CS15-005 Retrospective review of a pressure redistribution mattress and skin integrity

Charleen Singh, RN, MSN/ED, FNP-BC, CWOCN, Nursing, San Jose State University, San Jose, CA and Erica Thibault, RN, MS, CNS, APN, CWON, Clinical, Sizewise, Evergreen, CO
Aim and objectives: To determine if the use of pressure redistribution mattress will minimize pressure ulcers over resting points in a high risk pediatric population

Background: Until recently the ability to have a pressure redistribution mattress for cribs of different sizes for pediatric acute care use has been limited. As a result, pediatric intensive care nurses have had to be creative to maximize pressure redistribution for high risk pediatric patients. Positioning aides have been used in the attempt to redistribute pressure with the aim of minimizing the impact from pressure on the vulnerable pediatric patient population.

Methods: A retrospective review of charts of pediatric patients who were placed on the pressure redistribution mattress during a 12 week period was conducted. Each chart was reviewed for documentation of skin integrity prior to discharge. Descriptive data was collected as well as the Braden score to better understand the risk factors and acuity of each pediatric patient.

Results/Conclusion :A review of the charts of 23 pediatric patients between the ages of one month to seven years demonstrated no areas of skin breakdown over bony prominences which came in contact with the support surface. The acuity of children varied from requiring ECMO to chronic ventilator assistance. The results were compared to the previous 12 week period which had a pressure ulcer incidence rate of 39% in a similar cohort group.

Relevance to clinical practice: The availability of pressure redistribution mattresses for the pediatric population who are too big for an isolette and too small for an adult bed allows pediatric acute care organizations to provide effective pressure redistribution. The upfront cost of the mattresses is compensated for by reassuring families and children that everything possible is being done to prevent scaring pressure ulcers and potentially disfiguring skin damage.