Why is “Turning” so Important to Prevention of Bed Sores?

Turning is the universally acknowledged best method for bed sore prevention. Turning refers to repositioning a hospital patient or bedridden nursing home resident to relieve pressure on one area of the body. Turning can restore regular blood flow to an area, keeping the skin tissues healthy and alive and effectively preventing bed sores. It is a nursing staff’s responsibility to turn patients who could be at risk of developing bed sores. Failure to do so could constitute elder neglect or medical malpractice.

Why do Bed Sores Form?

Bed sores form because of inadequate blood circulation. Blood circulation is what keeps the organs working and the body alive. Blood circulation is necessary for skin tissue growth and health. When something interrupts blood circulation in the skin, such as a buildup of pressure against the skin surface, it can be detrimental to the skin’s processes. Prolonged loss of blood circulation can lead to tissue damage, and eventually necrosis, or tissue death.

A bed sore is a skin lesion that appears when an area of the skin loses blood flow and suffers tissue damage. Stage one bed sores are minor and shallow, only affecting the top layer of flesh. Stage four bed sores, on the other hand, extend deep into the muscles and tendons, and can form craters on the body. Catching a bed sore in stage one can lead to full recovery from turning the patient and relieving the pressure in the affected area. More serious bed sores may require debridement, surgery, and other treatments.

The Importance of Turning

Since interruption to blood circulation can cause a bed sore, maintaining circulation can prevent one. Turning helps an individual maintain proper blood circulation to all areas of the body – especially bony protrusions that are more likely to develop bed sores. Turning can relieve pressure and restore blood flow in the skin of the heels and ankles, backs of the calves, buttocks, hips, back, shoulder blades, elbows, and the back of the head.

It is important for nursing home staff members and hospital workers to regularly turn patients who cannot maintain blood circulation on their own through activity or exercise. People who are elderly, disabled, immobile, injured, comatose, or otherwise confined to a bed or wheelchair will require turning and other physical therapy methods to keep blood pumping throughout the body. Turning may be the only thing that prevents bed sores in at-risk individuals.

Best Practices for Turning a Patient

Although any type of movement or repositioning can be better for a patient than none, the medical industry agrees upon certain best practices for proper turning. Accepted guidelines exist for the prevention of pressure ulcers, but the exact strategy will depend on the patient and the situation. Skin condition, treatment plans, medical condition, and level of mobility can all determine the most appropriate turning strategy. A few best practices are as follows:

• Assess the patient or nursing home resident’s risk factors for bed sores. These include nutrition, weight, and mobility.
• Turn immobile patients at least every two hours, or as a doctor prescribes. Bedridden patients should turn to their sides, or should sit up for a while.
• Move people confined to wheelchairs to beds, lay them flat to alleviate a buildup of pressure.
• Keep a turning chart for each patient that documents when and where to turn the patient to prevent bed sores.

Whether a patient needs repositioning in bed, or needs to transfer from a wheelchair to a bed to alleviate pressure buildup, it is a nurse’s job to recognize the need and act accordingly. Failure to properly turn a patient or to stick to a turning schedule could qualify as negligence or malpractice if it results in a bed sore and related health complications. In these cases, the patient could have grounds to file an injury claim against the at-fault party.

Sources

• Why is “Turning” so Important to Prevention of Bed Sores?
• Repositioning to prevent pressure ulcers
• How to Prevent Pressure Ulcers or Bed Sores
• Repositioning Patients to Prevent Pressure Injuries