Essay Sample on Manual Repositioning Strategies

Some of the studies done took place between the year 2004 and the year 2007, studies done on patients who were aged over sixty-five and had undergone hip fracture surgeries. These studies were done in nine hospitals participating in the Baltimore Hip Studies Network (Baumgarten et al., 2009) The studies were done on patients undergoing different stages of pressure ulcers. The frequency of repositioning was determined by the number of times that the patient was repositioned. Frequent repositioning was recorded at twelve turns or more per day. Recordings were done depending on the frequency but not the number of turns made on the patient. Changes or effects of frequent repositioning were observed after twenty - one days from the start of the experience. Prominence was also put on perception on senses, the mobility of the patient, how active the patient is, level of exposure to factors that cause pressure ulcer, nutrition as well as the amount of moisture that the patient is exposed to (Rich et al., 2011). The mass/weight of the patient, the patient's mental status, and patient's height were other issues looked into in this study.
According to the study, frequent repositioning at a rate of more than twelve turns per day was experienced. The frequently repositioned pressure ulcers patients not only had a low Braden scale score but are more likely to experience nutrition problems. The incidence of pressure ulcer cases was dependent on the individuals and in most cases, not the repositioning strategy.

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According to the study, manual repositioning should be recommended according to the characteristics of the individual and the stage of pressure ulcer that they are in. It is important that manual repositioning be done to patients who are likely to benefit to avoid the time consuming and tedious job for patients who may not at all recover from the strategy. It was found that those patients who were frequently repositioned may have a higher probability of recovery than for those patients whose repositioning was less frequent. According to the Braden score, effectiveness of repositioning may be used in pressure ulcer prevention for the patients under high risk of the condition. Though these findings were inconsistent, there is still hope for manual repositioning (Rich et al., 2011).

The use of frequent manual repositioning has been advocated for since the pressure ulcers conditions are not reimbursed by medical facilities such as Medicaid while at the same time treatment of the condition is quite expensive. It is hoped that manual repositioning will aid the patient in avoiding such expenses while at the same time recover from the condition. Different medical institutions offer different solutions in the prevention of [pressure ulcers depending on the needs of the patient and the quality of care advocated for by the medical institution towards their pressure ulcer patients. According to this study, it is not clear if manual repositioning works best on bedbound patients than to other patients. This does not mean that frequent manual repositioning is not effective, the fact is that more studies are being done to ensure that it is known ways and means through the process can be made more effective and efficient to the pressure ulcer patients (Rich et al., 2011).

Studies are mainly done on the relationship between incidences of pressure ulcers and repositioning; the Braden scale used in scoring points for pressure ulcer patients and the risks that the patients may be facing. In manual repositioning, factors looked into includes the perception on senses, the mobility of the patient, how active the patient is, level of exposure to factors that cause pressure ulcer, nutrition as well as the amount of moisture that the patient is exposed to.

A study conducted in the year 2011 by Moore et al. on how repositioning can be done using a thirty -degree angle shows that pressure caused by immobility is responsible for pressure ulcers. A randomized trial that was controlled took place where pressure ulcers incidences among the old people were observed while repositioning was being done. The patients were aged eighty and above while the tilts were done at the interval of three hours. It was concluded that older people repositioning reduces the incidence of pressure ulcers as the ulcers were mainly caused by immobility and lack of activity. While undergoing frequent manual repositioning, the patient is monitored on how they respond to pain or other senses while they are being repositioned. The nurse also monitors moisture on the patient's skin so as to ensure that the patient is not exposed to moisture that can worsen the bruises on the patient's skin.

Once the nurses note moisture, they can induce means and provide medication to reduce such cases. The patient activity that aid movement of the patient can also be encouraged during frequent manual repositioning since the activity can reduce cell or tissue wearing off, and thus reduction of the pressure ulcers (Moore, Cowman & Conroy, 2011). The mobility of the patient can be easily monitored during frequent manual repositioning. The frequent visits help the nurse note patient changes in body positions. The nurse is in a better position to encourage the patient to be more physically competent than in the use of PRSS repositioning strategies.

Another study on hip structure and reduction of pressure ulcers conducted in the NHS hospital showed that repositioning reduced the ulcers by seventy- nine point eight percent. Pressure, friction, and tearing of tissues are causes of pressure ulcers. Frequent manual repositioning aids the nurse or the health care provider to check on these issues constantly. The provider while manually repositioning the patient is able to identify factors that can lead to the friction or tearing and offer solutions at a faster and efficient rate than in use of other pressure ulcer preventing strategies available in the health care sector (Mc Gee, & Mc Carthy, 2017). Nutrition is important for any patient. Undernourished patients tend to become weaker and especially in their conditions. Inadequate nutrition among pressure ulcer patients may have more injuries and develop intense stages of pressure ulcers.

Discussion

Sensation and mobility are important aspects in the prevention and healing of pressure ulcers. Repositioning provides a platform where these feelings could be experienced by the pressure ulcers patients. Repositioning is the turning or moving of an individual, in this case, a patient to a different position or angle so as to distribute, or remove pressure on the affected body part. Repositioning could be done through the use of PRSS, in other words the pressure-redistributing support surfaces such as overlays and mattresses. Repositioning could also be done manually where the patient is helped to stay in different positions and angles through physical or manual means without the help of equipment (Moore, Cowman & Conroy, 2011).

Frequent manual repositioning has been done to patients with limited mobility such as the elderly to ensure that pressure is redistributed on bruised areas that result from pressure ulcers. Recommendations on manual repositioning states that the patients should be repositioned after every two hours. Though this information has not been proven to be completely effective, the two - hour repositioning intervals is the one that is currently in use in the health care sector in manual repositioning of the pressure ulcers patients. Studies done on the repositioning strategy show that it is time consuming and could affect the health of the nurses providing the services thus its effectiveness is paramount to prevent wastage of time, among other consequences brought about by the strategy.

In the frequent manual repositioning strategy, the health looks into issues relating to skin care where they ensure that the factors that can result in skin irritation such as moisture are put under control. The skin is also protected from such issues through the application of protective creams (Baumgarten et al., 2009) However, monitoring and application of such products can only be done through frequent manual repositioning.

Reduction of pressure on body parts that bear much weight is also made possible through the frequent manual repositioning. Patients that are capable of moving are encouraged to do so while immobile or bedbound patients are helped to do so through manual repositioning. The patients are also encouraged to improve on their mobility while protecting the bony areas that bear much weight. During the manual repositioning, the nurses or the health care providers may note whether the patient is taking proper diet and they are under adequate nutrition. If not, they have the opportunity to advise and encourage the patients to be more keen on their nutrition and health. It is also common that during manual repositioning that the nurse identifies injuries that require treatment while at the same time helping the patients understand how to prevent such infections (Mc Gee & Mc Carthy, 2017).

Conclusion

Frequent manual repositioning strategies have been introduced in the health care sector with the aim of aiding patients to prevent pressure ulcers while at the same time reducing the expenses used in the treatment of pressure ulcers. Frequent manual repositioning strategies have also been used in the prevention of progression of pressure ulcers to extreme conditions.