Overcoming the Challenge of Support Surface Selection: Utilization of Standards.

ABSTRACT: Selecting the appropriate support surface for patients continues to challenge clinicians and facilities. The Support Surface Standards Committee has developed and published test methods that allow for informed comparisons among support surface characteristics. The first published standards address the performance characteristics of immersion/envelopment, shear/friction, and microclimate management. This article describes the full body support surface standards development and provides guidance on the use of the outcomes from those standard tests for clinicians and facilities to make more informed choices for patients and patient populations.

Informed Application of the Standards on Support Surface Performance for Clinically Meaningful Use.

BACKGROUND: The Support Surface Standards Initiative (S3I) has evolved with the goal of standardizing language and performance evaluation of support surfaces. There is a consumer need for education about support surface standards to transfer new information with clinical relevance. OBJECTIVE: To develop a framework for meaningful dialogue through consensus building that drives value-based purchasing, propose a clinically relevant path for understanding how to apply data from the standards into critical interprofessional analysis and support surface selection, and navigate the first tier of a process targeted as an educational initiative within the Standards Committee. METHODS: The authors purposively sampled the S3I Tissue Integrity Group with a semi-structured qualitative survey to identify the essential components of support surfaces standard performance testing. A two-phase interview and review process was implemented within the larger S3I group to achieve consensus on content for knowledge transfer, with a threshold of 80% agreement within the Standards Committee. RESULTS: Meaningful consensus was achieved on content associated with knowledge transfer of standards data. These standards will function as reliable benchmarks, enabling consumers to compare individual characteristics of one support surface to another. Product comparison will be based on the single characteristics of support surfaces and how those characteristics are relevant to the specific needs of the individual patient or patient populations, transferred in language that is meaningful to end users of the standards. CONCLUSIONS: The consensus process facilitated construction of a clinically relevant, interprofessional framework for the product selection process within the Standards Committee. It will enable the next tier of educational dissemination beyond the Standards Committee to a broader base of consumers to engage in value-based purchasing with enhanced understanding of support surface performance characteristics.

Visual Feedback of Continuous Bedside Pressure Mapping to Optimize Effective Patient Repositioning.

Objective: To evaluate the effectiveness of a new bedside pressure mapping technology for patient repositioning in a long-term acute care hospital. Approach: Bedside caregivers repositioned patients to the best of their abilities, using pillows and positioning aids without the visual feedback from a continuous bedside pressure mapping (CBPM) system. Once positioned, caregivers were shown the image from the CBPM system and allowed to make further adjustments to the patient position. Data from the CBPM device, in the form of visual screenshots and peak pressure values, were obtained after each repositioning phase. Caregivers provided feedback on repositioning with and without the CBPM system. Results: Screenshots displayed lower pressures when the visual feedback from the CBPM systems was utilized by caregivers. Lower peak pressure measurements were also evident when caregivers utilized the image from the CBPM systems. Overall, caregivers felt the system enabled more effective patient positioning and increased the quality of care they provided their patients. Innovation: This is the first bedside pressure mapping device to be continuously used in a clinical setting to provide caregivers and patients visual, instant feedback of pressure, thereby enhancing repositioning and offloading practices. Conclusion: With the visual feedback from the pressure mapping systems, caregivers were able to more effectively reposition patients, decreasing exposure to damaging high pressures.