To Turn or Not to Turn: Exploring Nurses' Decision-Making Processes Concerning Regular Turning of Nursing Home Residents.

Journal Article (Journal Article)

Background : Nursing home (NH) residents are at high-risk for pressure injuries (PrIs), and those living with Alzheimer's Disease and Related Dementias (ADRD) are at even greater risk. Understanding how nursing staff approach repositioning remains critical. Methods : As part of an ongoing clinical trial, this mixed-method prospective, exploratory, descriptive study examined repositioning efforts for PrI prevention. An investigator-developed checklist guided researcher observations, and focus groups revealed staff perspective on resident behaviors and corresponding repositioning approaches. Focus group transcripts were analyzed using the constant comparative coding method. Results: Repositioning observations were conducted for 88 residents. Resident behaviors and nursing approaches were similar between the ADRD (n = 62, 70%) and non-ADRD (n = 26, 30%) groups. Thirty-six staff participated in one of six focus group sessions. A conceptual model was developed to depict the repositioning process. Staff revealed care is guided by clinical frameworks and guidelines, along with resident preferences and behaviors. Conclusions: Protocol-driven, standardized PrI prevention care may limit the capacity to honor repositioning preferences. Insights from the focus groups highlight the importance of being cognizant of competing factors that may interfere with successful repositioning. Approaches by staff may be protocol-driven or an integrated method of care.

Full Text

Duke Authors

Cited Authors

  • Yap, TL; Alderden, J; Kennerly, SM; Horn, SD; Rowe, M; Sabol, VK

Published Date

  • January 2021

Published In

Volume / Issue

  • 7 /

Start / End Page

  • 23337214211046088 -

PubMed ID

  • 34631970

Pubmed Central ID

  • PMC8493305

Electronic International Standard Serial Number (EISSN)

  • 2333-7214

International Standard Serial Number (ISSN)

  • 2333-7214

Digital Object Identifier (DOI)

  • 10.1177/23337214211046088


  • eng