1555 Mattress selection: A cost saving project to improve Pressure ulcer rates and cost of rental equipment

Margaret Gerlach, RN, BS-BC, CWOCN, CFCN, Highland Hospital, WOCN, Rochester, NY
Objective: We studied and developed a plan to save money by using the correct mattress on the correct patient and decrease expense for renting.  This assured that at risk patients wound be on the correct surfaces.

Method: We looked at the process for ordering specialty mattresses and how many were in circulation. We went to each patient unit and found that pressure reducing mattresses were ordered inconsistently. Patients who were at risk were not always put on a pressure reducing mattress.  The materials management didn’t track who had a mattress or assure that their tracking was correct. There were no criteria for ordering a specialty mattress. Staff nurses didn’t recognize when a patient was on a specialty mattress.  We educated nursing  and  materials management staff. We developed a tool for criteria in ordering a specialty mattress and recognizing if a patient was at risk using the Braden scale. We reeducated 93% of all nursing staff and 100% of materials management staff. We worked with information systems to set up automatic daily reports of all rental equipment to the nursing units.  

Outcome: I tool I developed for ordering specialty mattress used the Braden scale and BMI. This is now in our Nursing Policy and Procedure Protocol for skin integrity. The unit charge nurse is responsible for assuring that a printout from the materials management department matches the actual use of equipment. The charge nurse reports usage at the bed meeting daily. I audited the tracking form monthly to assess compliance and accuracy. We are in compliance over 90 % of the time. We planned to decrease unnecessary rental expenses by 15 % or $ 50,000. annually. We increased the compliance with clinical criteria for use of specialty mattress and equipment to 95% accuracy. We actually saved $127,573 .Compliance was 93.7 % for use and tracking.