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Bedside Ergonomics Learn to Turn Training Series

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Lesson 1 – Why Do Bedsores Occur ?

Although people develop pressure injuries (aka pressure ulcers or bedsores) for a variety of reasons, at the root of ALL pressure injuries is pressure itself.

Did you know that 90% of bedsores occur on only two areas of the body? 1. The trunk area (sacrum/coccyx and hip sides, aka the greater trochanter) and 2. The heels.

In this chapter, we explore how pressure injuries (bedsores) develop, what they look like and why they commonly occur where they they do. This helps us to see why positioning to reduce pressure is the single most important thing we can do to prevent and treat bedsores.

Lesson 2 – Principles Of Neutral Posture

Ergonomics is not just for the worker anymore! Just as there is a right way and a wrong way to sit to protect your body from muscle-skeletal strain & injury (Momma always said “dont slump!”) so is there is a right way and a wrong way to lay while in a bed.

When you have to consider a persons illness or injury and you must prevent pressure from certain areas, things can get quite complicated indeed.

In this chapter we review the importance of positioning and the how the principals of neutral posture can be applied to achieve the best possible body alignment with optimal pressure distribution for a person who is laying on a bed.

Lesson 3 – Ergonomics and Offloading Techniques

Now that you know the fundamentals about the relationship between pressure and pressure injury, lets Learn to Turn!

In this lesson we put together the concepts of ergonomics and offloading techniques to demonstrate how to achieve the most comfortable and longest lasting pressure reduction possible.

We know turning can be difficult. If you have any questions regarding your specific circumstances, please feel free to contact us for suggestions. We’re here to help!

Lesson 4 – Caregiver Ergonomics

Perhaps the most important aspect of positioning for pressure injury prevention and treatment is also the most commonly overlooked. Lifting and helping people to move is heavy work, and it can be quite difficult, even when it is done correctly. But if the caregiver is hurt he/she is not able to help prevent bedsores, so it is critical that lift safety techniques are used at all times.

In this section we provide an overview caregiver lift safety for the bedbound person. We evaluate good body mechanics, acceptable weights to lift and how to determine if you are lifting too much and an overview of what to do if that is the case. This is not a comprehensive discussion on caregiver lift safety, so if you are having trouble please contact your medical team (a physical or occupational therapist would be best) to learn about lift equipment options that can suit your needs.

Tips for Difficult Turns

We understand there are many situations where positioning and supporting a person at a side turned position can be difficult. But when bedsores are an issue, it is important to be diligent about repositioning to relieve the pressure. We have put together a list of useful tips that nurses use to help.

It can be hard enough to support a person near a 30 degree side position. But sometimes the turning itself can be quite the challenge. There are way too many of Do’s, Don’ts and Try this’s to cover on this quick tip sheet, but there are a few universal things everyone should do when turning a person that is difficult to turn.

Quick Reference Guide For Comparing Positioning Devices

This guildeline outlines the basic expectations of supporting a person near a 30 degree lateral turn for the purpose of pressure injury prevention. Measure performance of any positioning device (pillows, wedge cushions, fluid devices) using these criteria.

Positioning Device Performance Measures

The better your positioning device works, the better your chances of preventing or healing a pressure wound. Below are performance measures you can use to evaluate how well a positioning device is serving its purpose.

How Often Should a Person Be Turned and Repositioned

It is well proven that consistent turning and repositioning works to reduce pressure injuries. But there is no single hard & fast rule for how often you need to reposition your person, because everybody is different. Turning and repositioning should be done as needed (aka PRN) to maintain stable pressure reduction and keep the skin clean and dry.

How To Prevent Wedge Slipping

We at Jewell Nursing Solutions took the time to understand why slipping and shifting happens so that we could figure out exactly how a positioner should be designed to prevent it. So solving the problem of wedge slipping is crucial to achieving the best possible pressure injury prevention.

Nursing Tips for Managing Difficult Turns

There are many situations where positioning and supporting a person at a side turned position can be difficult.But when bedsores are an issue, it is important to be diligent about repositioning to relieve the pressure. Below is a list of useful tips that nurses use to help turn and reposition.