Is turning to supine considered a turn?

Specialties MICU

Published

Specializes in Emergency nursing, critical care nursing..

Hello

When turning Q2 hours, is turning to supine position considered a turn? Our managment says that turning a pt. supine is not an adequate turn to relieve pressure, etc. Most of the nurses disagree with this. What are your thoughts?

Do you turn from side, to back, to side, every 2 hours? Or does anyone else avoid turning the pt. supine?

(I like laying on my back at times, and I would think the pt. would too).

Thanks.

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Side

Back

Side

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Side

Back

Side

This is also how I do it.

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Side

Back

Side

Yep. Same here . . . sounds like a dance step!!

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side

side

back

;)

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Specializes in ICU/Burn ICU/MSICU/NeuroICU.

Nobody mentioned a Do-si-do?

Whatever your mgmt. says rules!

I say and will always say, it depends on the pt. and my assessment of them!

My opinion, Some folks need to be turned about q15 minutes. and Most need to be turned twice Q1h!

The last larger facility I worked at used those HR beds that rotate and they rotated them Q20 min. Our mgmt considered that adequate. But I prefer my way!

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Specializes in ICU.

Side-Back-Side

I posted a few weeks ago about a patient I couldn't turn at all so I just moved his arms and legs whenever possible. Miraculously he didn't have any skin breakdown when I checked him the one time that I could.

I've never had a patient develop a pressure ulcer from the side-back-side method. I agree with a previous posted that there are some patients who need more frequent turning but I have found this to be the exception. That being said, even if I don't physically turn the patient, I try to "reposition" the bed at least 1x/hour (HOB up, chair position, etc.)

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Nobody mentioned a Do-si-do?

Whatever your mgmt. says rules!

I say and will always say, it depends on the pt. and my assessment of them!

My opinion, Some folks need to be turned about q15 minutes. and Most need to be turned twice Q1h!

The last larger facility I worked at used those HR beds that rotate and they rotated them Q20 min. Our mgmt considered that adequate. But I prefer my way!

:eek: How do you manage to turn every 15 - 30 mins?? when do you do everything else you need to do and who has time to help you? Your unit must be really well staffed and you surely only have 1 patient.

We turn 2-4 hourly but we just turn and rub and then place our patient's supine again they are never on thier side especially not if they are ventilated, most of our patients are on air mattresses tho, and we have very little skin breakdown issues

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Specializes in Medical.

I've had many patients who can't be turned side to side because of tubing or existing injuries (flank-length urine burns, fror example). I'm not in ICU so our patients are a little different, but I definitely count a half-turn as pressue care - even a quarter turn alters the distribution of pressure, reducing tissue damage. From my ICU colleagues I know some patients are just too sick to tolerate anything more than that!

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Specializes in ED, ICU, Education.
:eek: How do you manage to turn every 15 - 30 mins?? when do you do everything else you need to do and who has time to help you? Your unit must be really well staffed and you surely only have 1 patient.

We turn 2-4 hourly but we just turn and rub and then place our patient's supine again they are never on thier side especially not if they are ventilated, most of our patients are on air mattresses tho, and we have very little skin breakdown issues

Why don't you turn a patient to their lateral side when they are vented? I do it all the time if they're hemodynamically stable. It helps with pulmonary toileting, and I've seen a huge improvement in patients who have been turned laterally compared to those who just have pillows under their butt.

That said, I usually end up doing the pillow under butt and back thing most of the time. And I too am in love with the low air loss mattresses.

Further, I can easily turn 2-3 patients every 30 mins if necessary. That comes with their acuity and how heavy a load the patients are...and how heavy the patients actually are! LOL

Evidence based practice shows that massaging bony prominences is contraindicated.

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Why don't you turn a patient to their lateral side when they are vented? I do it all the time if they're hemodynamically stable. It helps with pulmonary toileting, and I've seen a huge improvement in patients who have been turned laterally compared to those who just have pillows under their butt.

That said, I usually end up doing the pillow under butt and back thing most of the time. And I too am in love with the low air loss mattresses.

Further, I can easily turn 2-3 patients every 30 mins if necessary. That comes with their acuity and how heavy a load the patients are...and how heavy the patients actually are! LOL

Evidence based practice shows that massaging bony prominences is contraindicated.

To be honest, I actually am not sure why we don't leave our pt's on thier sides after rubbing them, we do it with our baby's and kids but not the adult's - our unit is mixed we get all age's. I think we're just scared of the risk of extubating the patient, and how do you restrain when the patient is on thier side?

Do you turn on your own? Because even if I'm lucky enough to be 1:1 I couldnt turn most of my patient's alone, and there is very rarely any one to help that often.

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Specializes in Emergency nursing, critical care nursing..

we use HillRom beds too, but our leadership discourages us from using the turn function, stating it provides no pressure relief, but good for the lungs.

I disagree with that too! If the pt. is contantly rotated, lungs and skin win!

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