Preventing Sacral Pressure Ulcers
Turning and repositioning protocols—combined with the implementation of pressure-reducing and pressure-relieving devices—are crucial to addressing the risk of sacral pressure ulcers.
When implementing protocols, it is important to take into consideration the four main risk factors for sacral pressure ulcers: pressure, friction, shear, and moisture.1 The European Pressure Ulcer Advisory Panel (EPUAP) and National Pressure Ulcer Advisory Panel (NPUAP) guidelines recommend that repositioning should be undertaken to reduce the duration and magnitude of pressure over vulnerable areas of the body while avoiding subjecting the skin to pressure and shear forces and using an alternating 30-degree tilted side-lying position.2 The Wound Ostomy and Continence Nurses Society (WOCN) recommends addressing moisture with underpads that are absorbent to wick incontinence moisture away from the skin.3
Another important factor to consider when developing a turning and repositioning protocol is staff safety. Turning and repositioning puts staff at risk for musculoskeletal disorders (MSDs).4 In fact, one survey found that 89% of clinicians said that they or a co-worker have experienced a back, shoulder, or wrist injury due to turning or boosting a patient.5