Determining the right mix of support surfaces to minimize hospital acquired pressure ulcers.

In acute care settings, one variable in the incidence of hospital acquired pressure ulcers is support surfaces. Following a major change in the use of support surfaces, a retrospective study was conducted at a major university teaching hospital over a 12 month period. The study sample was based on ET Nurse referrals for skin and wound management and as such did not reflect hospital census or acuity. The purpose of the study was to examine the effect of the introduction of hospital replacement mattresses and the decreased use of 2-inch convoluted foam overlays and static air overlays, on the incidence of hospital acquired pressure ulcers. Initially, hospital replacement mattresses were implemented in the hope of eliminating overlays. Yet this study experience demonstrated a significant correlation between the decreased number of static air overlays used and an increased number of hospital acquired pressure ulcers during the first two months following introduction of hospital replacement mattresses. After reintroduction of static air overlays, the incidence in our study returned to baseline. The key is the right mix of products to minimize hospital acquired pressure ulcers and concomitantly minimize associated costs.