Recently, TBHC replaced all mattresses throughout the hospital. According to Debra Wright, RN, Skin Care (formerly Critical Care RN Educator), the majority of TBHC's population is comprised of senior citizens - Ms. Wright explained that the hospital receives nursing home patients from approximately 29 local nursing homes. These patients require long lengths of stay, and once they get to their floors, most require constant bed rest. One of the things that the nurses observed were pressure ulcers (more commonly known as bedsores) found on their elderly patients, due to decreased circulation on the sacrum & heels, which are the most common sites of ulceration.
In order to assess the needs of the patient population, a "Prevalence Of Incidence" study was conducted in October 2004. This study is a way of measuring the percentage of elderly patients who develop these ulcers during their stay in the hospital. The incidence rate looks at the number of patients that have acquired a pressure ulcer(s) in the hospital during a 5-day period. In other words, if a patient was admitted & developed an ulcer within certain time period, they would be part of this statistic.
Based on the study, the incidence rate was 9%, while the national average was only 6%. Ms. Wright explained that TBHC has a higher percentage than the average based on the Brooklyn community's large nursing home population, which then become patients at the hospital.
Explained Ms. Wright, "Our numbers were high - we needed to look at some of the reasons why, and to develop a plan or process to fix this problem - instead of being reactive , we were being proactive ." Next, Ms. Wright explained that they needed to look at the mattress surfaces that the patients were lying on: was there pressure relief or pressure reduction? The answer was neither. Ms. Wright posed yet another question: when did TBHC actually purchase these spring mattresses? Joe Caravaglio from Building Services looked and researched through the hospital's files, but was unable to find any answers. Ms. Goonan, V.P. Nursing, also researched the issue, but couldn't find any documentation. Ms. Wright came to the conclusion that in 1980, she remembers taking her clinicals as a Nursing Student, and TBHC was using the SAME MATTRESSES back then! That dates back to 25 years ago - definitely time for some new mattresses!
In addition to the fact that the mattresses were old and outdated, the nurses tried to compensate by using E-HOB overlay mattresses (or air mattresses) that were bottoming out - they were being placed on top of the mattresses in order to reduce the chance of patients developing ulcers.
With all of the research in place, the search was on to find appropriate mattresses for TBHC's patient population, particularly for the elderly nursing home patients. The final decision was to choose B & G mattresses on December 6 th , 2004 , based on different companies that were reviewed by the Patient Care Managers, Nursing Care Managers, Purchasing Department, and Skin Care Initiative Team. Mattresses were chosen that would provide both pressure relief and pressure reduction.
Two different styles of mattresses were chosen in order to accommodate the needs of the patient population and the procedures they will undergo. The first, a medical surgical mattress, is called the Maxi-Float. The Maxi-Float mattresses are blue in color, and feature the pressure-reduction attributes necessary for preventing pressure ulcers. Pressure Relief mattresses are in Critical Care Areas and are called Acu-Max. These green-colored mattresses are pressure-relief mattresses which provide additional, firmer support - usually these patients are in the unit for a longer stay, so firmer mattresses are required. The mattress is ergonomically sloped to prevent undue pressure on patient's heels.
Ms. Wright would like to thank everyone involved in the process of disposing of and installing the new mattresses, adding, "We worked very hard - this entailed an entire change of beds, including setting up and making the beds with fresh linens.it was a long & difficult process. I would also like to thank the Building Service people who brought the new mattresses up to all of the floors, unloading them, installing them, disposing of the old mattresses, and so on".
Mattresses that were salvageable were donated to a local charity, "Food for the Poor". The remaining mattresses are slated to go to a church in Haiti.
All in all, Ms. Wright noted that the patients of TBHC "were very comfortable and happy with our new mattresses".