The Impact of “Micro-Shifts” and Airbed Adjustments with the use of Continuous Bedside Pressure Mapping

Problem Statement

With advanced support surfaces, pressure ulcers continue to develop effecting 7.4 million people annually worldwide.^1,2 Research has suggested that repositioning interventions are ineffective³ and caregivers only know if their repositioning techniques are ineffective when damage occurs.  With the use of continuous bedside pressure mapping (CBPM) caregivers are able to assess areas of high pressure, and with “micro-shifts” (small adjustments made with draw sheets) and airbed adjustments can maximize pressure redistributions.

Methods

In SICU, daily rounds were made to identify high-risk patients. During a month-long study 10 patients were identified for CBPM intervention. An algorithm was implemented and with the help of the bedside caregivers (nurses and aides) the patients were repositioned the way they normally do. Initial pressure was recorded and the caregivers were shown the mapping image and then were allowed to make adjustments including “micro-shifts” prior to second measurement (25 separate measurements).  The CBPM allowed for support surface assessment for each individual, and when high pressures could not be managed with the hospital-owned mattress, a specialty surface and CBPM was rented.

Results

Bedside caregivers were able to “micro-shift” patients and adjust airbed settings to lower peak pressures by 25% using the image from the CBPM systems.  Screenshots overall showed lower pressures once “micro-shifting” and airbed adjustments were completed. CPBM highlighted hot or red areas prompting the caregivers to utilize “micro-shifts” and adjusts airbed settings to gain optimal pressure redistribution.

Conclusion

Turning a patient alone does not mean that high pressures have been minimized on that patient.  With the CBPM image, caregivers effectively assess high pressures and can then utilize the interventions of “micro-shifting” and adjusting air settings on mattresses to gain optimal pressure redistributions.  Effective patient repositioning and correct choice of support surfaces plays an important role in minimizing pressure under bedbound patients, preventing pressure ulcers.^2,4,5