Does The BackBone™ really work?
Everyone askes: “But Gwen: Do you have evidence that The BackBone™ turning wedge actually prevents pressure ulcers?”
My short answer is: I have evidence that The BackBone(tm) reduces pressure better than any other positioning support. But if someone told you that a positioning support can take the credit for reducing pressure injury incidence and prevalence, they are not being truthful. Asking if The BackBone(tm) reduces incidence is the wrong question. Asking if The BackBone(tm) reduces pressure is the right question.
Here’s the math on positioning to prevent pressure injuries: Turning works because turning reduces pressure. Reduced pressure = reduced pressure injury incidence. When pressure is back on = Its time to reposition.
But when it comes to looking at turning as part of your pressure injury prevention efforts, there is a lot more to pressure injury incidence than just pressure reduction. Moisture, friction, nutrition and a multitude of co-morbidities to name a few, can all contribute to pressure injury. Trying to draw a straight line between turning frequency and pressure injury incidence will never work. We can never know how frequent repositioning is contributing to pressure injury incidence without fist controlling for all the other variables that cause pressure injuries.
That being said, pressure itself is the #1 most important variable to control. If we can to control (lower) pressure, we can lower risk. Virtually all studies that set out to explore repositioning have concluded that turning can help reduce pressure injury incidence. But no study has been able to conclusively determine how frequently turning should be done. Why? Because they are not asking the right question, or measuring the right variable. We don’t need to answer how frequently to turn, and we should not be measuring incidence and prevelence. We need to ask how much pressure there is, and we need to measure how long can we keep the pressure off. Once we have that data, the question of frequency and incidence will be answered.
The real goal of turning is to reduce pressure for as long as possible. How can we do that? The key to getting best pressure reduction for the longest time possible is to provide comfortable and stable support without touching the sacrum/coccyx. The key to providing comfortable and stable support is to cradle the back and pelvis so that there is full distributed support under the person position, without touching the sacrum/coccyx.
The BackBone(tm) is the only positioning wedge designed to support the 30 degree lateral position in an ergonomically correct and fully supported postion so that pressure reduction can be maintained for an extended period of time.
When it comes to preventing and treating pressure ulcers; Start with comfortable and long lasting pressure reduction. If you want to reduce pressure injury incidence at your facility, always start with a cushion that honestly reduces pressure.
Gwen Jewell, Clinical II RN, BSN, CWS
Jewell Nursing Solutions for pressure injury.