Patient turning in SICU

**canoehead, BSN, RN** · Mar 6, 2010

Assigning each patient a nurse doesn't do the trick?

OK, low blow, but really...

NurseandNursesmom · Mar 6, 2010

LOL.. I know. Supposedly they could do that, but it doesn't always happen. We have a very high acuity unit, and sometimes things are going on with the other patient. Silly us, we want 100% compliance.

registeredin06 · Mar 6, 2010

The lift teams that I have seen utilized were never nurses, just people who applied for 'lift team' job, mostly men, but not always. They were awesome. Some places the team rounds on even or odd hours to turn, and in other places they are just available to be paged when needed...such as when needing to transfer a pt. with a hoyer or other mechanical lift, which takes 3-4 people.

I loved it, but silly me, I've screwed up my back too much by trying to turn and pull 150 kg of dead weight around in the bed when no help was available. And if they have drive-lines or other multiple tubes and lines, as they often do in ICU, 2 people just isn't enough.

**canoehead, BSN, RN** · Mar 6, 2010

If the RN has 2 patients someone should be covering the other if she's tied up in a room, the charge nurse maybe? Or her break buddy? I mean that for more than just a turning schedule, meds, drips, vitals.

Would it be helpful to have a porter drop by every two hours, then the RN watches lines while the porter does the lifting?

EMSnut45, BSN, RN, EMT-P · Mar 6, 2010

I work in a MICU that just implemented a "turning team." Every nurse and tech is assigned one "turn time" during the shift. The unit is divided into two (it is a large unit), so we have two teams of two. Every odd hour, the two assigned for that time go around and turn all of the patients in their half of the unit (after checking with the patient's nurse first to make sure that they are stable enough, etc.). From start to finish, it probably takes 10 minutes max to turn everyone-- we don't change diapers, move patients to chairs, etc.-- we just turn them. The process starts and ends at change of shift-- the off-going and on-coming nurse turn their patients. It has worked extremely well, and we have-- knock-on-wood-- not had ANY pressure sores develop while patients are on our unit, and existing sores are all healing very nicely. One plus that I've noticed is that the "team work" mentality seems to have grown since we implemented this.

**This is not a lift-team or call-when-you-need-us turning team. The nurses/techs are only on "turning duty" at their assigned time.

fiveofpeep · Mar 7, 2010

we have a lift team available by page who also round every couple hours to offer help. they are life savers. I love them so much being 5"3 and a new grad still learning body mechanics. It also really impresses me how knowledgeable they are--always holding the feeding and watching the lines and knowing how to work with the air fluidized beds

wanderlust99 · Mar 15, 2010

Turning teams/rounds are AWESOME. You get busy, you get behind, having turning rounds ensures that your patient is turned when they're suppose to (not an hour later because you were so behind).

I'm a traveler & I've seen it several different ways. It was funny because I worked at one hospital and floated between 2 ICUs. One ICU was great about turning rounds, the other ICU eventually stopped and I'd go 3-4 hrs without having time to turn my pt (no help, no time, etc..)

The ICU that was great with turning rounds usually had 1 patient care assistant and a charge nurse or the relief nurse come by to the room. I found what was most helpful is when 2 people would come in and turn the patient for you. This particular ICU we had float/relief nurses so we had the extra staff so that was helpful.

What would be awesome is if nurses implemented the lifting equipment....or were trained to do it properly. I've found that at pretty much all the hospitals I work with, the nurses aren't trained properly and just don't know how to use the equipment so they don't use it at all. Off topic, but I wish so much this could change.

gcj95 · Mar 17, 2010

HI there,

YES, we use turn teams. Our is a very high acuity 26 bed level one trauma center. Depending on the day, we use either 2 or 3 turn teams. They are 2 LNA's that have an assignment of 8 - 12 beds and every 2 hours your patient is turned, mouth care is done acu-checks are done temps taken and foleys emptied. They are absolutely Gods gift to the busy ICU.

We also utilize "Transpo". This is a whole different team that will help with the "Heavy patient" move or help push patients to CT MRI Angio etc etc, or to just help get the patient from the chair back to bed.

These resources are EXCELLENT!!

Good Luck!

moonischasingme1 · Mar 18, 2010

I work in a MICU that just implemented a "turning team." Every nurse and tech is assigned one "turn time" during the shift. The unit is divided into two (it is a large unit), so we have two teams of two. Every odd hour, the two assigned for that time go around and turn all of the patients in their half of the unit (after checking with the patient's nurse first to make sure that they are stable enough, etc.). From start to finish, it probably takes 10 minutes max to turn everyone-- we don't change diapers, move patients to chairs, etc.-- we just turn them. The process starts and ends at change of shift-- the off-going and on-coming nurse turn their patients. It has worked extremely well, and we have-- knock-on-wood-- not had ANY pressure sores develop while patients are on our unit, and existing sores are all healing very nicely. One plus that I've noticed is that the "team work" mentality seems to have grown since we implemented this.
**This is not a lift-team or call-when-you-need-us turning team. The nurses/techs are only on "turning duty" at their assigned time.

That is really cool

Zookeeper3 · Mar 18, 2010

We had one, but with budget cuts they were phased out quick. Unfortunately, in the deep south... a surprising winter trend of 300 and 400 pounders literally put 4 of our nurses out with pretty severe injury's. Three are having back surgery, one is fighting not to...

They all are now currently being paid from workers comp to do paperwork and only 2 look iffy to ever return to the bedside. Look, I couldn't even dream of making this up, they are family to me. So anyway, be wary that a lift team is really budgeted as a priority from the highest lvls of management, with the number crunchers in agreement. Although our stats alone prove the cost, I digress.

Our defunct lift team had criteria for taking on an assignment, the patient had to weigh 275 lbs or more period for a consult to transfer to them. The patient had to require the assist of two for OOB, or have little ability to assist with turning. We sent a request in the computer and every two hours, they would majically appear and toilet the patient to the bathroom... "yes mam, we were just here two hours ago, but you need the activity to walk to the bathroom so we can help you home sooner, even though you may not have to go, lets try.." and for the bed ridden ones, even in the ICU, they appeared asked for the nurse, got permission, turned them with my supervision while I wateched ETT and lines.

Yes this needed tweaking, they were late... it always takes longer, no they couldn't touch an ICU patient without me there, so we missed many turns if my other patient was busy, no one could "watch" for me or the patient put up too much a fuss, (they had little patient interaction skills).

So good luck on your venture with this, it is a life saver for our backs, we were just never allowed the time to work out the kinks, especially with those nurses who wouldn't let others do it for them, the teaching on how to talk patients into compliance and their lack of time to put up with us all:D