title: The turn team: a novel strategy for reducing pressure ulcers in the surgical intensive care unit.
abstract: BACKGROUND
  Pressure ulcers cause significant morbidity and mortality in the surgical intensive care unit (SICU). The purpose of this study was to determine if a dedicated team tasked with turning and repositioning all hemodynamically stable SICU patients could decrease the formation of pressure ulcers.
  
  
  METHODS
  A total of 507 patients in a 20-bed SICU in a university hospital were assessed for pressure ulcers using a point prevalence strategy, between December 2008 and September 2010, before and after implementation of a team tasked with turning and repositioning all hemodynamically stable patients every 2 hours around the clock.
  
  
  RESULTS
  At baseline, when frequent turning was encouraged but not required, a total of 42 pressure ulcers were identified in 278 patients. After implementation of the turn team, a total of 12 pressure ulcers were identified in 229 patients (p < 0.0001). The preintervention group included 34 stage I and II ulcers and 8 higher stage ulcers. After implementation of the turn team, there were 7 stage I and II ulcers and 5 higher stage ulcers. The average Braden score was 16.5 in the preintervention group and 13.4 in the postintervention group (p = 0.04), suggesting that pressure ulcers were occurring in higher risk patients after implementation of the turn team.
  
  
  CONCLUSIONS
  A team dedicated to turning SICU patients every 2 hours dramatically decreased the incidence of pressure ulcers. The majority of stage I and stage II ulcers appear to be preventable with an aggressive intervention aimed at pressure ulcer prevention.
authors: Emory University Hospital, Department of Nursing, Emory University, Atlanta, GA, USA.
authors: Mary D
authors: MD
authors: Still
authors: Linda C
authors: LC
authors: Cross
authors: Martha
authors: M
authors: Dunlap
authors: Rugenia
authors: R
authors: Rencher
authors: Elizabeth R
authors: ER
authors: Larkins
authors: David L
authors: DL
authors: Carpenter
authors: Timothy G
authors: TG
authors: Buchman
authors: Craig M
authors: CM
authors: Coopersmith
mesh_terms: D002081:Buttocks; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness / Q000628:therapy*; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration*; D010348:Patient Care Team / Q000458:organization & administration; D056888:Patient Positioning / Q000592:standards; D003668:Pressure Ulcer / Q000191:economics / Q000517:prevention & control*; D012447:Sacrum; D014481:United States