An investigation into night-time self-turning by nursing home residents

Repositioning (turning) remains a standard recommendation for pressure ulcer prevention (European Pressure Ulcer Advisory Panel, 1998). However, the need for turning some 'at risk' nursing home patients has been questioned by Schnelle et al. (1993) in a US study. They found that, although two-thirds of residents in nursing homes turned themselves during the night, care staff managed them in the same way as the third who did not turn themselves. Furthermore, they found that residents who turned themselves were more likely to be turned by staff. Schnelle and colleagues studied their subjects indirectly by monitoring their arm movements, using wrist actigraphy, and hip and shoulder movements, using pressure-sensitive film on the mattress. They did not use direct observation and were therefore unable to determine if any detected movements resulted in a sustained change in position or to discover why staff were more likely to turn self-turners than other residents. The aim of this study was to investigate the occurrence of night-time self-turning by residents in nursing homes