Not only has Bergstrom's research focused on pressure ulcers, but she says her own mother was in a nursing home, so she knows firsthand how serious pressure ulcers can be. And she knows that turning patients every two hours comes with its own problems, such as disrupting the sleep of patients who often can't get back to sleep after they've been awakened. Turning also takes a lot of time and physical labor from the staff.
"This isn't really a benign thing," Bergstrom says. So she started with the basic premise that pressure ulcers are caused by the amount and duration of pressure on the body.
"The high-density foam mattresses do a very good job of distributing pressure more evenly," she says. After conducting six pilot studies to be sure that her study participants would be safe, Bergstrom led a randomized controlled trial of 942 nursing home residents at-risk for pressure ulcers.
[Disclaimer: Bergstrom is co-owner of a website dedicated to dissemination, education, and training related to the Braden Scale for Predicting Pressure Sore Risk and pressure ulcer prevention and receives royalties.]
"The people that we studied were residents that were moderate or high risk, but not very high risk," Bergstrom says.
The patients were randomly assigned to being turned every two, three, or four hours, and an independent nurse who didn't know which patients were assigned to which turning frequency assessed the patients.