Incidence of pressure ulcer in patients using an alternating pressure mattress overlay: the ACTIVE study

Objective: The primary objective was to determine the clinical benefit of using a specific alternating-pressure mattress overlay (APMO) in the prevention of pressure ulcer (PU) in patients at medium to high risk. Method: This prospective study was conducted in five rehabilitation centres and three nursing homes. Patients at medium to high risk of PU, but without PU at baseline, and lying between 15 and 20 hours per day on a specific APMO were included. The primary endpoint was the percentage of patients who developed a sacral, spine, heel or trochanteric PU (supine support areas) of at least category II, at day 35. All patients were included in the analysis. Results: A total of 89 patients were included; of whom six patients (6.7%) dropped out of the study (average (±standard deviation) follow-up 32±5.4 days). No sacral, spine, heel or trochanteric PU of at least category II was reported (i.e., an incidence of 0% [95% Confidence Interval: 0–4.1%] according to the exact Clopper–Pearson method]. Patients were ‘satisfied’ or ‘very satisfied’ with the comfort and stability of the APMO. The caregivers assessed as ‘very easy’ or ‘easy’ the implementation, maintenance and use of the APMO (turning over, moving to a sitting position). Conclusion: In combination with the usual measures to prevent PU, the results of our study showed a low incidence of PU in high-risk patients lying for between 15 and 20 hours a day on an APMO, use of which is therefore recommended in these patients.

Pressure ulcer prevention using an alternating-pressure mattress overlay: the MATCARP project

Objective: The primary objective was to assess the incidence of pressure ulcer (PU) in patients at high risk of PU and lying between 15–20 hours per day on an alternating-pressure mattress overlay (APMO). Secondary objectives were the patient's satisfaction with the comfort of the APMO, patient acceptance of its sound level, and the care team's assessment of its use and the moisture level. Method: This prospective observational study was conducted in three rehabilitation centres and two nursing homes between June 2016 and March 2017. To be included, patients should not have PU at baseline and present a high risk of PU (Braden score between 10–15). The primary endpoint was the percentage of patients in whom a PU developed over a 35-day period. Results: A total of 83 patients were included in the study. Neurological disease was responsible for the reduced mobility of 44 (53.7%) patients, 10 patients (12.0%) dropped out (one patient for a serious adverse event (femoral neck fracture) considered not to be related to the APMO, four patients for adverse events, two of which were considered to be related to APMO and five for other reasons, including, in one case, discomfort with the APMO. These patients were considered in the analysis. Over the study period, 1.2% (1/83) (95% confidence interval (CI): 0.03 to 6.53) of patients developed a PU. Patient satisfaction with the comfort of the APMO, patient acceptance of its sound level, and the care team's assessment of its use were considered satisfying for most patients. Conclusion: Based on the findings of this study of a low incidence of PU in participating patients, the use of an AMPO is recommended in high-risk patients lying for between 15–20 hours a day.

Assessing effectiveness of regular repositioning in preventing pressure ulcers in children

Pressure ulcers have adverse effects on health. Thus, early detection of damage to skin integrity is important for preventing the occurrence of pressure sores. Meanwhile, two-hourly repositioning is a nursing intervention performed to prevent pressure ulcers. This study aimed to evaluate the implementation of regular repositioning for preventing pressure sores. The Braden Q Scale is an instrument that predicts skin breakdown caused by pressure ulcers. The designs used quasi-experiment pretest and posttest nonequivalent control group; 93 participants were selected through a nonprobability sampling technique by consecutive sampling (43 for the intervention group and 50 for the control group). Respondents in the intervention group were repositioned every 2 hours, and the control group received pressure mattress, which is done for 14 days or until the child can go home. The findings suggest that there is a significant difference in the Braden Q scores from before and after repositioning of the intervention group and the control group using pressure mattress (P<0.001). Nurses are expected to be able to detect early damage to skin integrity and to implement regular repositioning by using the Braden Q Scale.