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support surfaces
WOCN program
| Question | Answer |
|---|---|
| pt's with multiple pressure ulcers stage II or higher on turning surfaces or have 1 no turning surfaces should be placed on what type of surface | active with an AP feature or a reactive support surface with an LAL or AF feature |
| what surface is more effective in reducing the incidence of pt in persons at risk that standard hospital foam mattresses | high specification foam |
| which high spec foam is best | no evidence of one being superior |
| australian medical grade sheepskin | not readily available in the US, appropriate choice for pts' with braden subscore of 4 or 3 in moisture and mobility |
| which reactive/CLP support surface is best | insufficient evidence to support one over another |
| active support surfaces with an AP feature are more effective than what to prevent PU | standard hospital mattress |
| which is better to reduce incidence of PU'S, mattress with AP or overlay with AP | overlays and mattresses with AP features show similar efficacy in reducing PU incidence |
| mattresses with a multi stage AP feature are more effective that overlays with AP feature in preventing | full thickness PU |
| mattresses or overlays with single stage AP are equal or different in preventing what | equal in preventing partial thickness PU's |
| what can be done to prevent post op PU incidence | use of a support surface |
| suspected deep tissue injury (sDTI) on trunk or pelvis | surface that facilitates tissue temp reduction (turning, gel, AP, LAL, or AF feature |
| person with PU on head or upper or lower extremities | should be offloaded and may not require a change in current surface |
| if while on reactive /CLP surface with LAL or AF feature, pt's condition improves (no longer has PU or no longer at high risk) | reactive /CLP or an active support surface with an AP feature |
| what are contraindications for Reactive/CLP surfaces | unstable spine, weight limitations |
| what are contraindications or precautions for high specificity foam | braden moisture 1 or 2, weight limitations |
| what are contraindications for Reactive/CLP surfaces with LAL features | add precautions for combative, restless, agitated pt |
| what are contraindications for Reactive/CLP surfaces with AF feature | combative, restless, agitated pt, needs HOB elevated, need for mobility, claustrophobia, unstable spine, weight limitations, trendelenberg |
| immersion | the depth of penetration or sinking in to the surface, improves redistribution |
| envelopment | ability of support surface to conform to body irregularities w/o increasing pressure |
| friction | |
| shear | |
| what is a support surface | any surface that redistributes pressure |
| incidence | |
| prevalence | |
| preventive pressure redistribution | redistribute pressure over reader area so that pressure is is lower at any given point, doesn't consistently lower pressure to <CCP, must turn Q 2 also |
| therapeutic pressure redistribution | TIP is below CCP, prevent skin breakdown in person who can't turn themselves or only one turning surface, promote healing of current PI, reduce stress on an area of tissue |
| CLP | is REACTIVE constant low pressure, powered or non powered, redistributes pressure via immersion and envelopment (gel, foam, viscous fluid, static air, water, bead filled, sheepskin, doesn't move with pt, shear reduction via low friction and compliant |
| AP | is ACTIVE surface alternating or active, cyclic changes in loading and unloading, moves with pt, pressure and shear reduced via cyclic load reduction, |
| LAL | flow of air to manage microclimate |
| air fluidized | air forced through beads creates fluid like medium, provides immersion and envelopment |
| compare AP and CLP | AP= active, moves with pt, alternating pressure, pressure and shear reduced via cyclic load reduction, CLP=reactive, doesn't move with pt, pressure reduced via immersion and envelopment, shear reduction via low friction and compliant |
| indentation force deflection | number of lbs. needed to indent the foam 25% of the thickness, measures compressibility and conformability |
| braden scale no risk | 19 and higher |
| Braden very high risk | 9 or < |
| Braden high risk | 10-12 |
| Braden moderate risk | 13-14 |
| Braden mild risk | 15-18 |
Created by:
Beth Perry
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