Repositioning stroke patients with pusher syndrome to reduce incidence of pressure ulcers

Abstract

Pressure ulcers cost the NHS between £1.8 billion and £2.6 billion annually. In stroke and other neurological conditions, the pusher syndrome leads to a sensation of falling to the unaffected side of the body, even when lying still in bed. Regular turning fails to help in these cases, as patients turn themselves to the side on which they feel safe. In this quality improvement initiative, repositioning was carried out by placing pillows under the affected side. This prevented patients turned onto the unaffected side from turning themselves onto their back or onto their affected side. The incidence of pressure ulcers was one patient in 140 over 2 months compared with an average monthly rate of five patients over a similar period in the previous year. The pusher syndrome is a risk factor that causes difficulty with repositioning and increases the incidence of pressure ulcers. Training to identify and properly reposition patients with this impairment reduces the incidence of pressure ulcers.