Fiduciary Responsibility: A Cost/Benefit Evaluation of Positioning and Offloading System Related to Patient Safety & Caregiver Safety

Background: Turning and positioning immobilized patients is a necessary intervention in a pressure ulcer prevention program. This intervention promotes patient safety when effectively applied. However, turning and positioning may impose repetitive injury to caregivers. The U.S. Department of Labor estimates over $20 billion annually is spent on back injuries developing in the healthcare industry (2010). The caregiver should be offered a method of turning and positioning patients, which maximizes ergonomic efficiency and promotes proper body mechanics.

Description: A performance improvement project was undertaken to reduce safety risk to caregivers and patients associated with turning and positioning. The project examined the effects of single patient use overlay turning, positioning and offloading system in 300+ bed acute-care hospital. All direct-care nursing staff educated on directions/indications for use. Clinical RN determined clinical justification for utilizing assessment parameters: patient’s weight, Braden Sub-score Mobility and Sensory Perception. January 2013 – September 2013, ninety-eight patients placed on overlay device with basic prevention static support surface. All patients were identified at risk for pressure ulcers using Braden Risk assessment score or had an existing pressure ulcer at time of placement.

Outcomes: The ninety-eight patients provided large number of staff with the experience of utilizing the turning and positioning device. Anecdotal feedback included staff feeling increased confidence of safety during frequent turning and positioning while using the device. Zero staff members utilizing turning, positioning, and offloading system developed injuries as a result overexertion or straining during routine turning and positioning. Zero of the ninety-eight patients went on to develop pressure ulcers or worsening of existing pressure ulcers. An unexpected result of lowering bed-rental spend by $67,000 compared with January - September 2012 rentals.