Stephanie Adams, RN, VA Medical Center, Boise, ID
Kattie Payne, RN, PhD, VA Medical Center, Boise, ID
Margaret Doucette, DO, VA Medical Center, Boise, ID
Background: Patient turning is mainstay of pressure ulcer prevention. Prior studies have estimated compliance rates between 30% and 66%.
Methods: Wearable monitoring system shown to improve turn compliance6 was implemented on 27-bed medical/surgical unit. Two-hour turn protocol was assigned to all patients per unit protocol.
Results: Sixty-nine patients (mean Braden 19.4, min 13, max 23) were monitored over 31 days for 3287 hours. Average turn compliance was 90.3%. Least compliant times coincided with shift changes, high patient admit days and medication delivery. Patients with high Braden scores (19-23) repositioned up to 42 times per hour. Lower Braden scores were associated with fewer hourly repositionings.
Project Outcomes: The data provided evidence to exclude patients with high mobility/activity subscoresfrom turn protocol. Compliance by hour of day indicated that clustering certain nursing tasks would improve staffing effectiveness and compliance. Monthly compliance data was adopted as quality metric.