Positioning Duration and Pressure Injury Risk

SEMA ŞAHİNER82 enrolled

Overview

This research aims to investigate the effect of positioning times on the risk of pressure injury in critically ill patients.

Pressure injuries, considered an indicator of quality of care, remain a significant concern today. They are a health problem that reduces the patient's quality of life, complicates the treatment process, and significantly increases costs. Immobility is one of the main risk factors for pressure injury development. In healthy individuals, discomfort occurs in an area subjected to pressure for a long enough period to cause ischemia, and the person changes their position via the afferent sensorimotor feedback system. Fewer than 20 movements per night significantly increase the risk of ulcer development. The factor causing ulcer formation is the inability of the individual to relieve the pressure applied to the tissue. Patients with limited mobility cannot change their body position on their own, and tissue perfusion is impaired in pressure-exposed areas, facilitating ulcer formation. Both the intensity and duration of pressure affect the effect. High pressure causes pressure to build up quickly, while the longer the pressure, the greater the risk of pressure buildup. In individuals at high risk of pressure injuries, frequent position changes are a primary policy for preventing pressure injuries. Experimental studies show that irreversible ischemia occurs when pressure is applied continuously for two hours or longer. The best method for reducing pressure in patients is repositioning. The literature indicates that while pressure injuries cannot be completely prevented, their incidence can be significantly reduced through evidence-based practices, particularly through assessment of at-risk patients, appropriate early nursing interventions, and preventive measures. Advances in the early detection of pressure injuries have been reported in the literature and primarily involve measuring inflammatory markers in anatomical regions to capture the first signs of tissue damage.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Enrollment

Conditions

Pressure Injury Risk Assessment

Interventions

Position Change - 1 HourBEHAVIORAL

Patient positions will be changed at 1-hour intervals.

Position Change - 2 HoursBEHAVIORAL

Patient positions will be changed at 2-hour intervals.

Eligibility

Sex: ALLHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * \- If the patient is conscious, they must volunteer to participate in the study. * For unconscious patients, a first-degree relative (mother, father, spouse, child) must agree to participate in the study. * The patient's dependency level score on the Barthel Activities of Daily Living Index must be 90 or below (moderately dependent, severely dependent, completely dependent). * The patient must not have developed a pressure injury. * The patient must be meeting their daily calorie needs as determined by the nutrition team. * There must be no contraindications to turning the patient to any side. * Patients who are at low risk according to the pressure injury scale (15 points or above according to the Braden Risk Assessment Scale). * The patient must not have an acute neurological problem. * Patients with a GCS score above 7. Exclusion Criteria: * \- If the patient is conscious, they do not consent to participate in the study. * For unconscious patients, their first-degree relative does not consent to participate in the study. * Patients with a Barthel Activities of Daily Living Index score above 90 (mildly dependent, fully independent). * The patient has an existing pressure injury. * The patient is not meeting their daily calorie needs as determined by the nutrition team. * There is a contraindication to turning the patient to any side. * Patients with moderate to high risk according to the pressure injury scale (score below 15 according to the Braden Risk Assessment Scale). * The patient has an acute neurological problem. * Patients with a GCS score of 7 or below.

Locations (1)

Bartin University

Bartın, Turkey (Türkiye)

Outcomes

Primary Outcomes

Skin Integrity Changes

Evaluation of changes in body temperature as a risk factor for pressure injury.

Time frame: Recording body temperature by measuring it with a body temperature measurement device every 24 hours for 72 hours.

Skin Integrity Changes

Evaluation of changes in body moisture level as a risk factor for pressure injury

Time frame: Body moisture will be assessed and documented every 24 hours over a 72-hour period using a body moisture measurement device.

Skin Integrity Changes

Assessment of the occurrence of changes in skin appearance, such as bruising, considered as risk factors for pressure injury.

Time frame: Whether changes in skin appearance, such as bruising, occur will be assessed and recorded through observation every 24 hours over a 72-hour period.

Skin Integrity Changes

Assessment of the occurrence of changes in skin appearance, such as edema, considered as risk factors for pressure injury.

Time frame: The presence of changes in skin appearance, such as edema, will be assessed and recorded through observation at 24-hour intervals over a 72-hour period.

Skin Integrity Changes

Assessment of the occurrence of changes in skin appearance, such as redness, considered as risk factors for pressure injury.

Time frame: The presence of changes in skin appearance, such as redness, will be assessed and recorded through observation at 24-hour intervals over a 72-hour period.

Secondary Outcomes

Braden Risk Assessment Score

Pressure injury risk will be quantitatively assessed using the Braden Pressure Ulcer Risk Assessment Scale, which consists of six subdimensions: sensory perception, moisture, activity, mobility, nutrition, and friction/shear. Total scores range from 6 to 23, with decreasing scores over the assessment period indicating an increased risk of pressure ulcer development.

Data from ClinicalTrials.gov

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