Following the provision of accurate and relevant information about the healthcare intervention and alternative options available; and with adequate knowledge and understanding of the benefits and material risks of the proposed intervention relevant to the person who would be having the treatment, procedure or other intervention (Australian Commission on Safety and Quality in Health Care, 2020).

None of my narrative papers have been accepted for the new 2025 pressure ulcer prevention Guidelines. Yet my suggestions work… I can tell you how to have a pressure ulcer free facility.

References

Sharp CA Do Clinical Practice Guidelines for the Prevention of PUs really prevent PUs? An analysis based on the Guidelines. AJMS Vol 13 No 5 2022 1st June 2022

Sharp CA and Campbell J. Preventing pressure ulcers in aged care by auditing, and changing, work practices. AJMS Vol 13 Issue 4 April 2022

Human rights and litigation.

Sleep, like eating or drinking, is essential for living. Almost everyone has experienced the feeling of ‘falling to pieces’ after a night of poor sleep.

Sleep and Alzheimers

Gaur et al., (2022) described how inadequate sleep causes the aggregation of soluble amyloid beta protein and this may raise the likelihood of poor cognitive outcomes. One mechanism, they explained, is that, during slow wave sleep, the brain may be able to remove metabolic waste more effectively. In my opinion this puts an even greater responsibility on healthcare facilities to prioritise sleep for all patients and the main way this can be accomplished is to cease the two-hourly repositioning regimes, unless awake, use alternating pressure air mattresses, and let patients sleep.

Researchers are investigating the relationship between lack of sleep, or disturbed sleep, and a link with Alzheimer’s Disease (Gaur et al., 2022; Gobraeil, 2022). Therefore, it is imperative that patients are given the opportunity to sleep all night without being disturbed and to be informed of alternative therapies and strategies. Informed consent is a person’s decision, given voluntarily, to agree to a healthcare treatment, procedure or other intervention that is made:

References

Dimond, B (2003). Pressure ulcers and litigation. Nursing Times, 99(5) 5 Dube, A (2021).

Risk factors associated with heel pressure ulcer development in adult population: A systematic literature review. Journal of Tissue Viability https://doi.org/10.1016/j.jtv.2021.10.007

Gaur, A., Kaliappan, A., Balan, Y., Sakthivadivel, V., Medala, K., & Umesh, M (2022). Sleep and Alzheimer: The Link. Maedica (Bucur), 17(1), 177-185. doi:10.26574/maedica. 2022.17.1.177

Ta-Wei Guu, Dag Aarsland, Dominic ffytche

Light, sleep-wake rhythm, and behavioural and psychological symptoms of dementia in care home patients: Revisiting the sundowning syndrome

2022

https://doi.org/10.1002/gps.5712

Gobraeil, S. Rizq, G (2022). What is the Relationship Between Sleep and Alzheimer’s Disease? A Narrative Review. URNCST Journal, 6(1). doi: https://doi.org/10.26685/urncst.334

In 1944 Ludwig Guttmann went into the hospital at night to see how nurses were preventing pressure ulcers. After he explained the importance of repositioning to the nurses, the problem dissipated but still teams of three orderlies and a nurse repositioned patients 24 hours a day to prevent pressure ulcers. There was no mention of sleep deprivation caused by repositioning.

References

Frankel, H. L (2012). The Sir Ludwig Guttmann Lecture 2012: the contribution of Stoke Mandeville Hospital to spinal cord injuries. Spinal Cord, 50(11), 790-796. doi:10.1038/sc.2012.109