Fitted sheets vs.flat sheets for immobile patients

[Texas Tornado]

I've worked on units that use fitted sheets with a draw sheet on top, and others that use a flat sheet under patients who need q2 hour turns/boots, etc. Personally I like the flat sheets.

Does anyone know of any research on which is better/worse regarding skin breakdown? Thoughts? Experience?

[Dinsey]

My unit uses fitted sheets with a draw and chux on top. The nice thing about this is that the fitted hooks onto the mattress and stays. It usually doesn't come along for the ride when we boost. When we use Big Boy beds for our larger patients, we have to use flat sheets, and it just doesn't seem to work as well. I think we spend a lot of the power in our lifts moving their feet and legs, where the draw sheet focuses your power on their body.

[RNperdiem, RN]

My ICU uses a fitted sheet and a quilted, cloth chux on top. The chux is large and strong enough to use as a turn sheet. The fitted sheet stays neat and tucked in, most of the time anyway.

When this policy came in effect, we were told that plastic backed chux holds moisture against the skin and increases the risk of breakdown. Adult diapers are only used if patient is stooling and travelling off the unit. Now that there are excellent fecal management systems for patients with intractable watery diarrhea, skin is better protected.

[2008pn]

Flat sheet keep slid off I prefree fitted just casue you can put pads underneath if patient is incontinet

[WalkieTalkie, RN]

Fitted sheets on regular beds and flat sheets on air beds, bari beds, Triadyne beds, etc.