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Promising new research on reducing pressure ulcers

According to a new study published in The American Journal of Critical Care, “Continuous Bedside Pressure Mapping and Rates of Hospital-Associated Pressure Ulcers in a Medical Intensive Care Unit,” continuous bedside pressure mapping (CBPM) provided caregivers with a useful monitor to assess the effectiveness of repositioning patients off of pressure areas, a crucial component of providing better care towards minimizing the formation of pressure ulcers. This prospective, controlled trial utilized a bedside pressure mapping device to allow caregivers to monitor, in real time, their patient repositioning efforts. The study results showed that when repositioning was completed with use of the CBPM monitor, hospital-associated pressure ulcer (HAPU) reduction was significant.

“Reducing pressure ulcers has to become a top priority for all caregivers – they are extremely costly, in terms of both human suffering and costs to the healthcare system,” said study author Robert Behrendt, RN, BSN, a clinical quality facilitator in the Office of Clinical Quality and Safety at Henry Ford Health System in Detroit. “The Agency for Healthcare Research and Quality estimates 2.5 million people in the U.S. develop pressure ulcers each year, 60,000 of which ultimately die from pressure ulcer complications. The treatment of pressure ulcers costs the U.S. healthcare system approximately $9.1 to $11.6 billion each year and the cost of individual patient care ranges from $20,900 to 151,700 per pressure ulcer.”

In the two-month prospective controlled study, patients whose beds in the intensive care unit were equipped with Wellsense’s M.A.PTM, the first-ever continuous bedside pressure mapping system, were less likely to develop a pressure ulcer than patients whose beds were not equipped with the monitor. Only two out of 213 patients (0.9%) in the CBPM group developed a pressure ulcer compared to 10 out of 209 (4.8%) in control group (p=0.02). Anecdotal feedback from the nurses confirmed that the mapping function helped them feel more confident about the effectiveness of their repositioning of patients.

“Hospital acquired pressure ulcer prevention interventions have made an impact around the country. Despite this, challenges remain in acute care settings, especially intensive care units,” said lead investigator Aamir Siddiqui, MD, Division Head of Plastic Surgery at Henry Ford Hospital in Detroit, MI. “With the use of the M.A.P, caregivers were able to provide more effective repositioning and off-loading of pressure which is key toward reducing the formation of pressure ulcers.”

In a previous pilot study of the CBPM technology conducted by the team at Henry Ford, only one out of 307 (0.3%) patients monitored with real-time CBPM technology developed a pressure ulcer compared to 16 out of 320 (5%) patients in the historical control group who were placed on the same beds without the M.A.P one year prior. In a survey of the medical ICU (MICU) care providers, 90% of respondents reported that continuous bedside pressure mapping contributed to improved pressure detection and relief, 88% indicated the system assisted them with repositioning protocols, and 84% reported the pressure map provided for more efficient and effective patient repositioning.

“There are many challenges to repositioning an ICU patient but this technology has been shown to provide caregivers with a simple tool to better understand best practices for offloading pressure and to anticipate when patients are at increased risk for developing a pressure ulcer,” said Dr. Siddiqui.

The M.A.P’s pressure sensing mat is made of an intelligent textile, which constantly measures pressure from thousands of discrete points. The variations in pressure across a patient’s body are depicted on a monitor, using a color scheme to help caregivers visualize high (red) to low (blue) pressure points, which enables them to easily identify and minimize areas of high pressure.

Source

Continuous Bedside Pressure Mapping and Rates of Hospital-Associated Pressure Ulcers in a Medical Intensive Care Unit, Robert Behrendt, RN, BSN, Amir M. Ghaznavi, MD, Meredith Mahan, MS, Susan Craft, RN, BSN and Aamir Siddiqui, MD, Am J Crit Care, DOI: 10.4037/ajcc2014192 Am J Crit Care, published March 2014.

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