The copyright line for this article was changed on July 31, 2015 after original online publication.
Turning for Ulcer ReductioN: A Multisite Randomized Clinical Trial in Nursing Homes
Article first published online: 19 SEP 2013
© 2013, Copyright the Authors. The Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society.
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Journal of the American Geriatrics Society
Volume 61, Issue 10, pages 1705–1713, October 2013
How to Cite
J Am Geriatr Soc 61:1705–1713, 2013.
- Issue published online: 11 OCT 2013
- Article first published online: 19 SEP 2013
- National Institutes of Health
- National Institute of Nursing Research
- National Institute on Aging Research Grant. Grant Number: NCT00665535
- Ontario Ministry of Health and Long Term Care
- Toronto Health Economic Technology Assessment collaborative
- pressure ulcer prevention;
- nursing home;
- Turning for Ulcer ReductioN Study
To determine optimal repositioning frequency of nursing home (NH) residents at risk for pressure ulcers (PrUs) when cared for on high-density foam mattresses.
Multisite, randomized, clinical trial, known as Turning for Ulcer ReductioN (TURN Study).
NHs in the United States (n = 20) and Canada (n = 7) using high-density foam mattresses.
Consenting residents (N = 942) aged 65 and older without PrUs at moderate (scores 13–14) or high (scores 10–12) risk of PrUs according to the Braden Scale.
Participants were randomly allocated using risk stratification (moderate vs high) to a repositioning schedule (2, 3, or 4 hour) for 3 weeks. Blinded assessors assessed skin weekly.
PrU incidence (coccyx or sacrum, trochanter, heels).
Participants were mostly female (77.6%) and Caucasian (80.5%) and had a mean age of 85.1 ± 7.7. The most common diagnoses were cardiovascular (76.9%) and dementia (72.5%). Nineteen (2.0%) participants developed superficial PrUs. There was no significant difference (Wilcoxon test for ordered categories) in PrU incidence (P = .68) according to repositioning group (2 hour, 8/321, 2.5%; 3 hour, 2/326, 0.6%; 4 hour, 9/295, 3.1%), nor was there a statistically significant difference in the incidence of PrU between the high and moderate-risk groups (P = .79). Also, PrU incidence was not statistically significantly different between high-risk participants based on repositioning schedule (6/325, 1.8%, P = .90) or between moderate-risk participants based on repositioning schedule (13/617, 2.1%, P = .68).
There was no difference in PrU incidence over 3 weeks of observation between those turned at 2-, 3-, or 4-hour intervals in this population of residents using high-density foam mattresses at moderate and high risk of developing PrUs when they were repositioned consistently and skin was monitored. This finding has major implications for use of nursing staff and cost of NH care.