Sleep support surfaces play an important role in preventing pressure injury in hospitalized patients. There are hundreds of specialty beds and mattresses available through scores of companies. Because of differences in terminology, facility contracts, and product capabilities, it can be difficult for physicians caring for hospitalized patients to select the support surface appropriate for each patient.
We realized that in our facility, physicians were frequently ordering overlay mattresses to be placed on top of beds when the original mattresses offered better pressure reduction than did the overlays. The suboptimal overlays were also obtained at an additional expense to the hospital because it paid rent for the overlays but already owned the beds.
Achart was devised for easy reference to facilitate selection of the most appropriate and cost‐effective sleep support surface for each patient.
The protocol was based on the beds and mattresses that the hospital had in stock as well as those available through a rental contract the hospital had with a local distribution company.
The chart took into account the following issues:
Mobility of patient. Pressure‐reducing surfaces are typically adequate for patients with normal to slightly impaired mobility. A pressure‐relieving surface is preferred as the patient's mobility becomes more limited.
Ulcer present. Even if mobility is not significantly impaired, pressure‐relieving surfaces are preferred over pressure reduction if the patient already has a pressure ulcer.
Weight and height of patient. Extremes in weight and height must be taken into account when selecting a sleep support surface to minimize risk of pressure injury from limitations of individual products.
Skin moisture control issues. A dynamic air‐flow mattress is preferred to a static mattress if there is an issue of skin moisture control, such as urinary incontinence or perineal yeast infection.
Beds owned by facility. The chart indicated which beds are owned by the facility so that cost‐effective choices could be made. For example, a higher‐grade pressure‐relief surface might be more cost effective than a lower‐grade surface even when the lesser grade met all the patient's needs if the facility already owned the higher grade and would have to pay rent for the lower grade.
The chart enabled the effective selection of appropriate beds and mattresses based on mobility, skin moisture, body habitus, and intent to prevent or treat pressure ulcers. The chart not only improved patient care but also facilitated more cost‐effective use of the hospital's resources, resulting in an estimated savings of $100,000 to our facility in the first year of its use.
R. L. Williams, Smith and Nephew, speakers bureau; T. Meyers, Sage, research grants; Johnson and Johnson, speakers bureau.
To cite this abstract:Williams R, Meyers T. Simplifying Bed Selection Results in More Optimal Patient Care That Is Cost Effective. Abstract published at Hospital Medicine 2007, May 23-25, Dallas, Texas Abstract 104. Journal of Hospital Medicine. 2007; 2 (suppl 2). https://www.shmabstracts.com/abstract/simplifying-bed-selection-results-in-more-optimal-patient-care-that-is-cost-effective/. Accessed September 22, 2019.