title: Continuous bedside pressure mapping and rates of hospital-associated pressure ulcers in a medical intensive care unit.
abstract: BACKGROUND
  Critically ill patients are vulnerable to the development of hospital-associated pressure ulcers (HAPUs). Positioning of patients is an essential component of pressure ulcer prevention because it off-loads areas of high pressure. However, the effectiveness of such positioning is debatable. A continuous bedside pressure mapping (CBPM) device can provide real-time feedback of optimal body position though a pressure-sensing mat that displays pressure images at a patient's bedside, allowing off-loading of high-pressure areas and possibly preventing HAPU formation.
  
  
  METHODS
  A prospective controlled study was designed to determine if CBPM would reduce the number of HAPUs in patients treated in our medical intensive care unit. In 2 months, 422 patients were enrolled and assigned to beds equipped with or without a CBPM device. Patients' skin was assessed daily and weekly to determine the presence and progress of HAPUs. All patients were turned every 2 hours. CBPM patients were repositioned to off-load high-pressure points during turning, according to a graphic display. The number of newly formed HAPUs was the primary outcome measured. A χ(2) test was then used to compare the occurrence of HAPUs between groups.
  
  
  RESULTS
  HAPUs developed in 2 of 213 patients in the CBPM group (0.9%; both stage II) compared with 10 of 209 in the control group (4.8%; all stage II; P = .02).
  
  
  CONCLUSIONS
  Significantly fewer HAPUs occurred in the CBPM group than the control group, indicating the effectiveness of real-time visual feedback in repositioning of patients to prevent the formation of new HAPUs.
authors.affiliation: Robert Behrendt is a clinical quality facilitator in the Office of Clinical Quality and Safety, Henry Ford Health System, Detroit, Michigan. Amir M. Ghaznavi is a plastic surgery fellow and Aamir Siddiqui is a professor of surgery in the Division of Plastic and Reconstructive Surgery, Henry Ford Hospital, Detroit, Michigan. Meredith Mahan is a biostatistician in the Department of Public Health Sciences, Henry Ford Health System. Susan Craft is a staff nurse unit director in the medical intensive care unit at Henry Ford Hospital.
authors.forename: Robert
authors.initials: R
authors.lastname: Behrendt
authors.forename: Amir M
authors.initials: AM
authors.lastname: Ghaznavi
authors.forename: Meredith
authors.initials: M
authors.lastname: Mahan
authors.forename: Susan
authors.initials: S
authors.lastname: Craft
authors.forename: Aamir
authors.initials: A
authors.lastname: Siddiqui
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001513:Beds; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000592:standards / Q000706:statistics & numerical data; D008297:Male; D008824:Michigan; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation / Q000379:methods; D056888:Patient Positioning / Q000592:standards*; D019095:Point-of-Care Systems; D011312:Pressure / Q000009:adverse effects; D003668:Pressure Ulcer / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D055815:Young Adult