Continuous bedside pressure mapping and rates of hospital-associated pressure ulcers in a medical intensive care unit

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American journal of critical care


BACKGROUND: Critically ill patients are vulnerable to the development of hospital-associated pressure ulcers (HAPUs). Positioning of patients is an essential component of pressure ulcer prevention because it off-loads areas of high pressure. However, the effectiveness of such positioning is debatable. A continuous bedside pressure mapping (CBPM) device can provide real-time feedback of optimal body position though a pressure-sensing mat that displays pressure images at a patient's bedside, allowing off-loading of high-pressure areas and possibly preventing HAPU formation.

METHODS: A prospective controlled study was designed to determine if CBPM would reduce the number of HAPUs in patients treated in our medical intensive care unit. In 2 months, 422 patients were enrolled and assigned to beds equipped with or without a CBPM device. Patients' skin was assessed daily and weekly to determine the presence and progress of HAPUs. All patients were turned every 2 hours. CBPM patients were repositioned to off-load high-pressure points during turning, according to a graphic display. The number of newly formed HAPUs was the primary outcome measured. A χ(2) test was then used to compare the occurrence of HAPUs between groups.

RESULTS: HAPUs developed in 2 of 213 patients in the CBPM group (0.9%; both stage II) compared with 10 of 209 in the control group (4.8%; all stage II; P = .02).

CONCLUSION: Significantly fewer HAPUs occurred in the CBPM group than the control group, indicating the effectiveness of real-time visual feedback in repositioning of patients to prevent the formation of new HAPUs.

Medical Subject Headings

Adolescent; Adult; Aged; Aged, 80 and over; Beds; Female; Humans; Intensive Care Units; Male; Michigan; Middle Aged; Monitoring, Physiologic; Patient Positioning; Point-of-Care Systems; Pressure; Pressure Ulcer; Prospective Studies; Tertiary Care Centers; Young Adult

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