Journal
WOUND REPAIR AND REGENERATION
Volume 19, Issue 1, Pages 10-18Publisher
WILEY
DOI: 10.1111/j.1524-475X.2010.00644.x
Keywords
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Funding
- National Institute on Aging [T32 AG000262, F30 AG034008]
- National Institute of Arthritis and Musculoskeletal and Skin Diseases [R01 AR47711]
- University of Maryland General Clinical Research Center, National Center for Research Resources [M01 RR16500]
- National Institute on Aging Claude D. Pepper Older Americans Independence Center [P30 AG028747]
- National Institute of Child Health and Human Development [K12 HD043489]
- EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT [K12HD043489] Funding Source: NIH RePORTER
- NATIONAL CENTER FOR RESEARCH RESOURCES [M01RR016500] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES [R01AR047711] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE ON AGING [F30AG034008, T32AG000262, P30AG028747] Funding Source: NIH RePORTER
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Frequent manual repositioning is an established part of pressure ulcer prevention, but there is little evidence for its effectiveness. This study examined the association between repositioning and pressure ulcer incidence among bed-bound elderly hip fracture patients, using data from a 2004-2007 cohort study in nine Maryland and Pennsylvania hospitals. Eligible patients (n=269) were age >= 65 years, underwent hip fracture surgery, and were bed-bound at index study visits (during the first 5 days of hospitalization). Information about repositioning on the days of index visits was collected from patient charts; study nurses assessed presence of stage 2+ pressure ulcers 2 days later. The association between frequent manual repositioning and pressure ulcer incidence was estimated, adjusting for pressure ulcer risk factors using generalized estimating equations and weighted estimating equations. Patients were frequently repositioned (at least every 2 hours) on only 53% (187/354) of index visit days. New pressure ulcers developed at 12% of visits following frequent repositioning vs. 10% following less frequent repositioning; the incidence rate of pressure ulcers per person-day did not differ between the two groups (incidence rate ratio 1.1, 95% confidence interval 0.5-2.4). No association was found between frequent repositioning of bed-bound patients and lower pressure ulcer incidence, calling into question the allocation of resources for repositioning.
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