Effect of Frequency of Manual Turning on Pneumonia

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 kinetic therapy beds were superior to manual turning in reducing pulmonary...