Improving Pressure Injury Prevention by Using Wearable Sensors to Cue Critical Care Patient Repositioning

Abstract

Background Repositioning patients at regular intervals is the standard of care for pressure injury prevention, yet compliance with routine repositioning schedules can be hard to achieve in busy critical care environments. Cueing technology may help improve repositioning compliance. Objective To determine whether using wearable patient sensors to cue nurses about patients’ repositioning needs could improve compliance with an every-2-hour repositioning protocol. Methods A sequential pretest-posttest study design was used in a 12-bed medical intensive care unit. The study occurred in 2 phases. In phase 1, eligible patients wore a triaxial accelerometer-based sensor; nurses were blinded to the data. In phase 2, the sensor technology provided staff with visual cues about patients’ positions and repositioning needs. The primary measure was repositioning protocol compliance, which was compared between phase 1 and phase 2 with weighted t tests. Unit staff members were surveyed before the start of phase 1 and at the end of phase 2. Results In phase 1, 25 patients met the inclusion criteria. Phase 2 began 1 day after phase 1 and included 29 patients. In phase 1, repositioning compliance was 55%, and the mean repositioning interval was 3.8 hours. In phase 2, repositioning protocol compliance increased to 89%, and the mean repositioning interval was 2.3 hours. Nursing staff survey results showed improved teamwork in phase 2. Conclusion Visual cueing about patients’ mobility needs is associated with increased compliance with the facility repositioning protocol.