21 November 2016
EPUAP recommends frequent transfers in order to prevent pressure ulcers. However, the methods and aids we use make a difference.
Transferring bedridden people often proves to be one of the most physically demanding tasks in the health sector. Therefore, a wide range of transferring products and techniques has been developed over the years, in order to reduce the nursing staff's workload. Many of the conventional transferring principles are mainly developed in order to protect the carers’ musculoskeletal system.
Immobility is one of the primary causes of pressure ulcers developing among bedridden people. Therefore, EPUAP recommends repositioning immobile clients and patients every 2-3 hours.
But are the transfer techniques we use to ensure good work and health conditions for the carers, efficient in decreasing the risk of pressure ulcers development among bedridden people? This is what the Dutch brother and sister, Nico and Hanneke Knibbe, examined in the study “Prevention of Pressure Ulcers: Exploring the Influence of Nurses, Equipment and Working Techniques”.
In this study, they analyze the 3 most common transfer situations: Transferring in bed, turning, and moving up in the bed. The transfers are made without aids, respectively by using a standardized hospital bed, lifting equipment and a sliding sheet.
The study shows that the carers’ workload is reduced when they use aids and proper techniques, but these unfortunately have a negative impact on the bedridden person’s skin and underlying tissues.
When the carers move the patient sideways using a sliding sheet, the bedridden person’s tissue will be stretched. The movement is in fact absorbed into the tissue layer by layer, before the person is actually moved. This means that each and every tissue layer is stretched to the maximum before the next layer starts to move. This can directly damage the tissue and thus increase the risk of pressure ulcers developing.
From an ergonomic and biomechanical perspective, it is usually recommended to push or pull instead of lifting. But when we consider pressure ulcers prevention, these transferring techniques are not without consequences. By pushing and pulling, there is indeed a stronger load on the tissue.
Vendlet has conducted a series of studies and case studies, which show that mechanical transferring with the VENDLET system provides the by far the best relief for carers.
In our experience the VENDLET system is also by far the gentlest solution for bedridden people, whose tissue are less exposed to stretching and displacement.
The manual process typically starts with a strong acceleration in order to start the movement. Through pulling or pushing, the acceleration is transmitted together with the force in the tissue, layer after layer.
On the contrary, mechanical transferring with VENDLET is a slow process, without a noticeable acceleration in the beginning. The force used for the movement is directly transferred to the sheet the client lies on, and it is on the sheet that the shear forces are distributed. Throughout the process, the client lies in the same place on the sheet, and unintended tissue damages are minimized.
In the same time, by mechanically transferring with VENDLET, the bedridden person is slightly touched. We only use light guiding touching, which again decreases tissue damage.
The Dutch Msc in Human Movement, Nico Knibbe, agrees with this approach. Therefore, he has contacted Prof. Dr. Dimitri Beeckman from the University in Gent, who is now conducting an unbiased study of the impact on tissues while transferring with the VENDLET system.
The project is expected to finish in about 1 year. Therefore, we hope to present the results of this project during next year’s “International STOP Pressure Ulcers Day”.
Tissue damage during transfers