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Pressure ulcers (PU) cost the healthcare system $11.5 billion annually and individual PU can be $151,700 per ulcer to treat.1 Individualizing specialty mattress selection and repositioning techniques to maximize pressure redistribution is challenging in the bedside setting.2 Risk assessment tools3 do not give a clear guide on how to optimally select support surfaces. Utilizing specialty mattresses to prevent all PUs is not our only option.
Methods
An algorithm was implemented to help us pick the patient population that was at risk, but did not need the cost of a specialty rental to accomplish pressure redistribution. The CBPM was used to guide effective repositioning techniques for each individual patient and to assess for areas of higher pressure that could not be managed with the hospital-owned mattress and needed a specialty surface rental.
Results
During a month-long period, 6 patients were managed with a CBPM system and hospital-owned mattress, totaling 27 days. In using the CBPM system with hospital-owned mattress, a savings of $19/dat/patient was realized over a rented specialty support surface (currently is being used without knowing if the hospital-owned mattress was appropriate). Including the cost of the MAP, a savings of 13.5 days of specialty surface rentals was achieved. No patients developed a PU during the study, whether on the CBPM system and hospital-owned mattress, or a rental surface with a CBPM system. A cost savings was achieved without compromising clinical outcomes.
Conclusion
With the use of CBPM, cost-effective support choices are now available to help us prevent pressure ulcers. Caregivers learned the importance of “micro-shifts” to effectively reposition each individual patient and the assumption of pressure relief being obtained by simply turning the patient was shown to be false. By using real time mapping we could accomplish optimal pressure redistribution while decreasing cost.