Reducing Hospital Acquired Pressure Ulcers While Decreasing Mattress Rental Expenses

Some of the most critically ill patients in a large Midwestern Academic Medical Center are the cardiac surgery patients on Extracorporeal Membrane Oxygenation (ECMO). This involves the use of a heart-lung machine to provide temporary heart and lung function. Because of their critical illness with poor perfusion, they are at high risk for developing Hospital Acquired Pressure Ulcers (HAPU).

In 2012, Black, Berke, and Urzendowski published a research study comparing HAPU development on the coccyx/sacrum on two different mattress surfaces in the cardiovascular surgical ICU.  The researchers found a rate of 0% in pressure ulcer development on Low Air Loss (LAL) mattress compared to an 18% rate on the integrated power pressure air redistribution beds.

Based on this study, our institution conducted a quality project with the ECMO patient population.  Previously, these patients were being placed on a more expensive mattress with pulmonary functionality along with LAL and powered pressure redistribution features. For the project, we placed all patients on ECMO on a less expensive LAL mattress with an alternating pressure feature.

A total of 530 patient days on the previous pulmonary mattress were reviewed along with 566 patient days on the new LAL mattress. Patients on ECMO saw an overall 77% decrease in HAPU over all pressure points. When the coccyx/sacrum data was extracted, patients on ECMO saw a 33% decrease in HAPU. Over the specified days, the institution was able to save approximately $83,000.00 in bed rental costs.