Effects of a pressure-reduction mattress and staff education on the incidence of nosocomial pressure ulcers

Abstract

Purpose: The purpose of this study was to determine whether replacing standard hospital mattresses with pressure-reduction mattresses and educating the patient care team on Agency for Health Care Policy and Research prevention guidelines would decrease the incidence of nosocomial pressure ulcers. Design: Retrospective chart review before and after implementation of replacement of standard hospital mattresses with pressure-reduction mattresses and before and after patient care team education was completed. Setting and Subjects: A 6-month clinical study with 141 subjects was conducted on a skilled-nursing unit. Methods: The 3-month preintervention sample group of 141 subjects received routine nursing care on a standard hospital mattress. After the introduction of pressure-reduction mattresses and an education program, a 3-month postintervention sample group of 141 subjects was studied. Main Outcome Measures: Incidence of nosocomial pressure ulcers during a 3-month period. Results: Among the preintervention group, 21 of 141 subjects (15%) acquired nosocomial pressure ulcers, versus 16 of 141 subjects (11%) in the postintervention group. This improvement was not statistically significant ( χ 2 = 0.78, df = 1, p = 0.38). The incidence of ulcers staged II or higher dropped from 11 patients in the preintervention group to six in the postintervention group, a 45% reduction that was not statistically significant ( χ 2 = 1.56, df = 1, p = 0.21). Conclusion: Replacement of standard hospital mattresses and education of staff according to recommendations from the Agency for Health Care Policy and Research guideline for pressure ulcer prediction and prevention did not significantly change the incidence of pressure ulcers during a 3-month period in our skilled-nursing unit.