reduction in pressure injury incidence
in a randomized, controlled trial of 399 high-risk inpatients with Braden scores of 16 or less,

Non-secured Bed Support Surface Set-up with Patient in Bed
1. Prior to applying, ensure that the patient is not too low in the bed. Boost the patient to the appropriate position if needed.
2. To assist with correctly placing the surface, ensure that the patient icon on the surface is appropriately oriented in relation to the patient. Roll the bed enhancer up halfway.
3. With the patient in the side-lying position, place the surface beneath the fitted sheet and align the sacral target and arrow with the bend zone of the mattress, where the head of the bed meets the lower portion of the bed. Ensure that the enhancer is centered horizontally on the bed.
4. Position the patient to the opposite side and unroll the surface. It is recommended to elevate the knees to promote proper positioning on the surface while the patient is in supine with the head of the bed elevated.
Non-secured Bed Support Surface Set-up without Patient in Bed
1. To assist with correctly placing the surface, ensure that the patient icon is appropriately oriented in relation to the bed.
2. Place the surface underneath the bed linens, with the sacral target aligned with the bend zone of the mattress, where the head of the bed meets the lower portion of the bed.
3. Ensure that the surface is centered horizontally on the bed.
Correct patient alignment is with the sacrum centered both horizontally and vertically on the surface. Use the surface markings to assist with positioning your patient. The surface is marked with a white target to indicate the center of the surface. The patient’s sacrum should align with the center target. The blue arrows on the bed surface's side flaps point to the center target.
Please refer to the Guardian User Manual for more details on upright, side lying, and prone positions.
It depends on the type of alert.
Patient data not entered at initiation of therapy:
The alert will consist of an auditory chime, red status lights, and the data entry screen present. The only way to dismiss this alert is to enter the required data. This alert will occur if there is no interaction with the data entry screen for 5 minutes.
For Versions 2.0 and 2.5: Enter the patient's weight to clear the alert. Therapy will automatically start with a default patient weight selection at the time of alert; however, it is vital to select the correct patient weight in order for the patient to receive optimal, weight-based therapy.
For Version 2.7: Enter the patient's room number to clear the alert. Therapy will NOT begin until this data point is entered. It is vital to enter the patient's room number to start therapy in a timely fashion as well as for billing, inventory management, and information services.
Conditions that interrupt therapy:
The alert will consist of an auditory chime, red status lights, and a red alert screen. The alert screen will display instructions. Respond to each alert as follows:
No patient detected: Check to ensure that the patient is positioned correctly on the support surface, with his/her sacrum centered on the sacral target, using the visual on the screen as a guide
Leak detected: If a leak is detected, the surface should initially be disconnected and reconnected to the controller. If the problem persists, the support surface needs to be replaced. If the leak alert recurs after replacing the surface, replace the controller.
Airflow blocked: Assess the surface flap where the tubes exit the surface for folding or bunching. Next, assess the tubing for a kink or a pinch from the surface all the way to the controller.
Connect Surface to Controller: The surface has been disconnected from the controller for 5 minutes. Reconnect surface to resume therapy or select the ‘Discharge Patient’ button to end therapy
Battery alerts:
The alert will consist of an auditory chime, red status lights, and a red alert screen, for the following battery conditions:
AC Power Disconnected: plug the controller in as soon as possible or mute the alert to continue using battery mode
Low battery: plug the controller into AC power as soon as possible
Battery depleted / terminal battery shutdown: plug the controller into AC power immediately to avoid interruption in therapy
Yes. While the TurnCare Guardian System has been effective for certain patients who are too unstable to turn, it has not yet been studied in a large-scale clinical trial to investigate its effectiveness with less frequent repositioning. The TurnCare Guardian System is recommended as a therapy in addition to the standard of care, including Q2 repositioning, and not as a replacement to the standard of care.
Patients can be placed in the prone position while using the Guardian System. First, ensure the enhancer is positioned properly on the hospital bed. Press “Pause” on the controller, allowing the enhancer to deflate. If more than 30 minutes is needed to prone the patient, select the ‘Off Unit’ button to extend pause time for 1 hour. Then, place your patient in the prone position, following organizational policies. Be sure to press Resume to re-start Guardian therapy.
Yes, CPR can be safely performed while the Guardian System is set up on the patient bed. The controller can be paused and the support surface can be disconnected from the controller to deflate the surface if preferred, however it is not necessary. A CPR board can be placed on top of the of the surface.
Before transferring a patient in or out of bed, the support surface must be fully deflated for patient and staff safety.
1. Press pause to temporarily stop therapy. Allow the support surface to fully deflate.
2. Transfer the patient safely according to facility protocol.
3. If the patient is being transferred to the chair or recliner, be sure to reconnect the connector to the seat support surface.
Prior to transferring the patient to or from the stretcher, support surface must be fully deflated for patient and staff safety.
1. Press Pause on the touch screen. Allow the surface to fully deflate.
2. Place the transfer assist device beneath the patient according to facility policy and procedure.
3. Transfer the patient according to facility policy and procedure.
4. To perform the transfer from the stretcher to the bed, follow the above instructions.
If the patient is identified as a candidate for the Guardian System, he/she should use the Guardian System at all times unless it is interfering with safety or unless the patient develops a contraindication. The Guardian System should be used both in the bed and in the hospital chair. It is recommended that the Guardian System be sent with the patient to off-unit procedures longer than 2 hours (excluding MRI). For surgical procedures, appropriateness of use will depend on procedure specifics and patient positioning. Always consult with the surgeon for approval.
If you do not see your unit’s name, you may select ‘Other’ located on the last page of the unit selection screens. A unit must be selected to start therapy. Additionally, please contact TurnCare Support at (203) 290-1098 or support@turncare.com to correct the discrepancy.
First, press ‘Pause’ on the running screen to pause therapy. Next, press the ‘Off Unit’ button to access four different extended pause times (e.g. 1 to 4 hours). Once a time selection is made, the ‘Paused- Patient Off Unit’ screen will appear and the Pause time will be extended to the desired duration. Therapy will automatically resume at the end of the selected timeframe, or press resume when the patient returns.

Watch our how-to videos
Guardian How to Videos
Guardian How to Videos


TurnCare Guardian Nursing Training Video

TurnCare Guardian Seat Set up Video

TurnCare Guardian EVS Training

