Effects of using the Turn All automatic tilting system
Pressure ulcers remain a
costly problem
12-13% of older citizens in municipalities have pressure ulcers (Mathiesen et al., 2013). And research predicts that the trend towards ever shorter hospital stays and more people with multiple illnesses and requiring treatment in their own homes and in nursing homes could lead to an increase in the number of pressure ulcers in municipalities (Lindholm et al., 2018). Pressure ulcers are therefore an important prevention area for municipalities to focus on.
Recent studies have shown that 13-43% of patients admitted to hospitals have pressure ulcers, but there are no national surveys of the number of pressure ulcers in Denmark (Dorsche and Fremmelevholm, 2010 and Bermark et al.2009). However, we know that treating pressure ulcers costs DKK 1.3 billion each year (Mathiesen et al., 2013). This underlines the importance of prevention.
Pressure ulcers are prevented by ensuring pressure relief for those at risk of developing pressure ulcers. Depending on the person’s level of function, pressure relief can be achieved with mobilisation, position changes and with lying in bed in a 30-degree lateral position with manual turns.
The frequency of the reversals is a professional judgement and depends on the person’s level of function and risk of developing pressure ulcers. It can be from 20 minutes per day up to 240 minutes per day. A lateral positioning of a person takes about 10 minutes and typically requires the presence of two health professionals.
So that’s between 20 minutes and 4 hours each for two health professionals to do manual turns – every day, on one person.
By using the Turn All automatic tilting system, healthcare professionals have time for other important tasks and scarce healthcare resources are used in a more optimal way. The tilting system automatically turns the person at risk of developing pressure ulcers in a 30-degree sideways position, alternating between right and left sides.
You can make your own calculation and see how many hours you and your colleagues will free up for other tasks by using a Turn All automatic tilting system for people at risk of developing pressure ulcers who need pressure relief in bed.
Automatic turns contribute
to optimise resources
To show the impact of using Turn All in practice, the effects of implementing automatic keying systems in Turn All instead of manual keying are calculated below.
Aalborg Municipality is used as an example. In 2021, the municipality had 37,500 elderly people over 66 years of age (Statistics Denmark). On average, 12% of them will already have a pressure ulcer, and many more are likely to develop pressure ulcers if preventive measures are not taken (Mathiesen et al., 2013).
An example of a person at moderate risk of developing pressure ulcers and who would require turns 20 minutes per day could be a person who is hemiplegic after a stroke and who uses a wheelchair during the day.
An example of a person at high or extra high risk of developing pressure ulcers, and who would optimally require turns 240 minutes per day, could be a terminal person who is fully bedridden. Here, the chip system can of course be used both if the person is in hospital, in a hospice, in a nursing home or if the person wants to spend the last time in their own home.
For a person who needs assistance with turning 240 minutes per day, it takes almost a full year’s work to make manual turns.
The wage costs shown in the tables are calculated on the basis of average wages. pension and holiday pay as reported by FOA and the Ministry of the Economy and the Interior’s Benchmark Unit’s survey of sickness absence among social and health care workers in municipalities.
It is worth noting that real labour costs are likely to fall when Turn All is implemented, because fewer heavy lifts mean fewer sick days. Social and health workers have an average of 15.7 days of sickness absence in a year.
At the same time, and more importantly, it will provide a better physical working environment for health professionals. Indeed, lack of time to perform manual turns as prescribed can contribute to workloads that lead to attrition and overuse injuries as well as increased absenteeism due to illness (Januario et al., 2021).
| Background data |
| Focus group is older people over 66 years in Aalborg municipality |
| 2 health professionals spend 20-240 min. per day on manual turns for elderly people who have, or are at risk of developing, pressure ulcers |
| One camp takes two health professionals 10 min. |
| Statistical figures |
| Elderly > 66 years: 37,500 |
| Elderly who have pressure ulcers on average: 12% |
| Salary costs for a Social and Health Assistant per hour (including holidays, pension and sick leave) : 266,64,-* |
*FOA and the Benchmarking Unit of the Ministry of the Economy and the Interior
Effect per day
| Effect per day at 20 min | Effect per day at 20 min | Effect per day at 240 min | Effect per day at 240 min | |
|---|---|---|---|---|
| Effect in time (hour) | Effect in DKK | Effect in time (hour) | Effect in DKK | |
| Pr. senior citizen | 0.3 | 178 | 4 | 1,067 |
| 12% of elderly citizens | 1500 | 801,000 | 18,000 | 4,801,500 |
| 20% of elderly citizens | 2,500 | 1,335,000 | 30,000 | 8,002,500 |
Effect per. year
| Effect per. years at 20 min | Effect per. years at 20 min | Effect per. years at 240 min | Effect per. years at 240 min | |
|---|---|---|---|---|
| Effect in time (hour) | Effect in DKK | Effect in time (hour) | Effect in DKK | |
| Pr. senior citizen | 110,88 | 59,808 | 1,344 | 358,512 |
| 12% of elderly citizens | 504,000 | 269,136,000 | 6,048,000 | 1,613,304,000 |
| 20% of elderly citizens | 840,000 | 448,560,000 | 10,080,000 | 2,688,840,000 |
Annual work
| Annual work at 20 min | Annual work at 240 min | |
|---|---|---|
| Pr. senior citizen | 0,1 | 0,9 |
| 12% of elderly citizens | 654,80 | 3,925,30 |
| 20% of elderly citizens | 1091,40 | 6,542,20 |
References:
Bermark, S., Brostrup Jensen, L., Krejberg, E., Norden, A., Trangbæk, R., Palmberg, J., Ørskov, A., 2009. Six prevalence studies for pressure ulcers : snapshots from Danish hospitals. Wounds 17, 203-210.
Statistics Denmark, 2022. Population pyramid for Aalborg Municipality. URL //extranet.dst.dk/websites/pyramid/pyramide.htm (accessed 5.18.22).
Dorsche, K.M., Fremmelevholm, A., 2010. Incidence of decubitus in hospital. Ugeskrift for Læger. 172, 601-606.
Januario, L.B., Mathiassen, S.E., Stevens, M.L., Holtermann, A., Bergström, G., Rugulies, R., Karstad, K., Hallman, D.M., 2021. Are resident handlings in eldercare wards associated with musculoskeletal pain and sickness absence among the workers? A prospective study based on onsite observations. Scandinavian Journal of Work, Environment & Health 47, 609-618. https://doi.org/10.5271/sjweh.3979
Lindholm, C., Sommer, C., Fremmelevholm, A., 2018. Most pressure ulcers are preventable. Fag & Forskning, Trialog 4, 22-35.
Mathiesen, A.S.M., Nørgaard, K., Andersen, M.F.B., Møller, K.M., Ehlers, L.H., 2013. Are labour-intensive efforts to prevent pressure ulcers cost-effective? Journal of Medical Economics. 16, 1238-1245. https://doi.org/10.3111/13696998.2013.832256
