some of them have air, some of them don't. Even in a study that didn't include the air, which would make it even easier to do the repositioning, when they did an observation on timing, for a manual turn-in position with pillows and draw sheets, the average time was 16.5 minutes with a standard deviation of 10 minutes. When a turn-in position system was used, the average turn was 3.5 minutes with a standard deviation of 2.5 minutes. So if we were using the correct tools in the environment, it would take less time. It would allow us to be more efficient and we would be able and delivering the correct evidence-based care. So not just the practice, but the evidence-based resources to deliver the practice. 

So I think, and there's other strategies. Now, don't get me wrong. I understand the significant challenges of if you're running in a med-surg unit and you're running 6 or 7 patients to one nurse, and the data shows that becomes directly associated with our ability to not deliver the care. But that's even worse if you don't have the right tools. 

Another strategy, and I've seen this, it's been in publication, but I've also seen it out in practice, internal and external turn teams. So internal turn team is where everybody signs up to take a 2-hour window where they're participating with the practicing clinician to ensure the turns take place. So it's done once a shift and you rotate that activity so that there is assistance in making sure it gets done. So that's an example of an internal turn team. External turn teams, there are companies now that are partnering with hospitals to help identify those significant patients at risk and be the extra pair of hands for that frontline clinician to be able to achieve the care. 

So while it is real, I think there are things that we can do. Bundling some of our care practices that occur during our hourly rounding, the turn teams, reminder clocks. But there is an underlying premise that you have to have the right number of people as well. And the data shows that when you start to get above five on a med-surg unit, it becomes difficult.