Effects of the Trunk Maintenance Repositioning Method on Keeping a 30° Side-Lying Position, Comfort, and Skin Condition

체간 유지 체위변경 방법이 30도 측위 유지, 편안함 및 피부 상태에 미치는 효과

  • Lee, Chae Won (Asan Medical Center) ;
  • Yi, Young Hee (Department of Clinical Nursing Science, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2018.01.15
  • Accepted : 2018.01.30
  • Published : 2018.02.28

Abstract

Purpose : This study was performed to evaluate the effects of a prolonged a $30^{\circ}$ side-lying position on comfort and skin condition by applying the trunk maintenance repositioning method, which can keep the $30^{\circ}$ side-lying position effective for preventing pressure ulcers. Method : Fifty-four healthy nurses working at a general hospital in Seoul were randomly assigned to an experimental group (n=27) or a control group (n=27) and assumed a position of lying on their right or left side for two hours. The trunk maintenance repositioning method was applied to the experimental group using the pillow made by the researcher, while the original repositioning method was applied to the control group using the regular pillow from the subject hospital. Participants' posture angles, comfort, and skin condition were measured at the time of the intervention, as well as at one and two hours after the intervention. Results : There was no statistically significant difference in position angle, comfort, skin condition change, or sacrum and greater trochanter pressure change between the two groups over time. Conclusion : It is necessary to review the method and frequency of change of position in each hospital. In addition, a proper position changing pillow should be developed in consideration of patients' various body shapes.

Keywords

References

  1. An, N. Y., Jo, J. D., & Song, G. H. (2010). Comparison of cushion for prevention of pressure ulcer on seated pressure. Journal of Assistive Technology, 4(1), 45-55. https://doi.org/10.5042/jat.2010.0665
  2. Bennett, G., Dealey, C., & Posnett, J. (2004). The cost of pressure ulcers in the UK. Age and Ageing, 33(3), 230-235. https://doi.org/10.1093/ageing/afh086
  3. Cakmak, S. K., Gul, U., Ozer, S., Yigit, Z., & Gonu, M. (2009). Risk factors for pressure ulcer. Advances in Skin & Wound care, 22 (9), 412-415. https://doi.org/10.1097/01.ASW.0000360256.99980.84
  4. CAPE co., ltd (2015). Palm Q. Retrieved January, 7, 2016, from http://www.cape.co.jp/products/pdt017.
  5. Defloor, T. (2000). The effect of position and mattress on interface pressure. Applied Nursing Research, 13(1), 2-11. https://doi.org/10.1016/S0897-1897(00)80013-0
  6. Eom, J. Y., & Jung, D. Y. (2013). Systematic review for the pressure ulcer preventive interventions. The Korean Gerontological Society, 33 (1), 21-37.
  7. Gorecki, C., Closs, S. J., Nixon, J., & Briggs, M. (2011). Patient-reported pressure ulcer pain: A mixedmethods systematic review. Journal of Pain and symptom Management, 42 (3), 443-45. https://doi.org/10.1016/j.jpainsymman.2010.11.016
  8. Hagisawa, S., & Ferguson-Pell, M. (2008). Evidence supporting the use of two-hourly turning for pressure ulcer prevention. Journal of Tissue Viability, 17 (3), 76-81. https://doi.org/10.1016/j.jtv.2007.10.001
  9. Hospital Nurses Association. (2013). Evidence based clinical nursing practice guidelines, Prevention and management of pressure ulcer. Retrived December, 11, 2015, from http://www.khna.or.kr/web/information/data/khna_guide_ebp02.pdf.
  10. Kallman, U., Engstrom, M., Bergstrand, S., Ek, A. C., Fredrikson, M., Lindberg, L. G., & Lindgren, M. (2014). The effects of different lying positions on interface pressure, skin temperature and tissue blood flow in nursing home residents. Biological Research for Nursing, 17 (2), 142-151. https://doi.org/10.1177/1099800414540515
  11. Kang, M. S. (2016, June 29). "Eve, cool '3D mesh' bedding to hit the heat". Retrieved July, 17, 2016, form http://www.newswire.co.kr/newsRead.php?no=829811.
  12. Kim, D. S. (2013). Cancer therapy revolution: Immune enhanced cancer therapy (pp 164-165). Seoul: Sangsang pubulishing company.
  13. Kim, H. J. (2012). Optimal position change interval for pressure ulcer risk group in intensive care unit of using foam mattress. master's thesis, Pusan National University, Pusan, Korea.
  14. Korean Wound Management Society. (2008). Guideline for management pressure ulcers. Seoul: Purnurse pubulishing company.
  15. Lee, H. O., Kim, S. O., Kim, J. Y., Kim, J. H., Park, K. H., Park, S. A., . . . Han, E. J. (2009). Wound mangement. Seoul: Purnurse pubulishing company.
  16. Lim, K. C., & Soung, M. S. (1996). The effect of position change including $30^{\circ}$ laterally inclined position on decubitus. Journal of Korean Academy of Adult Nursing, 8 (2), 274-290.
  17. Moon, M., & Lee, S. K. (2017). Applying of decision tree analysis to risk factors associated with pressure ulcers in long-term care facilities. Healthcare Research Information, 23 (1), 43-52. https://doi.org/10.4258/hir.2017.23.1.43
  18. Moore, Z., Cowman, S., & Conroy, R. M. (2011). A randomized controlled clinical trial of repositioning, using $30^{\circ}$tilt, for the prevention of pressure ulcers. Journal of Clinical Nursing, 20 (17-18), 2633-2644.
  19. Moore, Z., Cowman, S., & Posnett, J. (2013). An economic analysis of repositioning for the prevention of pressure ulcers. Journal of Clinical Nursing, 22(15-16), 2354-2360. https://doi.org/10.1111/j.1365-2702.2012.04310.x
  20. Moore, Z., & Van Etten, M. (2014). Ten top tips: repositioning a patient to prevent pressure ulcers. Wounds International, 5 (3), 6-9.
  21. Myeong, E. Y. (2012). The effect of 30-degree tilt repositioning on pressure ulcer prevention for patients intensive care unit. master's thesis, Ajou University, Gyeonggi-do, Korea.
  22. National Pressure Ulcer Advisory Panel. (2016). Education and clinical resources, NPUAP pressure injury stages. Retrieved June, 3, 2016, from, http://www.npuap.org/national-pressure-ulcer-advisory-panel-npuap-announces-a-change-in-terminology-from-pressure-ulcer-to-pressure-injury-and-updates-the-stages-of-pressure-injury/.
  23. Oomens, C. W. J., Broek, M., Hemmes, B., & Bader, D. L. (2016). How does lateral tilting affect the internal strains in the sacral region of bed ridden patients? - A contribution to pressure ulcer prevention. Clinical Biomechanics, 35, 7-13. https://doi.org/10.1016/j.clinbiomech.2016.03.009
  24. Park, C. S., Heo, C. Y. (2015). Prevention and treatment of pressure ulcers. Journal of The Korean Medical Association, 58 (9), 786-794. https://doi.org/10.5124/jkma.2015.58.9.786
  25. Peterson, M. J., Schwab, W., Van Oostrom, J. H., Gravenstein, N., & Caruso, L. J. (2010). Effects of turning on skin-bed interface pressures in healthy adults. Journal of Advanced Nursing, 66 (7), 1556-1564. https://doi.org/10.1111/j.1365-2648.2010.05292.x
  26. Powers, J. (2016) Two methods for turning and positioning and the effect on pressure ulcer development: A comparison Cohort Study. Journal of Wound Ostomy Continence Nursing, 43 (1), 46-50. https://doi.org/10.1097/WON.0000000000000198
  27. Yoshikawa, Y., Sugimoto. M., Maeshige, N., Mishima, K., Tanigawa, D., & Yammamoto, M. (2011). Verification of comfort rating of 30 degrees lateral position, Jornal of Kansai Rehabilitation College, 4, 31-34.
  28. Young, T. (2004). The 30 degree tilt position vs the 90 degree lateral and supine positions in reducing the incidence of non-blanching erythema in a hospital inpatient population: a randomized controlled trial. Journal of Tissue Viability, 14 (3), 88-96. https://doi.org/10.1016/S0965-206X(04)43004-6
  29. Vanderwee, K., Grypdonck, M. H., De Bacquer, D., & Defloor, T. (2006). Effectiveness of turning with unequal time intervals on the incidence of pressure ulcer lesion. Journal of Advanced Nursing, 57 (1), 59-68. https://doi.org/10.1111/j.1365-2648.2006.04060.x