Pressure mattress as an innovation
It is generally argued that good sleep results from a good mattress. Many people are interrupted in their sleep by pain and physical discomfort several nights a week. Pressure ulcers are caused by this discomfort and pain and have devastating effects on both the patient and healthcare giver. Health institutions are faced with huge costs in treating pressure ulcers and not withstanding the risk of litigation from the patient’s family. The treatment for pressure ulcers can be said to be prevention of the occurrence of this condition. This is done using therapeutic equipment that help and assist in 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 one of them being the invention of pressure mattresses. Pressure mattresses are special mattresses made to heal and prevent the effects of bed sores. Alternating pressure mattresses strive to ensure that pressure points or bony prominences do not apply constant pressure on them hereby lowering the risk of getting pressure sores. Alternating pressure mattresses are equipment and systems designed for the purpose of medical treatment and consist of mattresses with numerous air cells that can be filled and emptied in alternating patterns. Powered mattresses usually have rotational features which assist or aide in the prevention of pulmonary complications that patients develop. Powered mattresses also come with built in sensors that are able to measure the patient`s weight and subsequently moves the mattresses to prevent any development of bedsore especially for patients who require long bed rest time (Miller, 2009).
Pressure mattress as an innovation
Pressure sore are a big challenge to health care providers and patients. They refer to an area of the skin which is broken and may even extend deep towards the bone. They cause pain and serious infections which may lead to fatalities. Pressure ulcers are also known to prolong hospitalisation longer than it would have required and increase the cost treating patients. Most old aged patients are faced with the challenge of mobility. They often stay in one position for hours at a time, some due to immobility caused by weak limbs. Pressure ulcers and sores most often result due to lack of mobility; patients who are immobile for long periods of time are at a great risk of suffering from pressure ulcers (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 which give relief to patients up to 300lbs. they are usually used by patients who are not able to move freely, they also aid in decubitus ulcers treatment and also act as a form of prevention and treatment of pressure ulcers. They are generally new versions of pressure mattresses which provide good and adequate air flow to enhance skin dryness, provide pressure relief and minimise the risk of bedsores (Comerford, 2006).
Alternating pressure mattresses aid in the healing current pressure ulcers and preventing the possibility of development of new ulcers. They focus on pressure points and bony prominences ensuring that they do not get continuous pressure hence lowering the chances of getting pressure sores. Lateral rotation mattresses are built to curb the risk of circulation problems and bedsores. They allow nurses to program the control unit to rotate at specific time intervals rather than making frequent visits to the patient`s bed to press the rotate button when ever rotation is needed. The turning and shifting of the patient weight greatly minimises the risk of contracting complications. Heavy duty powered mattresses are the best choice for protection of patient who are susceptible to developing pressure ulcers. They can also be used by families who receive unexpected overnight visitors to provide an instant bed for their visitors (Belland & Wells, 1986).
According to Mistiaen et al (2010), in a study carried out on the effectiveness of Australian medical sheepskin, they found out that AMS was able to act as an effective therapeutic device in the prevention of sacral pressure ulcers in patients. The number of occurrence of pressure ulcers was lower than what was initially expected based on the scanty literature review on the matter. Pressure mattresses are used in both prevention and in treatment of patients with or who are most likely to develop pressure sores. Here the choice of mattress is made based on the weight and the seriousness of the pressure sore (Jonsson et al, 2005).
Research has shown that pressure ulcer development is mainly caused by two major factors namely; the intensity and duration or interface pressure. Interface pressure can be equalized or redistributed by moving or turning the body using the required equipment and support surfaces such as pressure mattresses. For patients under intensive care it is essential that they are moved to redistribute their interface pressure. Pressure sores are generally caused when soft tissue is compressed between a bony protrusion and external surface over an extended period of time, and 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 the patient’s body weight at specific intervals as recommended by the doctor without manual supervision by nurses. It was also noted that during night and evening shift the number of nurses on duty is usually small as compared to day shifts. This in effect meant that nurses did not have enough time to provide specialised care to each individual patient, hence the recommendation of using pressure mattresses. It was further noted that use of pressure mattresses reduced the amount of labour required from nursing attendants during shifts (Catz, Zifroni & Philo, 2005).
It has been noted that pressure ulcers are a big problem to both patient and healthcare providers as they are very complex and expensive to treat. In this era of high professional standards it is necessary that nursing leaders put in place 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. There is no clear publication of evidence on how to prevent pressure ulcers in debilitated and immobile ICU patients, 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 in children and infants as compared to adults. This was due 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 an essential tool in the management of pressure ulcers, although there is no clear guideline to help clinician choose between the various devices on the market. No scientific prove has been advanced to suggest which device currently in the market is best suitable but evidence from previous study show that pressure mattresses relieve interface pressure. However adequately constructed and randomly organised clinical research is being done on this issue.it was observed that the infants placed on pressure mattress devices experienced low levels of pressure ulcers compared to the others who were not (Hegner, Acello & Caldwell, 2010).
The availability of pressure reduction mattresses in all health care providing institutions plays an important part in the maintaining the skin of high risk patients and also supports quality indicators initiative in old age care. Pressure reduction is achieved in various ways; static and dynamic systems. Static systems rely on the ability of the device used to take or copy the shape of the body a good example can be foam mattresses. Dynamic systems on the other hand are controlled by control unit that increases or decreases pressure. Different devices have different numbers of cells. Generally decisions on which device to use are governed by considerations such as the cost of and assessment of the patient in question. 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 relive pressure and leave the patient feeling cool and dry. They have special feature such as deflate switches which are used in the event of emergencies (Timby, 2009).
In several studies carried out no evidence has shown that foam overlay or alternating pressure pad is more 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 more effective compared to normal hospital mattresses; it was observed that high risk patients in the ICU using pressure mattresses developed fewer cases of pressure ulcers compared to other previous studies. Some scholars have advocated for the use of dynamic rather than static systems although research has not shown any significant differences (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 specific 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 comparing seven different mattress overlays, it was revealed that; large cell ripple mattresses were more 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 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 can not be used in isolation as patients differ in weight and medical complications. Other system 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 (Hess & Hess, 2008).
Frequently when clinicians talk about horizontal support mechanism they generally 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 (Lippincott & Wilkins, 2006).
Pressure mattresses have many advantages which may include ; pressure mattress are very comfortable because they are made from memory foam a material which give way to the pressure of the body and conforms to the body shape. There is no reason for the patient to turn or toss to find a comfortable position; pressure mattresses are proved to be longer lasting than normal mattresses; they can easily be adjusted without the need of moving the patient; they also facilitate the flow of air on the patient’s skin hence keeping it dry; it assists in the prevention of pressure sore in patient care and are generally light in weight hence can be carried which allows patients to move with them when they travel (Eckman, 2011).
Pressure mattresses are durable and last longer compared to normal mattresses. Their use should be encouraged as it saves on costs.
Viewed over a long period pressure mattresses are more cost effective as compared to assigning of nurses in night shifts. Human labour is expensive especially if they have to work in night shifts.
Pressure mattresses come in various forms and sizes hence they are the most appropriate support devices to use. Different patients have different needs to cater for.
Pressure mattresses are flexible and take the shape of the body hence making the patient comfortable.
Pressure mattresses have a control unit that can be programmed so there is no need for nurses to make frequent visits to the patient’s bed.
Although there are many support devices in the market none of them has been scientifically proven to work in isolation. No single alternative effectively works without the use of other alternatives. It is essential that patients and care givers should conduct extensive research making consultation with experts on the best mix to use. Patients have different needs such that what patient (A) needs may be similar but not the same to what patient (B) needs. Each patient’s case in unique and needs a unique solution to it. The type of support surface that a patient requires depends on various factors which may include and not exclude the following; 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. Use of pressure mattresses should be encouraged as they have proved to be effective in the prevention and treatment of pressure sore in old age nursing care. Sometimes nurses are very busy and may not have time to provide special care to an individual patient, use of pressure mattresses allows the nurse to attend to patients effectively.
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