Clinicians have long recognized that patients should be turned at least every 2 hours.1 In fact, routine turning of critically ill patients is viewed as a standard of care to prevent pneumonia.2 Although a 2-hour manual turning schedule is widely embraced in theory, it is unclear if it alters pulmonary function3 or if it is uniformly practiced. In a study4 of 74 critically ill patients from 3 hospitals, only 2 patients had position changes every 2 hours. Even if a 2-hour turning schedule is enforced, it is unclear if this frequency of turning would be sufficient to prevent pulmonary complications.5 

Although Traver et al6 found no difference in the incidence of pneumonia between patients cared for on oscillating beds and patients who had manual turning every 2 hours, other investigators3 found that...

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