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| The effect of various combinations of turning and pressure reducing devices on the incidence of pressure ulcers |
| Defloor T, de Bacquer D, Grypdonck MH |
| International Journal of Nursing Studies 2005 Jan;42(1):37-46 |
| clinical trial |
| 6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
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BACKGROUND: Turning is considered to be an effective way of preventing pressure ulcers, however almost no research has been undertaken on this method. AIM: The aim of the study was to investigate the effect of four different preventative regimes involving either frequent turning (2, 3 hourly) or the use of a pressure-reducing mattress in combination with less frequent turning (4, 6 hourly). SUBJECTS: 838 geriatric nursing home patients participated in the study. METHODS: During 28 days, four different turning schemes were used: turning every 2 h on a standard institutional (SI) mattress (n = 65), turning every 3 h on a SI mattress (n = 65), turning every 4 h on a viscoelastic foam (VE) mattress (n = 67), and turning every 6 h on a VE mattress (n = 65). The remaining patients (n = 576) received standard preventive care. MAIN RESULTS: The incidence of non-blanchable erythema (34.8 to 38.1%) was not different between the groups. The incidence of grade II and higher pressure ulcers in the 4 h interval group was 3.0%, compared with incidence figures in the other groups varying between 14.3% and 24.1%. CONCLUSIONS: Turning every 4 h on a VE mattress resulted in a significant reduction in the number of pressure ulcer lesions and makes turning a feasible preventive method in terms of effort and cost.
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