Paper Outline
Introduction
Pressure mattress as an innovation
Recommendations
Conclusion
Reference list
Pressure mattress as an innovation
Introduction
Good sleep is facilitated by a good mattress. Many people are interrupted in their sleep by pain and physical discomfort for several nights in a week. Pressure ulcers are caused by this discomfort and pain. This has devastating effects on the patient and health care giver. Health care institutions are faced with huge costs in treating pressure ulcers and not withstanding the risk of litigation from the patient’s family. The best way to address the issue of pressure ulcers is through prevention measures. This is done using therapeutic equipment that help in the prevention and treatment of pressure ulcers (Hogstel, 2001).
In the recent past, there have been a lot of technological advances made in the medical sector. This includes the invention of pressure mattresses. Pressure mattresses are special in that they are made to treat and prevent bed sores. Alternating pressure mattresses focus on pressure points or bony prominences, making sure they do not apply constant pressure resulting in the formation and development of pressure sores. Alternating pressure mattresses are a technological development designed for use in the medical sector to provide treatment and preventive measures. They are made of mattresses containing very many air cells which are filled and emptied in alternating patterns with air. Alternating pressure mattresses are usually installed with rotational mechanisms which assist or aid in the prevention of pulmonary complications that patients may develop. Powered mattresses also come with in-built sensors that can measure the patient’s weight.When required they adjust the position of the mattresses hence, preventing any would be development of bedsores. This is the case especially for patients who require long bed rest time (Miller, 2009).
Pressure mattress as an innovation
Pressure sores pose a big challenge to health care providers and patients especially in old care. Pressure sores refer to an area of the skin, which is broken and may even extend deep towards the bone. They cause pain and serious infections that may lead to fatalities. Pressure ulcers are also known to prolong hospitalisation more than it would have been required thereby increasing the cost of treating patients. Most old aged patients are faced with the challenge of mobility due to advancement in their age. They often stay in one position for hours, some due to immobility caused by weak limbs. Pressure ulcers and sores most often emanate from lack of mobility. The use of pressure mattresses on old people’s beds helps reduce shear and pressure (Penzer&Ersser, 2010).
There are various types of therapeutic powered mattresses and some of them include low air loss mattresses, alternating pressure mattresses, lateral rotation mattresses and heavy duty powered mattresses. Low air loss mattresses are therapeutic devices that give relief to patients up to 300lbs. They are usually used by patients who are not able to move freely. Old people are faced with immobility as a physical challenge and may be unable to turn their bodies. This can result to decubitus ulcers and pressure mattresses are recommended as a form of treatment and prevention. There are new versions of pressure mattresses that provide good and adequate air flow to enhance skin dryness. Excess heat causes shear and sores, some varieties of pressure mattresses improve airflow hence keeping the skin cool (Comerford, 2006).
Alternating pressure mattresses aid in healing current pressure ulcers and preventing the possibility of development of new ulcers. They emphasises on pressure points together with bony prominences as a result they prevent continuous pressure leading to the lowering of chances of developing pressure sores. Lateral rotation mattresses are built to curb the risk of circulation problems and bed sores. Old people faced with immobility suffer due nurses’ negligence. Nurses are required to make frequent visits but they are also human and may coincidentally skip a patient. Alternating pressure mattresses can be programmed to help the patient turn. This is convenient compared to making frequent visits to the patient’s bed to press the rotate button whenever rotation is needed. Turning and shifting of the patient weight greatly minimises the risk of complications. They can also be used by families that receive unexpected overnight visitors. Such mattresses provide an instant bed for overnight visitors (Belland& Wells, 1986).
In a study carried out on the effectiveness of Australian Medical Sheepskin (AMS), it was established that AMS could act as an effective therapeutic device in the prevention of sacral pressure ulcers in old age. The number of occurrence of pressure ulcers was lower than what was initially expected based on the scanty literature review on the matter (Mistiaen P, et al, 2010). Pressure mattresses are used in prevention and treatment of persons who are most likely to develop pressure sores. In this case, the choice of the mattress is made based on the weight and seriousness of the pressure sore (Jonsson, 2005).
Research has shown that the development of pressure ulcer is mainly caused by two major factors. This includes the intensity and duration or interface pressure. Interface pressure can be equalized or redistributed by moving or turning the body using the necessary equipment and support surfaces such as pressure mattresses. For old persons with mobility challenges, they need to be moved so as to facilitate the redistribution of their interface pressure. Pressure mattresses are built with mechanisms capable of elevating the head and feet hence are appropriate for use in old age care. This is common among patients suffering from sensory or mobility deficiencies (Sakai, et al, 2009).
Research has shown that where nurses are not able to perform repositioning effectively, it is advisable to use computerised mattress systems. Pressure mattresses are effective and can be programmed to turn a person`s body weight after some time as recommended by the doctor without actual manual turning from the nurses. Human labour is expensive and during night shifts few nurses are on duty. This means that nurses may not have enough time for each and every individual. This prompted the recommendation of using pressure mattresses. It is noted that use of pressure mattresses gives nurses enough time to visit and address specific needs of different persons fast and effectively (Catz, Zifroni& Philo, 2005).
It has been noted that pressure ulcers are a big problem to both healthcare providers and the aged persons; they are very complex and expensive to treat. In this era of high professional standards, nursing and caregivers should establish procedures to minimise complications and maximise on quality and financial efficiency. Such efforts will benefit the patient, health care givers, and the health care sector in general. Pressure mattresses can be used as a stopgap measure (Jackson, et al, 2011).
In paediatric research, it was observed that pressure ulcers occur in different places among children and infants as compared to adults. This was attributed to the fact that, at different stages of growth, children have different weight distribution and skin surface area. It has been noted that pressure mattresses are essential tools in the management of pressure ulcers. However, there is no clear guideline to help clinician in choosing between the various devices in the market. There is no scientific proof that has been advanced to suggest which the best device in the market is today. However, adequately constructed and randomly organised clinical research is being done on this issue. It is observed that infants placed on pressure mattress devices experienced low levels of pressure ulcers compared to others who were not placed on such devices this could also be true to old people (Hegner, Acello& Caldwell, 2010).
The availability of pressure reduction mattresses in all health care institutions plays an important part in maintaining the skin of elderly persons. In addition, it supports quality indicator initiatives in old age care. Pressure reduction is achieved in various ways through static and dynamic systems. Static systems rely on the ability of the device used to take or copy the shape of the body. The foam mattresses can be a good example (Rai& Mulley, 2007). On the other hand, dynamic systems are controlled by control unit that increases or decreases pressure. They are also fitted with urine disposal mechanisms which assist persons with challenged mobility. In general, decisions on the device to use are governed by considerations such as the cost and assessment of the needs of the individual. Other considerations include skin assessment, comfort, care needs, identified levels of risk and acceptability of the device to the patient and care giver. Low air loss beds are used to provide relief from pressure to patients who suffer from skin problems and other risk factors. They relieve pressure and leave the patient feeling cool and dry (Timby, 2009).
A common characteristic of old age is the breaking of skin. No evidence has shown that foam overlay or alternating pressure pad is significantly effective in preventing breakage of skin. When comparing alternating pressure pads, air mattress overlay and water mattress overlay in patient admitted to the ICU; it was observed that patient on alternating pads had extensive sacral and heel pressure sores. In a separate study, it was observed that pressure mattresses were quite effective compared to normal hospital mattresses. It was noted that high risk patients in the ICU using pressure mattresses developed fewer cases of pressure ulcers. Some scholars have advocated for the use of dynamic rather than static systems. Nonetheless, research shows that pressure mattresses could be an alternative for old age care (Maklebust&Sieggreen, 2000).
Alternating pressure mattresses are mechanical devices controlled by a control unit that alters the contact area of the patient’s body at programmed intervals. They ensure that the body’s weight is evenly distributed and that no area suffers from interface pressure. The first form of pressure mattresses was known as the simple ripple system. In a recent study that compared seven different mattress overlays, it was revealed that large cell ripple mattresses were efficient and effective in healing and prevention of pressure sore in old age patient care (Rai& Mulley, 2007).
Research conducted on various forms of skin and wound care in old age indicates that, pressure mattresses are very effective in the prevention and healing/treatment of sores and wounds. Although pressure mattresses have been shown to be effective, they cannot be used in isolation. This is because individual needs differ in weight and medical complications. Other systems of support can be used to compliment pressure mattresses such as pillows, changing the bed’s elevation, lifting devices such a trapeze, repositioning and foam wedges (Hegner, Acello& Caldwell, 2010).
In most cases, when clinicians talk about horizontal support mechanism, they refer to beds, mattresses overlays, and mattresses. Such products use foam, gels, water, and air to minimise the amount of pressure in contact with the body from external sources. Pressure mattresses use the manipulation of air to cushion the body against pressure. Air mattresses inflate and deflate air simultaneously through tubes in the mattresses to distribute pressure (Hogstel, 2001).
Pressure mattresses have many advantages. This includes the fact that pressure mattress are very comfortable. This is because the mattresses are made from memory foam-a material that give way to pressure from the body and conforms to the body shape. There is no reason for the patient to turn or toss so as to find a comfortable position. Pressure mattresses are proved to be long lasting than normal mattresses. They can easily be adjusted without the need of moving the patient. In addition, these mattresses can facilitate the flow of air on the patient’s skin hence keeping it dry. They also assist in the prevention of pressure sore during patient care. Lastly, these mattresses are light in weight hence can be carried easily. This allows old people to move with them when they travel (Eckman, 2011).
Recommendations
Pressure mattresses are built with a control unit that enables a person to control the elevation of the bed. This reduces the dependence of old people on help from nurses. They can be able to lift or lower themselves.
Pressure mattresses are built with mechanisms which help in urine disposal. For old people with challenges of holding urine, this offers a solution. Collected urine can be disposed of later.
For old people who spend a lot of time in bed they can use the dynamics of the pressure mattresses to compensate for their inactivity. By elevating their heads and feet they may not have to get out of bed.
We all know it is a challenge for old people to turn in sleep. Failure to re-adjust the body weight leads to formation of sores. Pressure mattresses can be used to help old people turn during the night hence avoiding pressure sores.
Conclusion
Innovations are meant to make life easy. In old age care, the pressure mattress is an innovation that has facilitated the care and treatment of pressure sores. Although there are many support devices in the market, they all work in coordination as none can work in isolation. There is no single alternative that effectively works without the use of other alternatives. It is essential that patients and care givers should conduct extensive research and make consultation with experts on the best mix to use. Patients have different needs such that what patient (A) needs may not be similar to what patient (B) requires. Each patient’s case is unique and needs a unique solution. The support surface that a patient requires depends on various factors. This may include the general health of the patient; the ability of the patient to turn their bodies; the body weight of the patient and the current condition of the patient. Other considerations would include cost of maintenance, durability, availability, and patient preferences. The use of pressure mattresses should be encouraged among the old age. This is because they have proved to be critical in preventing and treating pressure sore among the old age in nursing care. Sometimes, nurses are very busy and may not have time to provide special care to an individual patient. The use of pressure mattresses allows the nurse to attend to patients effectively.
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