Turn Teams?

Biffbradford · Jan 19, 2012

If you've got the staff, it sounds cool.

In our CVICU, all the fresh post op hearts had to get out of bed at midnight. Sometimes we'd team up and just do down the line, working as a team and do that. Boom, boom, boom.

I think the patients like it because they knew that everybody was getting up at that hour, they weren't alone. :)

BelgianRN · Jan 19, 2012

Must be wonderful to have the staff to pull it off. We barely manage turning Q 8 hours. But to make up for it we use alternating air mattresses on all our patients so pressure sores are usually a non-issue until they are in the ICU for an extended period. We do get our patients out of bed ASAP and if we manage twice daily but usually it boils down to once daily.

So I was wondering are you turning Q 2 hours on top of using alternating air mattresses or do you have another type of bedding for your patients? I'm looking forward to hearing the results. Could be a way in for the administration at my hospital to finally invest in additional help.

@ Biffbradford: Must be a nice sight lining all the hearts up at twelve ^^.

fiveofpeep · Jan 19, 2012

All the hospitals I've worked at have had it. IT's good on our backs. We still use air beds, but management still wants them turned, not for the skin, but for pulmonary hygiene.

meandragonbrett · Jan 20, 2012

I've never worked anywhere that we didn't turn all the ICU patients that weren't independent q2H.......but I've never worked where there is a lift team...it was always the primary nurse who was responsible to get the turning done.

canurse24 · Jan 20, 2012

We do use specialty air mattresses -all of our beds are; and then we order other beds for totally bedbound patients and bariatrics, etc. We are doing this because yes the expectation is to turn q 2 hrs, but does it honestly get done that way especially with lower staffing ratios and higher acuities/needs of patients and families?

Healthcare is changing, and hospitals are not being reimbursed for pressure ulcer related costs as it is deemed as something preventable.

I think this would also optimize the way we utilize our aides and would help them feel like there is more onus to their role on the floor, so hopefully it would increase job satisfaction? as in response to meandragon, that is just like where I work -the nurse is responsible for everything including turns/baths etc right now. We have aides but they are not "responsible" for the patients care. They answer call bells, help with transfers, "try" to get accuchecks done and meals set up but pretty much everything else is like they have to be asked to do something -its not like its assumed its to be done; like turning patients side to side.

Will come back and let you know our results. It will take us about 6-8 months.

Anyone else have experiences with having a Turn team i'd like to know how it is being done and what the pros/cons are.

Kitesurfing bum · Jan 21, 2012

We have a lift team. It is a GREAT asset to the hospital.

They work 12hr shifts 1030-2300 everyday, 2 Lift Team Techs at a time. They help with turns and transfers. They can be paged by any floor at anytime and when they get to the floor they do rounds and turn all pts that need it. Obviously the ICU has the most immobile pts, so the Lift Team recently made a deal with us to automatically round on the ICU (20 beds) every 2 hours on the odd hours. They come down, team up with the ICU tech who is more vent/line savvy and turn anyone who needs it.

I imagine the hospital finds $$ in the budget because it will likely decrease OTJ injuries and pressure ulcers.

We turn pts q2h with or without the lift team. Everyone is happy to help each other out when needed. We also use auto-inflate/adjusting mattresses.

Good luck with your study, hopefully it all works well, look forward to your results!

NCRNMDM, ASN, RN · Jan 24, 2012

I've done volunteer and CNA work in two hospitals prior to nursing school. The first did not have a turn team, and it was up to the nurses and CNAs to work together and turn the patient. The second had a dedicated staff of techs who came in and turned patients every two hours, or more frequently if needed. I think patients at the second hospital got the most optimal care, had the lowest incidence of pressure ulcers, and suffered fewer complications (like pneumonia, longer hospital stays, etc). At the smaller hospital with no turn team, nurses were usually short staffed, and it wasn't uncommon to have five patients in the ED and at least three, if not four, in the ICU. On the medical floors, nurses had between six and ten patients apiece. At the larger hospital, staffing was much better, and the turn teams were a tremendous help.

Verbatim · Jan 27, 2012

I've worked at a hospital with an excellent turn team. As already stated, two trained personnel come q2h to assist with turns. However, unlike the "team" that your unit trialling, this team is independent of the units they serve.

I work at a hospital that is going to begin trialling the aides as a turn team. Perhaps it has already begun. :rolleyes: However, I don't see it working well. Someone must continue to help w/ various tasks: clean ups, help w/ transfers, stocking linen, etc.

Contact OSF ST. Francis Medical Ctr. in Peoria, IL. This is the hospital w/ an excellent turn team: tried and tested.

LaylaHendrix23 · Jan 30, 2012

We have a turn team on our floor. We have a 32 bed cardiac progressive care unit and each nurse and tech signs up for 1 turn team time and turn team goes around every 2 hours. On each turn team there are 2 people turning pts. I really like it because if you are super busy you know someone will be helping you turn your really heavy pts. I work nights, so usually the techs sign up for the busier times like 8pm and 6am, and the nurses fill in the other times! I personally like it! If we don't have enough staff then maybe the techs will go twice or the charge nurse will fill in.

Esme12, ASN, BSN, RN · Jan 30, 2012

We do use specialty air mattresses -all of our beds are; and then we order other beds for totally bed bound patients and bariatrics, etc. We are doing this because yes the expectation is to turn q 2 hrs, but does it honestly get done that way especially with lower staffing ratios and higher acuities/needs of patients and families?
Healthcare is changing, and hospitals are not being reimbursed for pressure ulcer related costs as it is deemed as something preventable.
I think this would also optimize the way we utilize our aides and would help them feel like there is more onus to their role on the floor, so hopefully it would increase job satisfaction? as in response to meandragon, that is just like where I work -the nurse is responsible for everything including turns/baths etc right now. We have aides but they are not "responsible" for the patients care. They answer call bells, help with transfers, "try" to get accu checks done and meals set up but pretty much everything else is like they have to be asked to do something -its not like its assumed its to be done; like turning patients side to side.
Will come back and let you know our results. It will take us about 6-8 months.
Anyone else have experiences with having a Turn team i'd like to know how it is being done and what the pros/cons are.

How many patients do you have in ICU that you can't see that your patient is turned every 2 hours? Nurses aides that I have worked with were held accountable for patient care and were held to task when they did not fulfill their assigned duties. They felt apart of the team because we treated them as team members. Whether or not you have "Turn teams" will not release you from direct responsibility of "everything including turns/baths etc".

Maybe I am confused but, if you have 1 or two even three patients......in a 12 hour shift I would think one would be able to get the patient bathed and turned with in that time constraint. What is the nurse patient ratio in your unit? I can see the use of "Lift teams" as it is sometimes hard to get enough "hands" to get the task and to have someone available to help would be beneficial.

But in an ICU setting I am not clear why the patients are not being turned every two hours (or pretty close to that) and why the resposibility should not be the nurses. If the aides need to be asked, then ask them. The manager needs to sit them down and fill them in about their responsibilities and hold them accountable......or begin the progressive dicipline plan to the front door.

turnforthenurse, MSN, NP · Jan 30, 2012

Healthcare is changing, and hospitals are not being reimbursed for pressure ulcer related costs as it is deemed as something preventable.

That is very true. But what about the patients who are too unstable to turn? Where does that fall in terms of reimbursement? I've always wondered about that.

Regarding turn teams, I think that is a wonderful idea if you have the staff to do so.