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Higher-category pressure redistribution mattresses are considered a critical component of a pressure ulcer prevention program, but few studies have quantified the impact of specific preventive measures on the incidence or prevalence of hospital-acquired pressure ulcers (HAPUs). Therefore, this study was undertaken to determine the impact of low-air-loss beds on HAPU prevalence.This prospective, comparative cohort study monitored the prevalence of HAPU at our hospital and compared rates of matched medical-surgical units with and without low-air-loss beds. Units without low-air-loss beds used a variety of alternative pressure redistribution devices for patients deemed at risk for pressure ulceration. The prevalence of HAPU was operationally defined as the number of patients with HAPUs divided by numbers of patients observed.The prevalence of HAPU over 3 quarters in 2008 ranged from 1.0% to 3.3% (overall rate 2.4%). Eighty-three percent of patients with HAPUs were cared for on low-air-loss beds. Of 12 patients with 16 HAPUs during this time, 75% were aged 70 years or older and 25% were managed in critical care units. Over half of patients who developed HAPUs had been hospitalized for 20 days or more. Half of the patients with HAPUs were scored as no—low risk on the Braden Scale.On the paired medical-surgical units, no statistically significant differences were found when patients with low-air-loss beds were compared to standard hospital mattresses supplemented by a variety of pressure redistribution devices. Seven of 11 HAPUs (63%) occurred in patients placed on low-air-loss beds.The prevalence of HAPU in patients placed on low-air-loss beds was no different from patients placed on standard hospital mattresses supplemented by a variety of pressure redistribution devices. Further research is needed to determine the impact of specific strategies on prevention of HAPU.