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Better Bed Positioning Short Term, Greater Benefits Long Term

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Patient positioning is one of the most frequently performed tasks in long-term care facilities, but it can also pose a daily struggle for practitioners as bedridden residents who are weak, immobile, or medically or cognitively compromised do not have the physical ability to reposition themselves. This puts them at a significantly higher risk of incurring skin breakdown or pressure injuries induced by friction, shear, moisture, or pressure, which can cause severe pain and discomfort, and in some circumstances, death.

The Economic Impact of Pressure Injuries

The development of pressure injuries can have a considerable economic impact on facilities, often requiring an increase in care, length of stay, and overall burden on caregivers. The Society of Actuaries reports the following costs as the result of pressure injuries in hospitals or other healthcare facilities in the United States:¹

• Patients affected: 2.5 million per year
• Total cost: $9.1 to $11.6 billion per year
• Cost of individual patient care: $20,900 to $151,700 per pressure injury
• Added cost to individual care: Medicare estimated in 2007 that each pressure injury added $43,180 in costs to a hospital stay
• Lawsuits: More than 17,000 lawsuits are related to pressure injuries annually, making it the second most common claim after wrongful death and greater than falls or emotional distress
• Death: About 60,000 patients die as a direct result of a pressure injuries each year

The Benefits of Proper Positioning and Supportive Aids

Following basic and proper positioning guidelines to turn patients at least every two hours (depending on resident needs) or employing commonly used methods such as the Rule of 30 help to greatly decrease the risk of pressure injuries.^2,3 However, equally as important are the tools used to aid with correct positioning and body alignment such as bed wedges, skin and heel protectors, and contracture management braces. These devices along with applicable repositioning go one step further in helping to mitigate costly injuries by:

• Relieving pressure on injury-prone areas such as bony prominences
• Minimizing friction and shear to reduce skin trauma
• Reducing painful contracture formation
• Improving blood flow and circulation

Proactively addressing positioning needs in the short term can lead to meaningful benefits in the long term for both the patient and the caregiver. An effective positioning care plan combined with appropriate positioning aids can have a positive impact on residents, promoting a more active role in their daily care and improving their overall quality of life and independence—all of which results in a decreased burden of care on caregivers.

Useful Solutions for Patient Positioning

• Body Positioners provide secure positioning and maintain safe turning schedules to ensure skin integrity and safety in bed. AliMed’s Tuff-Coat™ Body Positioning Wedge supports proper side-lying while the antimicrobial-treated coating helps control infection risk.
• Skin Sleeves protect fragile body parts such as shins, ankles, forearms, and elbows from skin tears, bruising, and friction burns caused by contact with hard bed surfaces or bed linens. Non-compressive, breathable material guards against skin irritation and moisture build up.
• Contracture Management Devices properly position extremities without risking joint contracture, excessive bone-on-bone pressure, or cross-limb injury. Available for the hand/wrist, elbow, knee, or foot/ankle. AliMed Grip Splints therapeutically position wrists, hands, and fingers, and are particularly helpful post-stroke.
• Heel Protectors cradle the foot and ankle while suspending the heel for complete pressure relief. AliMed Heel-Up Foot Positioners feature a skin-friendly, microsuede interior with SaniGuard® AG antimicrobial that wicks moisture for cooling comfort and added skin protection.

References

1. https://www.ahrq.gov/professionals/systems/hospital/pressureulcertoolkit/putool1.html
2. https://rnao.ca/sites/rnao-ca/files/Positioning_Techniques_in_Long-Term_Care_-_Self-directed_learning_package_for_health_care_providers.pdf
3. https://www.shieldhealthcare.com/community/popular/2015/11/18/move-every-two-repositioning-patients-to-prevent-pressure-ulcers/
4. https://www.npuap.org