People with reasonable mobility on average alters their position every 10 minutes throughout the night. This is because the body needs small repositions for blood flow, comfort, pressure distribution, respiration and more. But immobile clients and people with impaired sensory function also need these repositions during the night. Not least if we want to prevent pressure ulcers and provide better comfort.
By Physiotherapist Peter Maindal
Recent research in the field shows that small movements, also called micro-positioning, are of great importance in the prevention of pressure ulcers. Bedridden clients that frequently change their position during the night are much less likely to develop pressure ulcers than clients that lie completely still.
Micro-positioning is therefore about creating frequent and discreet changes to the client's positions. If the client is lying on his back, a small support cushion is placed alternately under the shoulder and hip on both sides. In lateral position, the micro-movements can be created by alternately placing a small cushion under the abdomen.
As such, when using micro-positioning it is not always necessary to turn the client to the lateral position to relieve pressure. Research shows that small shifts in position can also be effective in the fight against pressure ulcers. At the same time, micro-positioning has the advantage that they are usually more discreet and can be made without disturbing the client during the night allowing for better rest and recovery.
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Watch how micro-positioning works in this video:
To assist with micro-positioning, we have developed a special support cushion which we call the LEJRELET Oval. The cushion has been tested on several patients at a hospice. The physiotherapist had the following statement:
“The cushion is really easy to work with. Unlike many other cushions, Oval stays where it is placed due to the friction of the cover. It is brilliant. In addition, it shapes itself to the individual client and provides a stable bearing. Our tests showed that micro-positioning with the small positioning cushion is enough.”
The repositioning concept was also tested at a nursing home. Here the physiotherapist had the following statement:
“We are very impressed with the cushion and especially how little effort is needed when positioning clients with it. The residents only wake up a little or not at all when we do micro-positioning." She also notes that the cover is very breathable, and that no moisture is formed between the skin and the cushion.
The nursing home trialled the cushion at two clients. One client was terminal and in a lot of pain. It was very hard to position him and he was at high risk of pressure injuries. With micro-positioning, he could be positioned without pain and he avoided pressure injuries. He also did not need an alternating air mattress.
The other client who trialled the Oval cushion only wanted to lie on her back, which increased her risk of pressure injuries. But with the help of micro repositioning with the LEJRELET Oval, it was possible to prevent pressure ulcers while allowing the woman to lie in the supine position.