Mattress Replacement Project: Putting the S3I Testing Protocols into Practice

In 2015, a large Midwestern Academic Medical Center needed to replace aging mattresses and bedframes. The purpose of the project was to use the best available evidence to objectively evaluate support surfaces as part of pressure injury prevention efforts. The Clinical Nurse Specialist (CNS), tasked with leading the institution’s mattress replacement project, proposed using the Support Surface Standards Initiative (S3I) and British testing protocol results to inform the decision making process.  The objective was to be able to reliably compare the performance of different surfaces and use that data to make recommendations to the purchasing department.

S3I was founded by the National Pressure Ulcer Advisory Panel and is now the official testing standards body for therapeutic support surfaces. In 2014, S3I for the first time published mattress testing protocols making it possible for hospitals to request testing results from manufacturers that would allow accurate comparison of similar surfaces. The protocols were designed to measure immersion and microclimate (Stone et al., 2015). A British standard protocol for measuring sliding resistance was also published and available for testing.

Implementation of the process included the following key elements. Mattresses were selected based on current use across the 5-state hospital system. Once mattresses with key features were identified, manufacturers were requested to provide immersion, microclimate, and friction testing results to the hospital in order for their product to be considered for purchase. An outside consultant was contracted to assist us in analyzing and ranking the test results while considering our specific patient populations and established nursing practices. This comprehensive data successfully guided the decision for the purchase of new mattresses for our medical center.