New Surface Selection Algorithm Helps Prevent Pressure Ulcers

A new study presents a consensus algorithm that takes the guesswork out of choosing a bed surface to help treat and prevent pressure ulcers (PUs).

The Evidence-and Consensus-Based Support Surface Algorithm, developed by a team of 20 clinical experts led by the Wound, Ostomy, and Continence Nurses Society (WOCN; Mount Laurel, NJ, USA), distills more than 20 years of published research into an easy-to-navigate visual decision tree that clinicians can easily use to guide bed surface selection in the hospital. Users enter the algorithm at the point of the initial skin assessment, followed by PU risk assessment. Based on the Braden score, or presence of PUs, users follow pathways that guide clinical decision making for support surface use.

Support surface selections—based primarily on Braden moisture and mobility subscale scores—are provided, as well as guidance regarding performance of skin and PU risk reassessments, determining the need for a change in or removal from a support surface, and support surface considerations and contraindications. The consensus panel members acknowledged the need for individual facilities to adapt the algorithm by including the specific products used at their facility, along with appropriate staff education. The study describing the new algorithm was published in the January/February 2015 issue of Journal of Wound Ostomy Continence Nursing.

“We all saw a clear need for this tool. This algorithm will contribute to patient outcomes in hospitals around the country. Clinicians know and guidelines emphasize the importance of surface selection to protect patients from pressure ulcers,” said lead author and Laurie McNichol, RN, of Wesley Long Hospital (Greensboro, NC, USA). “Yet a comprehensive review of the available research was lacking. Clinicians needed a validated approach to maximizing the potential benefits of choosing a surface to treat and protect our patients.”

Support surfaces comprise a variety of overlays, mattresses, and integrated bed systems used to redistribute pressure, reduce shearing forces, and control heat and humidity. The use of support surfaces is included in nearly all evidence-based clinical practice guidelines as a component of comprehensive PU prevention programs and treatment recommendations.

Related Links:
Wound, Ostomy and Continence Nurses Society