A Comparative Study of 2-Hour Interface Pressure in Different Angles of Laterally Inclined, Supine, and Fowler's Position.

Soo-Yeon Kim,Yong-Soon Shin

doi:10.3390/ijerph18199992

Abstract

Insufficient research exists for position change intervals to eradicate pressure ulcers. We tried to provide evidence for the position change interval by comparing peak pressure, risk area ratio, and the time to reach 30 mmHg and 60 mmHg, and presented this in detail, according to the angle in the three positions. The study conducted RCTs on a total of 64 healthy adults. For two hours, interface pressure measurements were compared with 30° and 90° tilting at the inclined, 0° and 45° head-of-bed (HOB) elevation at the supine, and 30° and 45° HOB elevation at the Fowler’s position. The peak pressure on 30° tilting remained less than 60 mmHg for 2 h, unlike 90° tilting. To reach 60 mmHg took 78.18 min at 30° tilting, within 30 min at the 30° supine, 30° and 45° at the Fowler’s position, and 39.55 min at 0° supine. The pressure difference according to the angles was only significant at 30° and 90° tilting, with no difference in the other groups. To prevent pressure ulcers, position changes are required every 2 h in the 30° tilting position, every 1.5 to 2 h at 0° supine, and at least every 1.5 h for all the other positions.

Highlights

Pressure ulcers refer to local tissue damage resulting from external forces such as continuous pressure, shear force, and friction [1], and are an important part of nursing care in terms of maintaining skin integrity [2]
As a result of verifying the homogeneity of the general characteristics of the experimental and control group in the three groups in the laterally inclined, supine, and Fowler’s position groups, gender, age, and body mass index (BMI) were all homogeneous in the group divided by position
If the 90◦ tilting position is inevitable, high pressure is concentrated in the greater trochanter, so preventive intervention is needed to prevent the occurrence of pressure ulcers in the greater trochanter area

Summary

Introduction

Pressure ulcers refer to local tissue damage resulting from external forces such as continuous pressure, shear force, and friction [1], and are an important part of nursing care in terms of maintaining skin integrity [2]. Pressure ulcers do cause discomfort or pain owing to ischemia and tissue damage [3], and physical problems that cause complications, lead to poor clinical outcomes, psychological, and social problems caused by increased health care costs [4]. The clinical field uses the occurrence of pressure ulcers as an indicator of quality of care [5]. Efforts are made to prevent the occurrence of pressure ulcers through guidelines and research [4]. Pressure ulcers are caused by a variety of causes and depend on the individual condition of the patient. Pressure ulcer preventive nursing interventions suitable for individual subjects need to be provided, and such arbitration must be based on scientific evidence

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