Implementation of Turning Clocks for Pressure Ulcer Prevention and Management

The use of an individualized repositioning schedule is a recommended strategy for prevention and management of pressure ulcers. As individuals’ needs differ, it is often a challenge to communicate specific repositioning schedules to care staff which may result in inconsistent positioning. The literature suggests that using a visual cue or diagram with body positions may be a helpful reminder of Resident positioning schedules.

Prior to the implementation of the Turning Clocks, communication of at-the-bedside information relating to individualized Resident repositioning schedules was limited. Therefore, to promote a person-centred care approach in pressure ulcer prevention and management, the Turning Clock (by Safe Moves Injury Prevention Solutions) was trialed and evaluated in one Manitoba Revera Home in 2010. Based on the positive outcomes of the evaluation, the Turning Clock was implemented in the 7 other Manitoba Revera Homes in 2011 and extended to Revera Homes across Canada.

The Turning Clock is an interactive communication tool placed at Resident’s bedside that outlines the individual positioning plan including; frequency of positioning, the type of position and time for next position change. Upon initial assessment of the Resident’s repositioning needs, the Turning Clock is customized to reflect the care required. When care is provided at the bedside, the caregiver can tell by looking at the Clock when and how the Resident is to be positioned next. The Turning Clocks are primarily used for Residents who are at high-risk of skin breakdown (with impaired bed mobility) or have an existing pressure ulcer, and in end-of-life care.

Managers and Wound Care Team Members report that the Turning Clocks are an effective tool to promote and monitor positioning schedules. Caregivers that refer to the Turning Clocks in their daily care to Residents report an increased frequency and consistency of positioning with no guessing about the proper or next position and feel they are an effective means to help prevent pressure ulcers.