- Evaluating pressure reducing foam mattresses and electric bed frames
It could be argued that pressure ulcer prevention is simply a matter of matching those patients at risk of developing tissue damage with suitable pressure reducing equipment. However, as many authors have identified, this can be complicated because of the lack of reliable evidence to support many products. This article seeks to evaluate the combination of a pressure reducing mattress with an electric profiling bed frame. The study was conducted in a high-dependency cardiac surgery unit. Forty-four subjects were recruited during a 6 month period and their progress observed. Two outcome measures were used: pressure ulcer incidence and perceptions of comfort. No pressure ulcers developed during the trial and the perceptions of comfort were generally positive. The small sample size restricts the conclusions that can be drawn from the study, but when taken in conjunction with other small studies in this area there appear to be benefits from using such a combination of equipment.
- Pressure area management: a static-led approach
An increase in expenditure and inappropriate use of pressure-relieving equipment, along with high-prevalence figures, initiated the evaluation of current practice of pressure damage prevention in the acute general hospital. This evaluation started with the organization of a project group, who (after a baseline clinical audit) identified and procured the resources required to introduce and manage an effective pressure damage prevention programme. The investment in high-quality static mattresses for all patients including those who are at high risk of developing pressure damage was based on available clinical evidence. This investment meant a reduction in the amount of dynamic systems needed as many of those patients are at high risk of pressure damage, and are now successfully managed on a static system. The development of a local policy including documentation facilitated regular reassessment of risk based on a risk assessment tool and clinical rationale. This static-led approach has reduced not only costs but also improved the appropriate allocation of pressure-relieving/ reducing equipment. The approach has also simplified the choice of equipment for staff who were previously expected to match patients' need with varying levels of dynamic mattress efficiency. This article highlights the action taken from the initial identification of a specific need though to the effective implementation, management and monitoring of this innovative practice.
- A static-led approach to pressure ulcers: an evaluation after 3 years
Pressure damage has high cost implications to the patient and care providers. The choice of appropriate equipment to help in the prevention of tissue damage is hampered by extensive choce and little guidance on the most effective product to use. This static-led approach was introduced into Camarthenshire NHS Trust 3 years ago. This approach simplified the choice of equipment, improving the appropriate usage and reducing expenditure. This article aims to evaluate the approach 3 years after its introduction to determine if the benefits to the patient and the organization still apply.
- The role of education, technique and equipment in pressure area care
This paper aims to reflect on the successful management of pressure ulcer equipment within a district general hospital. Insight is given into what is considered as effective, efficient and economic use of static and dynamic mattress, underpinning by a fundamental education package into pressure ulcer management and prevention techniques.
- A clinical audit of the Softform Premier Active mattress in two acute care of the elderly wards
This article reports on the findings of a study which was carried out to compare the effect of the Softform Premier Active mattress™ (a foam mattress with a dynamic, alternating underlay), versus a standard air mattress on pressure ulcer incidence in two acute, care of the elderly wards over a six-month period. The results revealed a pressure ulcer incidence of 8% in both groups, which was considered to be unexpectedly low in such a vulnerable, high risk population. It was concluded that the Softform Premier Active was as effective as the standard air mattress in pressure ulcer prevention, but had the advantages of dual functionality and lower cost.
- Achieving effective outcomes: monitoring the effectiveness of the Softform Premier Active mattress
The identification of pressure-relieving mattresses to achieve positive clinical outcomes for patients and financial considerations for organizations is a challenge for health-care staff. This article reports on an audit undertaken within a primary care trust to determine the clinical and cost effectiveness of the Softform Premier Active mattress. Preliminary results have been previously published (Stephen-Haynes, 2008) and are presented here in full.
- Softform Premier Active Mattress: a novel step-up/step-down approach
In the UK it is estimated that as many as 412 000 patients who are already ill will develop pressure ulcers (Bennett et al, 2004), which are an unnecessary and expensive complication to treat (Hitch, 1995). One way to try and reduce these risks is by investing in suitable mattresses. The author's investigations into existing mattress stock in the years 1996-97 illustrated the inadequacy of the NHS standard mattress (Santy, 1995; Fox, 1997). Investigators (e.g. Rithalia, 1996) were recognizing the inadequacy of the pink marble standard NHS foam mattress for pressure reduction (Medical Device Directorate, 1993; Dunford, 1994) which included reports necessary to help develop guidelines in pressure ulcer prevention and management (Coull, 2004), as well as make value-for-money recommendations about product purchases (Fletcher et al, 1994; Value For Money Update, 1994; Cullum et al, 1995).
- Evaluation of Static Support Surfaces
The incidence of pressure ulcers to the heels of those patients deemed 'at risk' from pressure damage is a constant concern to clinicians. Heels present a specific concern because although the heels are not heavy, the contact area is very small and the interface pressures are high. Work undertaken as part of the Department of Health Mattress Evaluation Project showed that interface pressures on the standard Kings fund marbled mattress are of the order 150mm Hg. Static systems, which have a softer more deformable top layer, will enable the surface contact area. this method then helps to reduce contact interface pressures.
- Strikethough: review of research on mattress cover performance
During the past few years there have been increasing concerns regarding the performance of pressure-reducing foam mattress covers. Initially, a small numbr of people observed these problems. However, recently, many more people have begun to identify simular problems with their covers. This article is the result of a collaboration between Medical Support Systems and members of the editorial board of the British Journal of Nursing Tissue Viability Supplement. Medical Support Systems commissioned research from Nottingham Trent University and Cardiff University. The research findings were then passed to members of the editorial board for consideration and the development of this article. The article will present the rationale for the research and the results will be highlighted. It is hoped that it will help inform us and assist those currently working towards a resolution of this problem. The full benefit of this new information will only be felt after an extended debate of not only the results, but also their wider implications.
- Wounds UK E-Academy
The Wounds UK E-Academy provides healthcare professionals with a range of online education in the field of tissue viability. A sample of some of the courses available are Maintaining Skin Integrity, Managing Wound Infection, Wound infection treatment pathways and the recently added Moisture lesion module. This looks at why moisture lesions occur, how to distinguish moisture lesions from pressure ulcers and outlines current best practice for prevention and management.