I work in ICU that has a mixed bag of both surgical -hearts and you name it.. with medical patients. It has 32 beds. We therefore get a large variety of patients. One hot topic lately is pressure ulcer prevention.
We are starting a project of trialing our PTCAs (aka Aides) as a turn team; they are going to turn all high risk patients every 2 hours. We will compare the incidence of pressure ulcers before and during/after use of this turn team.
Has anyone out there done a similar project or are currently doing this?
What do you think of it?
As part of my unit council it would be nice to see what others have experienced; and good to have this feedback to get my other staff all aboard to give it an honest go!
I didn't say that the patients are not being turned every two hours.. i Said we all Try to make it happen. But do you not agree that in an ICU the events are not predictable, times when docs and families are there are not predictable; and nurses and/or aides have their own ways of working and different priorities etc etc? This would assure that there is a uniform goal being aimed at and most likely met as per guidelines. I love my hospital and my unit. we have 32 beds in this ICU. They try to staff us 2:1 or 3:1 for more stable patients. We have the best team I have ever worked with -and I was a travel nurse. I am pretty sure our aides do feel as part of the team.
But I was referring to the fact that as you stated "it is sometimes hard to get enough Hands to get the task done" -which is the main issue! In the past two years I have worked here I can see staffing has changed enough that we all feel a strain being able to meet the needs of all of the patients, and still have time to study the charts, and leaving them and the rooms, clean and neat as can be when we report off. First and foremost of course is to keep your ICU patient alive (as I guess there is a need to state the obvious in case of any misunderstanding).
Anyway I had asked if people have experiences with turn teams and to share them?
My purpose here was not to analyze the inner workings of my unit, but myself and my council believe that trialing a turn team can help reduce costs of pressure ulcers and increase staff satisfaction. I don't really feel like it is necessary to explain beyond that as it does not add or change anything to the research topic.
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 ^^.
I could not imagine only turning my patient once q8h???? What? All our patients who are not mobile or in bed all day get turned q2h. They still need some repositioning on most airbeds. But a lift team helps us do turns q2h.
I mentioned it yesterday at work "you know I've heard of other hospitals where they turn Q2 hours". And things just got silent and I was given the odd look followed by some huffing and puffing... Wish we had the luxury to spend some more time on actual patient care instead of having to deal with everything around it.
I've worked in many different ICU's staff, traveling, etc... And thus far I am at the best in terms of support for turning. We have permanent lifts mounted on the ceilings in each room with slings under our patients so we can boost and turn patients independently with out additional staff in most situations. Still need another person or people to change linen, and to get a good look at patients posterior but so much better than the HillRom auto turn function
In my previous med-surg job we had a turn team. 1 RN and 1 tech would go around and turn all the Q2 pts. (24 beds). Sometimes if we had a very large number of turn pts. we would split it up into two teams. 7a and 7p turns were done by a two pct team. Pros- regardless of how your assignment was (you were the one nurse who got 6 of the completes) everyone did an equal amount of turns. Pt.s who refused-multiple people to document the refusal. Pt.s seemed to like meeting all staff.
Cons-Code browns on multiple patients at a time could become extremely time-consuming and pull you away from your pts. Family members and pt.s multiple requests, slack coworkers who could never manage to actually take their turn. Still need multiple coworkers for bariatric turns.
Overall our pressure ulcer rate remained the same as it was before the implementation of turn team. I would say it has its benefits on a busy med-surg floor, but in ICU? I have no problem making sure my two are turned q 2. I would rather see mechanical turn aids or lift teams such as the ones described in this thread!
A prior workplace had a "Lift Team". We loved these guys!! All were young, energetic and strong!! They carried pagers and could be paged anytime. Unfortunately, the "bean counters" determined that there was no reduction in work-related lifting/pulling injuries . . . so, the allmighty dollar prevailed and the team was eliminated.
canurse24
4 Posts
I didn't say that the patients are not being turned every two hours.. i Said we all Try to make it happen. But do you not agree that in an ICU the events are not predictable, times when docs and families are there are not predictable; and nurses and/or aides have their own ways of working and different priorities etc etc? This would assure that there is a uniform goal being aimed at and most likely met as per guidelines. I love my hospital and my unit. we have 32 beds in this ICU. They try to staff us 2:1 or 3:1 for more stable patients. We have the best team I have ever worked with -and I was a travel nurse. I am pretty sure our aides do feel as part of the team.
But I was referring to the fact that as you stated "it is sometimes hard to get enough Hands to get the task done" -which is the main issue! In the past two years I have worked here I can see staffing has changed enough that we all feel a strain being able to meet the needs of all of the patients, and still have time to study the charts, and leaving them and the rooms, clean and neat as can be when we report off. First and foremost of course is to keep your ICU patient alive (as I guess there is a need to state the obvious in case of any misunderstanding).
Anyway I had asked if people have experiences with turn teams and to share them?
My purpose here was not to analyze the inner workings of my unit, but myself and my council believe that trialing a turn team can help reduce costs of pressure ulcers and increase staff satisfaction. I don't really feel like it is necessary to explain beyond that as it does not add or change anything to the research topic.