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Recommended Citation
Clontz S, Thompson L, Kelly L, Smalls T. Advancing Turn Equality to Reduce Pressure Injuries: A Nurse-Led Visual Tool for Acute Care Units. Quality Improvement podium presentation at Transforming Practice: The Intersection of Technology and Nursing Excellence; Advocate Health Nursing Research and Professional Development Conference 2025; November 12, 2025; Virtual.
Presentation Notes
Quality Improvement podium presentation 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
Despite the implementation of evidence-based bundles, hospital-acquired pressure injuries remain a persistent challenge. The literature highlights inconsistent patient repositioning and a lack of team accountability as key contributors. Visual tools and interdisciplinary engagement have shown promise in promoting reliable turning practices.
Local Problem
Audits on two critical care units and one progressive care unit revealed that patients were frequently left in supine positions and not rotated equally. Night shifts demonstrated the greatest gaps in documentation and compliance. The electronic medical record did not provide an at-a-glance overview of turning history, creating confusion among nursing and ancillary staff, and hindering consistent repositioning.
Method
A nurse-led team introduced a visual “turn tool” that displayed each patient’s last position and time since turning. The tool was posted outside rooms and updated collaboratively by staff. Implementation followed a Plan-Do-Study-Act model, with education, feedback collection, and staff champions reinforcing use. Weekly audits reviewed electronic medical record documentation, and daily audits reviewed the turn tool for turn equality (balanced usage of left, right, and supine positions across 12 hours).
Results/Conclusions
Post-implementation audits demonstrated turn equality rates consistently ranging from 91% to 100% across all three units. Staff surveys indicated increased communication, accountability, and engagement in repositioning practices. Importantly, no new hospital-acquired sacral pressure injuries were reported in any of the three monitored units after the tool’s implementation. Staff reported improved interdisciplinary hand-offs and heightened awareness of turn schedules.
Implications for Practice
This low-cost, nurse-driven intervention successfully improved turn equality and pressure injury prevention. The tool promoted shared ownership of patient safety and was easily adopted across shifts. Future plans include evaluating long-term sustainability, continuing education efforts, and expanding the tool to other facilities.
Document Type
Oral/Podium Presentation
Publication Date
11-12-2025
Advancing Turn Equality to Reduce Pressure Injuries: A Nurse-Led Visual Tool for Acute Care Units
Background
Despite the implementation of evidence-based bundles, hospital-acquired pressure injuries remain a persistent challenge. The literature highlights inconsistent patient repositioning and a lack of team accountability as key contributors. Visual tools and interdisciplinary engagement have shown promise in promoting reliable turning practices.
Local Problem
Audits on two critical care units and one progressive care unit revealed that patients were frequently left in supine positions and not rotated equally. Night shifts demonstrated the greatest gaps in documentation and compliance. The electronic medical record did not provide an at-a-glance overview of turning history, creating confusion among nursing and ancillary staff, and hindering consistent repositioning.
Method
A nurse-led team introduced a visual “turn tool” that displayed each patient’s last position and time since turning. The tool was posted outside rooms and updated collaboratively by staff. Implementation followed a Plan-Do-Study-Act model, with education, feedback collection, and staff champions reinforcing use. Weekly audits reviewed electronic medical record documentation, and daily audits reviewed the turn tool for turn equality (balanced usage of left, right, and supine positions across 12 hours).
Results/Conclusions
Post-implementation audits demonstrated turn equality rates consistently ranging from 91% to 100% across all three units. Staff surveys indicated increased communication, accountability, and engagement in repositioning practices. Importantly, no new hospital-acquired sacral pressure injuries were reported in any of the three monitored units after the tool’s implementation. Staff reported improved interdisciplinary hand-offs and heightened awareness of turn schedules.
Implications for Practice
This low-cost, nurse-driven intervention successfully improved turn equality and pressure injury prevention. The tool promoted shared ownership of patient safety and was easily adopted across shifts. Future plans include evaluating long-term sustainability, continuing education efforts, and expanding the tool to other facilities.
Affiliations
Atrium Health Union and Union West