Pressure ulcer prevention: An efficient turning schedule for bed-bound patients

Pressure ulcer is a critical problem for bed-ridden and wheelchair-bound patients, diabetics, and the elderly. Patients need to be regularly repositioned to prevent excessive pressure on a single area of body, which can lead to ulcers. Pressure ulcers are costly to treat and cause many other health problems, including death. The current standard for prevention is to reposition at-risk patients every two hours. This level of attention is becoming increasingly unrealistic for already overworked nursing staff. In this paper, we present a scheduling algorithm that uses data from a pressure mat on the hospital bed to compute a repositioning schedule that minimizes nursing staff interaction while still preventing pressure ulcer formation. Our experimental results show a 30% increase in the average time between repositioning over the standard schedule. Furthermore, some postures were found to be unsafe if not changed for more than one hour.

[1]  Jorge J. Moré,et al.  Digital Object Identifier (DOI) 10.1007/s101070100263 , 2001 .

[2]  Eunice Park-Lee,et al.  Pressure ulcers among nursing home residents: United States, 2004. , 2009, NCHS data brief.

[3]  D. A. Lee,et al.  Compressive Deformation and Damage of Muscle Cell Subpopulations in a Model System , 2001, Annals of Biomedical Engineering.

[4]  J. B. Reswick,et al.  Experience at Rancho Los Amigos Hospital With Devices and Techniques to Prevent Pressure Sores , 1976 .

[5]  H N Mayrovitz,et al.  Blood perfusion hyperaemia in response to graded loading of human heels assessed by laser-Doppler imaging. , 1999, Clinical physiology.

[6]  Clay J Cockerell,et al.  Decubitus ulcers: A review of the literature , 2005, International journal of dermatology.

[7]  A. Gefen,et al.  Pressure-time cell death threshold for albino rat skeletal muscles as related to pressure sore biomechanics. , 2006, Journal of biomechanics.

[8]  Martin Ferguson-Pell,et al.  Remote monitoring of sitting behavior of people with spinal cord injury. , 2002, Journal of rehabilitation research and development.

[9]  J. Wille,et al.  Pressure sores and pressure-decreasing mattresses: controlled clinical trial , 1994, The Lancet.

[10]  R. Narechania,et al.  Relationship of Spine Deformity and Pelvic Obliquity on Sitting Pressure Distributions and Decubitus Ulceration , 1985, Journal of pediatric orthopedics.

[11]  C. Dangoisse,et al.  [Prevention and treatment of pressure ulcers]. , 1991, Revue medicale de Bruxelles.

[12]  William V. Padula,et al.  Pressure Ulcer Risk Assessment and Prevention , 2013, Annals of Internal Medicine.

[13]  Amit Gefen,et al.  Risk factors for a pressure-related deep tissue injury: a theoretical model , 2007, Medical & Biological Engineering & Computing.

[14]  Nancy Sims,et al.  Effects of Different Cyclic Pressurization and Relief Patterns on Heel Skin Blood Perfusion , 2002, Advances in skin & wound care.

[15]  C. Steiner,et al.  Hospitalizations Related to Pressure Ulcers Among Adults 18 Years and Older, 2006 , 2008 .