• Am. J. Crit. Care · Mar 2014

    Controlled Clinical Trial

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

    • Robert Behrendt, Amir M Ghaznavi, Meredith Mahan, Susan Craft, and Aamir Siddiqui.
    • Robert Behrendt is a clinical quality facilitator in the Office of Clinical Quality and Safety, Henry Ford Health System, Detroit, Michigan. Amir M. Ghaznavi is a plastic surgery fellow and Aamir Siddiqui is a professor of surgery in the Division of Plastic and Reconstructive Surgery, Henry Ford Hospital, Detroit, Michigan. Meredith Mahan is a biostatistician in the Department of Public Health Sciences, Henry Ford Health System. Susan Craft is a staff nurse unit director in the medical intensive care unit at Henry Ford Hospital.
    • Am. J. Crit. Care. 2014 Mar 1;23(2):127-33.

    BackgroundCritically 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.MethodsA 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.ResultsHAPUs 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).ConclusionSignificantly 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.

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