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Background Repositioning is widely recommended to prevent pressure injury (PI). Documentation of implemented pressure injury prevention (PIP) strategies is necessary for continuity of care. This pilot observational study aimed to describe the positioning patterns of patients at risk of developing PIs and to identify gaps in documentation of PIP strategies. Methods Patients were recruited from neurology and orthopaedic wards. Positions adopted were recorded during a two-hour observational period over three consecutive nursing shifts (day, evening, night). Demographic data, clinical details and recommended or implemented PIP strategies was obtained from medical records. Data were analysed descriptively using frequencies, percentages, medians, ranges and interquartile ranges as appropriate. Results Twenty-six out of 38 patients participated; the majority were orthopaedic patients with a median age of 66 years. Twenty-four had a PI risk assessment completed; 12 (50%) were scored at moderate to very high risk of PI. Four (33%) of those in the PI moderate to very high risk categories were prescribed a turning regime; 2 (17%) had received PIP education; and 6 (50%) had a pressure-relieving device recommended. The most observed positions for day shift were supine 46°-90° and sitting out; for afternoon shift were supine 46°-90° and supine 1°-45°, and for night shift left lateral or supine 1°-45°. Conclusions Acute care patients were most often observed in positions that place them at risk of PIs. Targeted PIP strategies are required that take into account patient movement patterns and address deficiencies in documentation of care. [ABSTRACT FROM AUTHOR]

This article outlines the development, implementation and evaluation of a formal training program in skin care and pressure injury prevention and management. The program was developed for assistants in nursing (AINs) at St Vincent's Private Hospital (SVPH), Sydney. SVPH is a not-for-profit, acute care facility with 250 beds. Our current case mix index for January to May 2012 is 1.871. In late 2009 the wound clinical nurse consultant (CNC) identified that the AIN cohort received no formal education in skin and pressure injury prevention and management. In 2010 a tailored program specifically for AINs was developed by the wound CNC in consultation with the Nursing Education Training and Development Council to update and extend AINs' knowledge and skills in this area. With the support of the nurse unit managers (NUM) and clinical nurse educators (CNE), all 19 AINs enrolled completed the course successfully. On review of the 2010 Pressure Ulcer Point Prevalence Audit (PUPPA) results, there was a decrease in the prevalence in pressure injury from 11% to 7%, with the only new pressure injury intervention being the AIN education program. Although we have no true measure as to the effect of the AIN education program, it can be hypothesised this was a significant contributing factor to the reduction of pressure injuries acquired at SVPH. [ABSTRACT FROM AUTHOR]