Dynamic Physiologic Skin Monitoring to enhance a Pressure Ulcer Prevention Program

Purpose

Monitoring assists bedside staff to make informed decisions increasing the quality of patient care which improves outcomes. Knowing that pressure is the main causative agent of a pressure ulcer, a good prevention program should incorporate ways to monitor the pressure beneath individual patients.  The need for individualized monitoring is high as every patient presents with different body types and different comorbidities that put them at high risk for pressure ulcer development. 

Methods

Continuous bedside pressure mapping (CBPM) systems were installed in January of 2012.  The CPBM systems gave bedside caregivers the ability to see a visual image of real time pressures under patients and monitor that pressure continuously.  Patients with existing wounds and at high risk for pressure ulcer occurrence had CBPM systems placed on their mattresses.  Caregivers used the pressure images on the monitors to effectively reposition patients and utilized the alerts on the monitors to turn patients by their individually determined turn schedules.

Results

From January through June 2012 no facility acquired pressure ulcers (FAPU) occurred.  These 6 months accounted for a total of 7,014 patient days.  For a historical comparison, in 2011 from January to June, accounting for 7,166 patient days, 16 FAPUs occurred.  Caregivers found the CBPM systems easy to use and also found that family and patients were less likely to refuse repositioning and turning as they could now see the high pressures below the patient that needed lessened.

Conclusion

Innovative objective pressure monitoring practices with CBPM systems have assisted our pressure ulcer prevention program to obtain the goal of zero FAPUs.  Dynamic physiologic skin monitoring shows promise in decreasing the occurrence of pressure ulcers in a high risk patient population.