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Turning patients prevents pressure ulcers Essay

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I.             Introduction/ Preparation

  1. Statement of the Problem

As for the study, the main problem to be considered is to determine the significant effects of turning in the prevention of pressure sores or ulcers. With the relational focus between the occurrence of the condition and the physiological processes involved, the study determines the most appropriate time allowance that the nurse should provide in bed turning administration to the patients.

Considering different factors that influence the occurrences of bedsores, the study takes into account the possible factors contributing to their occurrences.

The study aims to determine the relationship of providing bed turn for patients in order to reduce the occurrences of pressure ulcers. Within the study, the nursing intervention of bed turning is to be analyzed as to how it can further alleviate the condition of the patient, especially those who are prone to the development of pressure ulcers (e.g. skinny individuals, immunocompromised, immobile patients, unconscious, etc.).

The condition of Pressure ulcer consists of localized disruption of skin integrity as well as the underlying tissue layers experience intense and prolonged exposure to most commonly pressure, while other etiologies can also include shear, friction, or any combinations of these causal factors.

According to Lyder CH. (2003), pressure sores or also known as decubitus ulcers tend to occur in all cases wherein skin experiences sustained mechanical loads, but are usually common in those patients who are immobile and bedridden or those with administered orthopedic devices.

  1. Background and Significance of Problem

The occurrences of decubitus ulcers have become one of the most common health problems that occur throughout the heath care unit, especially for clients who are immobile and currently under orthopedic therapy. According to statistics, it has been approximated that 1 million adults annually progress into acquiring pressure ulcers due to faulty nursing or care management. The incidence rates vary greatly depending on the health care delivery system. However, statistics evidently show that the occurrence of pressure ulcers range from 0.4% to 38%, which if broken down and categorized to the scope of quality of nursing care, it resulted from ranges 2.2% to 23.9% for health care facilities, and 0% to 17% for home health agencies (Fitzpatrick and Wallace,  2006 p.482).

The most common age groups to develop this type of condition are those individuals aging from 70s and above due to the decreasing blood circulation. Significantly, insufficient and incompetent nursing care in the inpatient setting has been linked to the increasing conditions of this disease condition. In addition, the statistical incidence rates of decubitus ulcers are most prominent among inpatients of the hospital population under this age criteria. In fact, epidemiological ratings usually exceeds higher for those orthopedic cases (Baumgarten M et al., 2003). From the physiological point of view, the reason for the occurrence of decubitus ulcers is the inadequate oxygenation due to progressive or reoccurring pressure.

This impedes the normal case of capillary refill and blood flow, which is responsible for cellular oxygenation; hence, due to impediment and impaired tissue perfusion, the end results to tissue necrosis. The development of these pressure ulcers usually occurs on the lower half body, two-thirds around the pelvis and a third on the lower limbs (National Pressure Ulcer Advisory Panel, 1989). Added by Fitzpatrick and Wallace (2006), the development of pressure ulcers and high epidemiologic ratings of patients under a particular health care delivery system can negatively influence the credibility of nursing care provided by the indicated institution (p.482).

Considering the attempts made in order to reduce or prevent the occurrences of pressure ulcers, the results obtained have significantly provided a small decline of in the epidemiological statistics. Bed turning is one of the most commonly utilized nursing procedures in order to alleviate and reduce the cases of bed sore occurrences. However, there has been no clear study on how to better apply this procedure in terms of frequency as influenced by etiologic factors contributing to the occurrence of pressure ulcers.

To be able to do so, a thorough literature review has been conducted in order to determine the conditions for the application of patient turning. The gathered literature review is an essential component of this study since outcomes of the data gathered could be used in order to act as basis for coming up a nursing care plan for these patients in an effort to reduce the morbidity ratings of pressure ulcers in the health care setting (Gordon MD, Gottschlich MM, Helvig EI, et al., 2004).

In the study done by De Laat et al published in 2005, the authors did utilized a form of review of literatures for the purpose of demonstrating the measures that other studies have utilized in order to prevent or treat pressure ulcers. From this, turning patient had become the most simple and commonly used nursing procedure for this purpose. By determining the standard frequency time for the turning of patients in consideration of factors associated to bed sore occurrences, further guidelines can be mandated in health sectors to effectively reduce the cases of prolonged immobility of patients; hence, reducing as well the risk of pressure ulcer occurrences.

  1. Purpose of the Study

            The purpose of the study is to provide information for the physiological relationship between the occurrence of pressure ulcers and the time standard required in between turning of patients. Critical analysis, comprehensive data integrations, and interpretation of research outcomes are the founding methodologies applied in the course research. The study should provide additional learning awareness for the public and health care institutions especially in terms of the most appropriate time allowance to be allotted in between patient turning. Turning patients can proved to be an important nursing procedure; hence, this study explores this procedure in an effort to raise the credibility of nursing care management in pressure ulcer management via patient turning.

  1. Independent and Dependent Variables
Independent Variables

  1. Patient Age group
  2. Patient – Nurse ratio


Dependent Variables

  1. Hospital protocols and policies
  2. Awareness of nursing facilities in the procedure
  3. Patient cooperation



Definition of Terms:

  1. Independent Variables
    1. Patient Age group

This pertains to the age criteria of those patients who have incurred the condition of bed ulcers. The study does not limit the age criteria although considers and categorizes the age group who had conjured the condition.

  1. Patient – Nurse ratio

This variable pertains to the number of nurses available to cater to patients and the number available in providing the nursing procedure of bed turning for patients against the number of patients requiring need for turning, specifically those are at risk at acquiring the condition and those who have the condition already.

  1. Dependent Variables
    1. Hospital protocols and policies

This dependent variable consists of those rules and standards utilized by the nursing service as the foreground basis in administering nursing procedures to their patient. This component can be modifiable granted that ethical concerns and rightful justifications are provided.

  1. Awareness of nursing facilities in the procedure

The variable involves the knowledge of the nursing facility in terms of properly administering the turning of the patient, which consists of the standard time allotted per patient turning, and if there are considerations being applied depending on the etiology of pressure ulcers.

  1. Patient cooperation

This involves the patient’s willingness to participate in the procedure provided by the nurse. Some patients demonstrate feeling of anxiety and reluctance, which causes resistance in participating in the given procedure.

  1. Significance of Project:
  2. To Patient Care

The study is significant to patient care because the concept of turning patients facilitate appropriate physiological advantage on the part of the patient. By knowing the most recommended time allotted for every turns or repositions, the patient can lessen the risk of developing pressure ulcers, which, on the longer perspective, this can help reduce to morbidity ratings for pressure ulcers among patients.

  1. To Nursing

The study is significant to nursing service since by knowing the most appropriate time necessary to stand as basis for every patient turns or repositions, the nurse may increase their competency in preventing the occurrence of bed sores for in-service patients. In addition, the decrease of pressure ulcer epidemiology in the nursing care facility can provide higher credentials in terms of perception in the nursing unit specified.

  1. To Society

The study is significant to the community as it provides awareness expansion in the boy of nursing care for the sick. The concept of the study is more of a preventive task; hence, those families requiring preventive means for pressure ulcers can utilize the result of the study to further develop their care standards for their own patients; hence, fostering independence among family and community nursing care perspective.


Baumgarten M et al., (2003). Risk factors for pressure ulcers among elderly hip fracture patients. Wound Repair Regen;11:96-103.

Fitzpatrick, J. J., & Wallace, M. (2006). Encyclopedia of Nursing Research. Springer Publishing Publisher.

Gordon MD, Gottschlich MM, Helvig EI, et al. (2004). Review of evidence-based practice for the prevention of pressure sores in burn patients. J Burn Care Rehabil.;25:388-410.

Lyder CH. (2003). Pressure ulcer prevention and management. JAMA;289:223-226.

National Pressure Ulcer Advisory Panel. Pressure Ulcers: Incidence, Economics, Risk Assessment—Consensus Development Conference Statement. West Dundee, Ill: SN Publications; 1989

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