Acute Care Patient Mobility Patterns And Documented Pressure Injury Prevention - An Observational Study And Survey

BackgroundRepositioning is widely recommended to prevent pressure injury (PI). Documentation of implemented pressure injury prevention (PIP) strategies is necessary for continuity of care. This pilot observational study aimed to describe the positioning patterns of patients at risk of developing PIs and to identify gaps in documentation of PIP strategies.MethodsPatients were recruited from neurology and orthopaedic wards. Positions adopted were recorded during a two-hour observational period over three consecutive nursing shifts (day, evening, night). Demographic data, clinical details and recommended or implemented PIP strategies was obtained from medical records. Data were analysed descriptively using frequencies, percentages, medians, ranges and interquartile ranges as appropriate.ResultsTwenty-six out of 38 patients participated; the majority were orthopaedic patients with a median age of 66 years. Twenty-four had a PI risk assessment completed; 12 (50%) were scored at moderate to very high risk of PI. Four (33%) of those in the PI moderate to very high risk categories were prescribed a turning regime; 2 (17%) had received PIP education; and 6 (50%) had a pressure-relieving device recommended. The most observed positions for day shift were supine 46 degrees-90 degrees and sitting out; for afternoon shift were supine 46 degrees-90 degrees and supine 1 degrees-45 degrees, and for night shift left lateral or supine 1 degrees-45 degrees.ConclusionsAcute care patients were most often observed in positions that place them at risk of PIs. Targeted PIP strategies are required that take into account patient movement patterns and address deficiencies in documentation of care.