Using Pressure Mapping Technology to Decrease Hospital Acquired Pressure Ulcers

Purpose:
The pressure mapping mattress is a technology that can be used to help alert staff to hidden pressure. The standard of care in ICU is typically to turn patients every 2 hours. What if every 2 hours isn't enough? How would you know?

Relevance/Significance:
Pressure mapping allows the bedside nurse to see, real time, pressure that the patient may not be able to tell you they are experiencing. Hospital Acquired Pressure Ulcers or HAPU's are costly to treat. HAPU treatments can range from $2,000 to $40,000. Surgical interventions for Stage III and Stage IV wounds can cost on average around $25,000. HAPU also cause patients pain, increased hospital or rehab stay, and increase a patients chance of developing sepsis.

Strategy and Implementation:
The Adult Intensive Care Unit has struggled with HAPU rates, specifically HAPU involving the sacrum, buttocks, and coccyx. Purpose: The purpose of this evidence based practice project was to see if implementing usage of the Pressure Mapping Mattress supplied to us by our Wound Ostomy Continence department could impact our HAPU rates. Our day shift PCC is the champion for the pressure mapping mattress. We are a 30 bed Adult Intensive Care Unit and have a very high acuity daily on the unit. The PCC would select a patient and with the aid of the bedside nurse place the patient on the mattress. At this point the PCC and staff nurse can see in real time the pressure points on the patient. They could immediately intervene to decrease the pressure. Often they found pressure was not where you would expect to see it. The pressure map would remain under the patient for 2-3 days until staff could learn that patients problem areas. The mattress would then be moved to the next patient.

Evaluation:
Since the implementation of the Pressure Mapping Mattress and the PCC champion in November of 2013 our unit has seen a significant decrease in HAPU involving the sacrum, coccyx, and buttocks. In 2013 the AICU had 18 HAPU in the sacrum, buttocks, and coccyx areas. In 2014 we decreased this to 4 HAPU in the sacrum, coccyx, and buttocks areas.

Implications for Practice:
The pressure mapping mattress can be an effective tool to teach nurses about pressure points on patients and the importance of turning patients. Our unit was able to reduce not only our HAPU in the sacrum, buttocks, and coccyx areas but our overall HAPU rates have fallen as well.