Evaluation of the Hybrid-Air Mattress

Posted on March 14th 2018

This is the web version of the clinical trial that was first published in PDF format on this page.  

Evaluation of the Hybrid-Air mattress within an Acute Trauma Unit

Authors: Heather Newton (Consultant Nurse Tissue Viability), Kathy Smith (Trauma Unit Ward Sister),

Susan Ingram (Trauma Unit Ward Sister) & Andrew Squires (Drive DeVilbiss Healthcare Clinical Advisor)

Introduction

Greater demands are being placed on healthcare organisations to implement cost effective strategies for pressure ulcer prevention and it is important to understand which types of patients can benefit from different types of support surfaces¹.

Pressure ulcer prevention is, therefore, a high priority for patients admitted to a Trauma Unit who are particularly vulnerable. Not only have the majority of patients sustained a fracture following a fall but many are elderly, have multiple comorbidities and many have a diagnosis of dementia. All of these factors increase the risk of pressure ulcer development. As part of the Trust’s lower limb pathway developed to manage pressure ulcer risk in this patient group, dynamic mattresses were a standard intervention on admission and throughout their post-operative period.

The aim of pressure ulcer prevention strategies is to reduce either the magnitude or duration of pressure between the patient and his or her support surface or both². Stepping down from dynamic mattresses onto static foam mattresses was not routine practice because of the patients’ sustained level of risk. The Trauma Unit had the highest number of pressure ulcers reported on a monthly basis and the drive to reduce the incidence in this area was an organisational priority.

The utilisation of the Hybrid-Air as an alternative to the current mattresses in use was discussed with the ward team and an evaluation was commenced within the Trauma Unit. Hybrids combine foam and air to maximise the benefits offered by both static and alternating surfaces³.

The Hybrid-Air mattress system from Drive DeVilbiss Healthcare is a non-powered self-regulating hybrid mattress that adjusts with body movement, activating air displacement and resulting in optimum pressure redistribution. The mattress conforms to the shape of the person’s body as he or she moves, increasing the surface area whilst reducing the patient/support surface interface pressures. The potential for skin cell and tissue breakdown is reduced when using this safe and cost effective support surface.

Method

The trial was conducted over a 2 month period and captured data from patients nursed on the Hybrid-Air mattress. For the purpose of this evaluation, the Trauma Unit placed the Hybrid-Air mattress into a six bedded enhanced care bay. Training was provided by Drive DeVilbiss Healthcare on the specification and design of the Hybrid-Air.

Nursing staff were asked to continue their standard pressure ulcer preventative practice as per Trust policy which included skin assessments and repositioning according to the level of risk.

The Tissue Viability Team reviewed the patient records at the end of the evaluation period against the agreed outcomes, these were measured as follows: reason for admission, length of stay, number of days on the mattress, pressure ulcer risk score, mobility, the frequency of skin assessment and skin integrity on discharge.

Results

21 patient records were reviewed.

• The average age of the patients was 83 with a range of between 18 and 97
• The majority of patients as expected were admitted following a fracture to their neck or Other patients were admitted with general medical reasons associated with the older person
• The average length of stay was 15 days with a range of between 2 and 61 days
• The majority of patients were at high risk of developing pressure ulcers with a range of between 8 and 25 on the Waterlow risk assessment scale
• There was only one patient that was independently mobile with all of the other patients needing help to reposition in bed and mobilise
• 18 out of 21 patients had intact skin on admission. One patient had a Grade 2 and one a moisture lesion
• The frequency of skin assessments ranged from daily to three times daily with the majority having 2 - 3 Only two patients required a reduction in the frequency of skin assessments
• One patient developed a Grade 2 pressure ulcer on her heel, however, all appropriate interventions were in place to prevent this incident

Discussion

Key to the successful implementation of new mattress technologies into clinical environments is equipping ward staff to be confident in their appropriate use.

Conclusion

This evaluation confirmed that the Drive DeVilbiss Hybrid-Air mattress provided a clinically effective support surface which met the evaluation outcomes and reduced the need to step up to a dynamic mattress for this patient group. As staff became more confident with the mattresses they felt able to manage those patients at high risk of pressure ulcers safely on the Hybrid-Air mattress.

It is important to consider the impact of a combination of interventions namely regular skin assessments, re assessment of pressure ulcer risk, reposition regimes and support surface selection, all of which contributed to the prevention of pressure ulcers.

References:

1. Pressure relieving support surfaces: a randomised evaluation. Nixon J, Nelson EA, Cranny G, Iglesias CP, Hawkins K, Cullum NA, Phillips A, Spilsbury K, Torgerson DJ, Mason S; PRESSURE Trial Health Technol Assess. 2006 Jul;10(22):iii-iv, ix-x, 1-163.
2. Support surfaces for pressure ulcer prevention. McInnes E, Jammali-Blasi A, Bell-Syer SE, Dumville JC, Middleton V, Cullum N. Cochrane Database Syst Rev. 2015 Sep 3;(9):CD001735. doi: 10.1002/14651858.CD001735.pub5
3. Hybrid support surfaces Made Easy. Jacqui Fletcher etal. 8 May 2015 Wounds International www.woundsinternational.com