How to Reduce Pressure Injuries in the ICU by more than 10%

Purpose: Determine whether intensive care unit (ICU) patients require a more substantial mattress than the general patient population.  

Background:  A level 2 trauma center in the Southeastern United States purchased new mattresses for their facility with a “one size fits all” approach. The chosen surface was an alternating pressure redistribution surface with a foam overlay. Two years following the purchase, the pressure injury (PI) rates in the ICUs accounted for approximately 55% of the total hospital-acquired pressure injuries (HAPIs).ICU patients are a special population and at high risk for PIs. Incidence rates for an ICU may be as high as 38%¹,demonstrating that ICUs warrant special concern.

Methods:The hospital chose to trial several products against their facility-owned surface (Control bed A). A static low air loss (LAL) surface was chosen as Control bed B and an alternating pressure LAL surface as Control bed C. The trial entailed monitoring 112 ICU patients during two consecutive 30-day periods. Data was collected on length of stay, daily skin assessments, Braden scores, and patient height and weight.

Outcome:During the trial period, a total of 12 PIs developed: three PIs on Control Surface A (hospital owned), nine on Control Surface B, and zero on Control Surface C. 

Conclusion:  Control bed C, the surface with LAL and alternation therapy, proved most effective in reducing HAPIs in the ICUs. The facility elected to replace all 26 ICU beds with the new mattress in order to reduce the HAPI rate in these high acuity units. In the eight months following, the ICUs accounted for 40% of the total HAPIs—a reduction of 11%.