Effectiveness of using turning clocks for the prevention of pressure ulcers in a neurology and stroke rehabilitation unit

Background: Pressure ulcers remain a significant healthcare challenge, particularly in patients with limited mobility. Frequent repositioning is a cornerstone prevention strategy, yet adherence to repositioning schedules remains suboptimal in clinical practice. Visual cues have shown promise in improving compliance with repositioning protocols, but evidence from resource-limited settings is scarce. This study aimed to assess the effectiveness of introducing a turning clock with customised repositioning schedules to prevent pressure ulcer incidence and to promote adherence to a two-hourly repositioning practice in a neurology and stroke rehabilitation unit.
Methods: A pre- and post-intervention study was conducted in a 22-bedded neurology and stroke rehabilitation unit at Teaching Hospital Rathnapura. Patients unable to reposition independently were included. Baseline data on pressure ulcer incidence and repositioning adherence were collected over ten months (March–December 2022). Following the implementation of turning clocks in January 2023, similar assessments were conducted for a further 10 months (January–October 2023). Both groups received comparable pressure-redistributing surfaces.
Results: The pre-intervention period included 40 patients, with 662 patient-days and 10 pressure ulcer incidents. Post-intervention assessment included 38 patients, with 680 patient-days and 3 pressure ulcer incidents (p<0.001). Adherence to the two-hourly repositioning schedule improved significantly with the turning clock intervention.
Conclusion: The implementation of turning clocks significantly reduced the incidence of pressure ulcers and improved the consistency of repositioning practice. This simple, low-cost visual cue intervention shows promising impact on prevention of pressure ulcers in resource-limited settings.