Pressure Map Technology for Pressure Ulcer Patients: Can We Handle the Truth?
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Index: WOUNDS. 2013;25(2):34–40.
Abstract: Objective. The purpose of this study was to trial new pressure mapping technology for patients with pressure ulcers. Methods. Pressure mapping data was recorded during 3 phases of technology implementation, as nurses became increasingly familiar with pressure mapping technology in a 55-bed, long-term acute care (LTAC) facility in North Texas. Forty-three patients with pressure ulcers were selected for the study. Patients with pressure ulcers, or who were considered at high risk for developing pressure ulcers based on a Braden score of ≤ 12, were selected to utilize a pressure-sensing device system. Results. Turning timeliness improved greatly from the baseline phase to the last phase. The average turning after the 2-hour alarm decreased from 120 minutes to 44 minutes, and the median time to turning decreased from 39 minutes to 17 minutes. If time past 2 hours is considered the most damaging time to tissue, these reductions (average and median) represented 63% and 56% less potential tissue damage. Conclusion. Pressure mapping technology is in its infancy and this paper discusses implications for the future, including barriers to implementation and potential advanced applications. While only changes in nursing practice were measured in this study, the changes observed suggest the technology can be instrumental in reducing hospital-acquired pressure ulcers and improving the healing of pressure wounds in the future.
Pressure ulcers remain a huge burden, in terms of financial cost to the medical system and the suffering of patients. Despite advances in bed technology and many aspects of wound care from 1993 to 2006, the number of hospitalizations for pressure ulcers reported to Medicare increased 80% despite only 15% more patients.1 Reasons for this persistence involve many factors. One important contributor is that medical advances are postponing death from other causes, thus creating an ever more aged and frail patient population. As more frail patients are becoming more numerous, it is clear providers need more tools in their armamentarium to prevent and treat pressure ulcers. With this in mind, technology that can help facilities reduce pressure wounds is greatly needed.
Methods and Materials
The pressure-sensing device. The device (The MAP System, Wellsense Inc, Nashville, TN) is a thin mat placed on a mattress that has a color monitor attached. The mat contains thousands of sensors, and is secured to the top of the mattress with straps. These sensors measure pressures through a sensing area measuring 1945 mm x 805 mm. The sensors display specific areas of pressure, and the system provides live feedback to clinicians as they reposition patients. The monitor acts as an educational tool for staff, patients, and family by indicating where the pressure points are located. (Figure 1). It can also assist clinicians in optimal surface selection and detection of malfunctioning mattresses. Figure 2 shows an image from the device monitor of a patient on a bed that was inadvertently deflated, while Figure 3 shows an image from the device monitor of the same patient with the bed properly inflated.