NursingNotes
  • login
  • signup
  • Latest News
  • Clinical Updates
  • Professional
  • Education
  • Opinion
No Result
View All Result
NursingNotes
No Result
View All Result

Home > News

Two-hourly repositioning is ‘unintentional institutional abuse,’ claims study

The researchers highlight that the chronic sleep deprivation such regular turning causes could constitute "torture".


11 February 2019
elderly man in bed

Shutterstock

Two-hourly pressure area care could constitute torture or  “unintentional institutional elder abuse”.

The practice of repositioning patients who are at a ‘high risk’ of developing ulcers may be interrupting their natural sleep rhythms and could be classed as “unintentional institutional elder abuse”, a new study has claimed.



Researchers from the University of New South Wales examined the records of eighty patients living in eight different care homes in Australia. A key limitation of the study is its size and narrow focus.

The controversial study found that despite nearly all of the patients being repositioned every two hours, even through the night, more than one-third of them still had one or more of the “excruciating” pressure ulcers when they died.

‘Chronic sleep deprivation’.

In their paper,  published in Bioethical Enquiry, the researchers Catherine Sharp, Jennifer Schulz Moore and Mary-Louise McLaws write, “For decades, aged care facility residents at risk of pressure ulcers have been repositioned at two-hour intervals, twenty-four-hours-a-day, seven-days-a-week. Yet, pressure ulcers still develop.”

“We concur with others who have shown that the ritualistic practice of waking residents every two hours for the purpose of repositioning contributes to severe sleep deprivation and behaviours of concern”.


“Sleep is a fundamental phenomenon in most organisms and the sleep–wake cycle is a physiological rhythm which modulates endogenous neuronal activity in the brain.”

“Chronic sleep deprivation can cause significant and cumulative physiological deficits and the disruption of normal neurophysiological mechanisms.”

Adding that the chronic sleep deprivation caused by regular turning causes could be in violation of the Optional Protocol to the Convention against Torture.

The team also questioned the ethical implications of repositioning patients who lack the ability to consent to two-hourly repositionings, such as those with severe dementia.


An alternative.

Rather than two-hourly repositioning, the researchers suggest the use of alternating pressure air mattresses (APAMs).

“Pressure relief should be provided in the form of an APAM, not waking residents up for the purpose of repositioning,” the researchers say.

“An APAM provides pressure relief to all parts of the body every few minutes throughout the twenty-four hours without waking residents, whereas repositioning for pressure relief is usually only carried out two-hourly.

While APAMs have been shown to prevent pressure ulcers, the research dates back to 1967.



Popular

Patient face mask in GP

GP practices can now deregister patients for ‘unrealistic service demands’

2 June 2022

student nurse staff nurse

Student nurses ‘used and abused’ on placements

13 June 2022

RCN

Nursing staff demand immediate review of ‘not fit for purpose’ Agenda for Change pay and conditions

8 June 2022

Insight

Busy A&E waiting room

‘The NHS is having its worst winter ever – and the reasons run much deeper than COVID’

28 January 2022

Hospital curtain intensive care

‘During the Downing Street Christmas Party we were caring for dying patients and forbidden from seeing family’

8 December 2021

Vaccine inPPE

‘Making vaccination compulsory for NHS frontline workers likely to make patients suffer’

19 November 2021


Related Posts

Healthcare workers in PPE
Workforce

NHS staff on track to suffer a further 7% real-terms pay cut

25 June 2022
Sad,Tired,Young,Woman,Touching,Forehead,Having,Headache,Migraine,Or
Clinical

US abortion ban dangerous for women, warn UK doctors

24 June 2022
Community nurse dressing a wound
Workforce

Community nursing ‘no longer viable’ due to astronomical fuel prices

24 June 2022
NursingNotes

© 2019 NursingNotes.co.uk

Navigate Site

  • Who are we?
  • Terms of Service
  • Privacy Policy
  • Contact Us
  • Agenda for Change Pay Scales

Follow Us

No Result
View All Result
  • Latest News
  • Clinical
  • Education
  • Health Politics
  • Opinion
  • Resources

© 2019 NursingNotes.co.uk