Confirming Effective Off-Loading and Repositioning Using Continuous Bedside Pressure Mapping

Purpose

National Pressure Ulcer Advisory Panel Guidelines recommend repositioning patients to reduce the magnitude and duration of pressure over vulnerable areas of the body and repositioning in such as way that pressure is relieved or redistributed.¹ Techniques such as the 30 degree side-lying position are recommended, but ultimately considerations for each individual patient’s conditions need to be considered when assessing for effective positioning and off-loading of pressure¹.  Currently caregivers have no real-time, bedside assessment tool to see if their repositioning and off-loading for each individual patient is effective.

Methods

A continuous bedside pressure mapping (CBPM) system was utilized to assess different off-loading and repositioning scenarios to understand if its use could enhance individual off-loading and repositioning techniques at the bedside.  Scenarios of heel off-loading, side-lying positioning, supine positioning, head of bed elevation, and detecting objects under a patient were observed utilizing the CBPM with a standard foam hospital mattress and an air mattress.  Peak pressures and images were recorded as positioning was completed both without and with the visual image from the CBPM system’s monitor.

Results

With the use of the CBPM system, lower peak pressures and lower overall pressures were observed.  Effective heel off-loading can be easily and quickly monitored without having to disrupt patients, or remove blankets, with the use of the CBPM system.  Objects that can cause high pressures beneath patients, like cell phones and tape rolls, are easily identified on the CBPM monitor.  These results were consistent on both the standard foam mattress as well as the air mattress.

Conclusion

CBPM provides real-time monitoring to confirm effective off-loading and repositioning on both foam mattresses and air mattresses.  CBPM provides monitoring that could alert caregivers to situations that could put patients at high risk for pressure damage to their skin.²