Device shows promise for preventing pressure sores

A purpose-designed positioning device has proven more effective at keeping residents in a good sleeping position than standard pillows, the results of a Melbourne University study show.

Demonstration of placement of the fluidised positioner for the side lying lateral tilt position in bed

A purpose-designed positioning device has proven more effective at keeping residents in a good sleeping position than standard pillows, the results of a Melbourne University study show.

The study published in the International Wiley Journal in July compared the effectiveness of a fluidised positioner, which is a purpose-designed device filled with a viscous fluid mix that conforms to and supports the body during positioning, and the standard care pillow, in keeping residents in a 30-degree side-lying lateral tilt position.

Using this position in bed is considered an effective strategy in reducing pressure injuries in a resident’s tailbone area.

The study involved 12 aged care residents who were immobile in bed and at the risk of developing pressure injuries from Illoura Residential Aged Care in Wangaratta, Victoria.

Residents were observed at the time of positioning for a baseline measure and after one and two hours on 10 occasions over four weeks.

Staff were on average able to position residents at 30.7 degrees using the fluidised positioner compared to 26.7 degrees using a standard pillow, said Dr Suzanne Kapp, the study’s lead investigator.

“When they used the positioner, residents were better maintained in their position,” Dr Kapp told Australian Ageing Agenda.

The average angle of residents with the fluidised positioner was 29.3 degrees after one hour and 26.8 degrees after two hours, compared to 21.5 degrees and 16.6 degrees respectively for residents with the standard pillow, the study found.

The positioner keeps the shape its moulded in and does not flatten over time to support the resident to maintain the desired body position, unlike pillows which do flatten out over time, Dr Kapp said.

Dr Kapp said pillows are widely used to position aged care residents care facilities, despite not being designed to be.

“Pillows were never designed for us to use with that purpose, they were designed for us to put our heads on in bed for healthy people to get a good night’s sleep,” said Dr Kapp, a nurse and a researcher.

The study also looked at the impact of using a tortoise turning pad, a device with air cells that envelops a resident in a reverse tortoise-like shell compared to a slide sheet, which is commonly used to reposition residents.

Dr Kapp said residents felt more comfortable and safe when being repositioned with the tortoise turning pad.

The fluidised positioner was also well-received by staff, a survey involving 25 nurses from the study showed.

“There was the general consensus that the positioner kept people in the position better than the pillows did, the nurse’s opinion therefore mirrored what we found in the data,” Dr Kapp said.

Nurses also reported the fluidised positioners were easier to clean than pillows, she said.

Dr Kapp encouraged aged care nurses to consider turning and positioning more than a comfort and hygiene measure.

“When we are turning and positioning people it’s an opportunity to make sure they don’t have skin damage associated with pressure injuries. It’s important that we aren’t just turning them to move the body from position A to position B, we’re actually thinking about what position we put them in,” she said.

“We all know that turning and positioning is important, but I think we have to take our thinking to another level and go, right, what is it exactly that we need to do to prevent pressure injuries? I think that’s a really important first step,” Dr Kapp said.

Dr Kapp is now working on a proposal to conduct a larger aged care trial evaluating the fluidised positioner and tortoise turning pad.

Access the study here.

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Tags: Department of nursing, Dr Suzanne Kapp, fluidised positioner, fluidised positioning device, Illoura Residential Aged Care, International Wiley Journal, university-of-melbourne,

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