Effects of a continuous lateral turning device on pressure relief

Psychometric testing and evaluation of user acceptance of an automatic lateral turning device for the prevention of pressure ulcers

INTRODUCTION

Repositioning of patients with reduced or impaired mobility could lessen pressure ulcers (PU). Automated preventive devices can support nurses, but user acceptance must be determined with valid and reliable tools. This study measured user acceptance of an automatic lateral turning device, using a self-developed questionnaire.

METHOD

The study included 194 nurses in leadership positions from 75 institutions. A two-page user acceptance questionnaire was designed and tested for internal validity (exploratory factor analysis; EFA) and reliability (Cronbach's-α). A linear regression analysis was used to test the model's theoretical framework.

RESULTS

The overall response rate was 74.9%. The EFA revealed five exploratory factors ("pain/well-being", "PU prevention", "handling", "nurse support", and "obese patient support") from the two outcomes ("general satisfaction" and "can replace manual repositioning"). The adjusted r² was 0.607 for "general satisfaction", with the maximum standardized β for "PU prevention" (0.476), "pain/well-being" (β = 0.197) and "handling" (β = 0.145). The adjusted r² for "can replace manual positioning" was 0.458. The β for "nurse support" was 0.264, followed by "pain-wellbeing" (β = 0.224) and "obese patient support" (β = 0.218).

CONCLUSION

The psychometric testing results were satisfactory. Overall user acceptance of the automatic lateral turning device was high. A positive evaluation of the system's functionality, regarding the prevention of PU, is essential for patient and staff satisfaction, as well as user recommendation.

Friction characteristics of preventative wound dressings under clinically-relevant conditions

Wound dressings can be used prophylactically or during actual treatment. Preventative dressings have become a standard of care to prevent pressure ulcers in patients while in bed. While the mechanism of the preventative benefit has not been completely explained, the friction between the dressing and linen is hypothesized as being a key performance factor. The objective of this project was to quantify the static and kinetic coefficients of friction (COF) of various brands of prophylactic dressings under the stresses experienced in situ, while the dressings are in contact with bed linen materials. The COF of six commercial dressings were calculated using tribometer measurements. The ranges of static COF were 0.333-0.542 and kinetic COF were 0.333-0.513. Four dressings exhibited COF that were consistent with skin-linen values reported in the literature and all dressing COF appear to be lower than the COF of moist skin against linen.

Evaluating patient turn effectiveness using turn-assist technologies

Pressure ulcers are commonly developed in bedridden patients due to prolonged pressure on bony prominences. Turn-assist support surfaces have been developed to help reposition patients to redistribute interface pressure. The aim of this study was to determine if turn-assist technologies confer benefits to patients relative to manual turning, and to determine if different turn-assist functionalities influence patient outcomes differently. Interface pressure (contact area, average and peak pressure) and patient turn quality metrics (turn angle and repeatability) were recorded during manual and facilitated turns on two different turn-assist hospital beds at initial patient position, turn-assist (maximal mattress inflation) and final patient position. Manual turns produced the most repeatable turn angles, and closest to the recommended 30° compared to both turn-assist surfaces. Interface pressure differences between surfaces were most prominent in the pelvis region across all three time points. Overall, turn-assist surfaces produced interface pressure outcomes similar to manual turning, but manual turning produced more repeatable and optimal patient turn angles. Different turn-assist surfaces achieved different patient turn angles, so functionalities should be examined before device implementation.