Pressure ulcers are found on bony prominences and are due to continuous pressure supporting the body. Bed-bound patients are at a greater risk due to immobility or impaired neurological status; these conditions prevent patients in making minor shifts in body movement. increasing the risk of skin breakdown. Pressure ulcers can develop in less than 12 hours (Rich et al. 2011a).
Proper interventions are necessary for preventing complications and infections caused by pressure ulcers. Health care facilities are currently repositioning and using redistributed pressure support surfaces (RPSS) to decrease the risk of skin breakdown. The purpose of this review is to analyze secondary and primary studies on the comparative intervention of redistributed pressure support surface and frequent positioning in treating or preventing pressure ulcers. The literature review PICO question is “Does the use of redistributed pressure support surface versus frequent repositioning reduce the risk of pressure ulcers in bed-bound patients?”
Literature of Review
Ten articles were selected for literature of review on pressure ulcers and support surfaces. The articles were narrowed down to five. The articles selected focused on repositioning and pressure redistributing support surfaces. Five articles were removed because of no relevance to the topic, and outdated information.
Frequent Repositioning
The article by Rich et al. (2011a), was an observation study on elderly patients with hip fractures. The study found patients’ that had a higher score on the Braden scale were at a greater risk of developing pressure ulcers despite frequent positioning. Patients’ with a lower score on the Braden scale who received frequent reposition had a lesser chance of getting pressure ulcers. The second article by Bergstrom et al. (2013), was a randomized clinical study on patients with a diagnosis of cardiovascular and dementia. The results found patients’ whose nutrition was inadequate, displayed incontinence, and had higher muscle wasting were a higher risk for pressure ulcers, and that frequent repositioning was not vital. Both studies showed that frequent repositioning was not signifi cant in preventing pressure ulcers in patients’ with systemic issues, poor mental status and decrease in musculoskeletal functioning. Although both studies showed frequent positioning to be ineffective in a large number of patients, they also showed that it was beneficial to some, and that manual repositioning should still be utilized.
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