Sand bed-turn or not?

[mmccool719]

Home health nurse caring for elderly man with stage 2 and 3 ulcers on buttock and sacrum. He is in a Clinitron sand bed for about 4-5 hours per day. Is it necessary to do every 2 hour turns? Getting mixed answers from co-workers. Any trusted website I could use as reference? Thank you!

[amoLucia]

Hate to add another question to your already question, but ...

the pt's on bed ONLY 4 - 5 hrs/day??? Who's paying for the bed???

I thought pts could only be OFF the bed for minimal time for special reasons only. Like that's the purpose of the bed - to get as much max pressure relief time as poss.

Now to your question - have you tried contacting Clinitron directly. I'd bet that they have someone who could answer your question or provide literature.

I googled Clinitron and the manufacturer Hill-Rom has a big web site. There could be answers there.

[mmccool719]

Good question. It’s a very unusual and sad situation in a private house. Stage 7 Alzheimer’s, which is pretty much vegetative. Pt splits time between hospital bed, recliner and sand bed per the family wishes. The wound nurse who visits says we should still be turning every 2 hours in sand bed. Good idea about Clinitron. Thanks.

[amoLucia]

I truly can appreciate the family's desire for the gentleman to have some semblance of a normal type activity lifestyle oppt'y. Hope is understandable.

As I remember many eons way back, we did NOT really 'turn' the pt. Merely some kind of a shimmy/wiggle/little pull-up in the bed. And I don't think we were supposed to be padding the bed with turning sheets/drawsheets. Like that would DEFEAT the shifting sand/beads. Even had to be minimal with incont pads.

Hope the Hill-Rom Clinitron people can be more definitive for this guy's best care.

And thank you for your initiative on his behalf.

[marienm, RN, CCRN]

We've occasionally used these beds for burns. My memory is that we did at least weight-shift the patient every 2 hours. We also had to have some amount of sheet/absorbent pad under the patient because of wound drainage, so we knew we were defeating part of the bed's function.

With this patient (and maybe the wound nurse's approval) would it make sense to put him fully on his side when in the sand bed? Normally you'd want to avoid the trochanters but the sand might offload them enough that you could also truly avoid pressure on his sacrum while he was side-lying. Obviously, pillows between knees and under the top arm, as tolerated by the patient, and then change sides every couple of hours.