Technology Assistance for Turn Protocol

Background

Patient turning is mainstay of pressure ulcer prevention.¹² Prior studies have estimated compliance rates between 30%³and 66%.⁴⁵⁶

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 subscores from 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.