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Affiliations

Atrium Health Union and Union West

Presentation Notes

Quality Improvement poster presented at Transforming Practice: The Intersection of Technology and Nursing Excellence; Advocate Health Nursing Research and Professional Development Conference 2025; November 12, 2025; Virtual.

Abstract

Background

Hospital acquired pressure injuries are a preventable yet persistent challenge in acute care settings. National guidelines recommend routine repositioning every two hours to redistribute pressure, promote circulation, and prevent skin breakdown. However, inconsistent documentation, communication gaps among team members, and lack of visual cues can contribute to unequal offloading and missed turns.

Local Problem

Prior to the intervention, high-risk patients spent over 50% of their time in the supine position—a factor contributing to the 68 hospital-acquired pressure injuries reported in 2024, of which more than half were sacral. Prior to the turn tool initiative there was not an emphasis on turn equality, to promote equal distribution of offloading.

Method

Turn tool was designed and implemented to retrain staff to avoid routinely repositioning patients back to the supine position following each lateral turn. The tool added a visual for staff to acknowledge where patient was last positioned to promote equitable offloading and staff accountability. This dry erase tool was placed as a standard on the outside of all patient rooms.

Results/Conclusions

Following the implementation of this initiative, the incidence of overall pressure injuries decreased by 56% from February to March with an 80% reduction in sacral injuries. There was a 25% increase in compliance in electronic medical record documentation for turning.

Implications for Practice

The successful implementation of the turn tool demonstrates that simple, visual interventions can significantly improve bedside accountability, interprofessional communication, and patient outcomes. Incorporating visual aids in routine care enhances real-time decision making and empowers both nursing and support staff to participate in pressure injury prevention. Sustaining these efforts through leadership support, routine auditing, and ongoing staff education is essential.

Document Type

Poster

Publication Date

11-12-2025


 

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Nov 12th, 12:00 AM

Improving Turn Equality and Pressure Injury Prevention

Background

Hospital acquired pressure injuries are a preventable yet persistent challenge in acute care settings. National guidelines recommend routine repositioning every two hours to redistribute pressure, promote circulation, and prevent skin breakdown. However, inconsistent documentation, communication gaps among team members, and lack of visual cues can contribute to unequal offloading and missed turns.

Local Problem

Prior to the intervention, high-risk patients spent over 50% of their time in the supine position—a factor contributing to the 68 hospital-acquired pressure injuries reported in 2024, of which more than half were sacral. Prior to the turn tool initiative there was not an emphasis on turn equality, to promote equal distribution of offloading.

Method

Turn tool was designed and implemented to retrain staff to avoid routinely repositioning patients back to the supine position following each lateral turn. The tool added a visual for staff to acknowledge where patient was last positioned to promote equitable offloading and staff accountability. This dry erase tool was placed as a standard on the outside of all patient rooms.

Results/Conclusions

Following the implementation of this initiative, the incidence of overall pressure injuries decreased by 56% from February to March with an 80% reduction in sacral injuries. There was a 25% increase in compliance in electronic medical record documentation for turning.

Implications for Practice

The successful implementation of the turn tool demonstrates that simple, visual interventions can significantly improve bedside accountability, interprofessional communication, and patient outcomes. Incorporating visual aids in routine care enhances real-time decision making and empowers both nursing and support staff to participate in pressure injury prevention. Sustaining these efforts through leadership support, routine auditing, and ongoing staff education is essential.

 

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