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Hill-Rom® Clinical Resource Center

Helping you implement evidence-based programs with connected technologies

Hill-Rom® Clinical Resource Center

Pressure Injury Management


  • Pressure Ulcer Risk in the Incontinent Patient
    Lachenbruch C | Journal of Wound, Ostomy & Continence Nursing | 2016

    This article is an analysis of incontinence and pressure ulcers from the International Pressure Ulcer Prevalence™ Survey. It concludes that incontinent patients had higher Braden Scale scores and higher overall and facility-acquired pressure ulcer prevalence. Incontinence was associated with an increased risk for all pressure ulcers, but especially full-thickness injuries.

  • Pressure Ulcers: More Lethal Than We Thought?
    Redelings MD, et al. | Advances in Skin & Wound Care | 2005

    This descriptive study assesses the prevalence of pressure ulcer associated deaths in the US, including associations with other conditions, such as septicemia, and demographic characteristics, such as age.  Approximately 10,000 patient die each year from complications due to pressure ulcers.

  • The Economic Measurement of Medical Errors
    Shreve J, et al. | Society of Actuaries | 2010

    This study, provided by Milliman, Inc. and sponsored by The Society of Actuaries, Health Section, measures the annual frequency of medical errors in the United States and the total measurable cost to the overall economy due to these errors. Analysis of an extensive claim database of reported medical events revealed that pressure ulcers are ranked as the most costly medical error with an annual cost of $3.86 billion.

  • Pressure Ulcer Risk Assessment and Prevention: Comparative Effectiveness
    Chou R, et al. | Agency for Healthcare Research and Quality | 2013

    Pressure ulcers are a relatively common occurrence across all care settings, resulting in significant health burdens. However, risk-assement scales and preventive interventions can decrease the incidence or severity of pressure ulcers. 

  • Implementation of a Pressure Redistribution Mattress
    Walden KE | Journal of Wound, Ostomy & Continence Nursing | 2008

    In an effort to combat the rising cost of rental therapy products, The Jewish Hospital purchased and evaluated various mattresses from several manufacturers, observing patient comfort level and patient skin redness or breakdown over pressure points. Extensive assessment resulted in the hospital choosing the Accumax Quantum™ Convertible, a nonpowered redistribution surface, due to a 16% decrease in facility acquired pressure ulcers.  The new surface also led to a decrease in rental costs in the first year by $15,000 per month with a projected savings of $900,000 over a five year life.

  • Effects of a Nonpowered Dynamic Surface on Reducing Facility-Acquired Pressure Ulcers
    Strilko B, et al. | Journal of Wound, Ostomy & Continence Nursing | 2005

    Due to rising costs in specialty bed rentals and increased concern over hospital acquired pressure ulcers, Provena St. Joseph Medical Center's 350-bed hospital opted to purchase new pressure redistribution surfaces for all Med-Surg beds. Replacement of the standard foam mattress to the nonpowed, dynamic AccuMax Quantum™ Surface resulted in a 61.5% decrease in facilty-acquired pressure ulcers over a 8-month time period. 

  • The Path to Excellence: How One Facility Received and Maintained a CMS 5 Star Rating
    Onday A | 2010

    This whitepaper describes surveillance and documentation processes for quality measure, including facility-acquired pressure ulcers, weight loss, medical errors, and infection control. Quality improvement process changes incorporating the use of pressure-redistributing mattresses have improved rates and facility-acquired pressure ulcers.

  • Evaluation of the Incidence of Pressure Ulcers Using Hill-Rom VersaCare Surfaces
    Korniewicz D, et al. | Advances in Skin & Wound Care | 2011

    This study evaluated the clinical impact of the VersaCare® P500 low-air-loss surface with Advanced Microclimate® Technology for pressure ulcer prevention in 127 post operative orthopedic surgical patients.

  • Comparison of Air-Fluidized Therapy With Other Support Surfaces Used to Treat Pressure Ulcers in Nursing Home Residents
    Ochs RF, et al. | Ostomy Wound Management | 2005

    This retrospective pressure ulcer prevention and treatment study compared healing rates for different support surfaces in nursing home residents. Support surface types were categorized into 3 groups: static overlays and replacement mattresses (1); low-air-loss beds, alternating pressure, and powered/non-powered overlays/mattresses (2); and air-fluidized beds (3). Mean healing rates were as follows: 5.2 cm2/wk (Group 3); 1.8 cm2/wk (Group 2); 1.5 cm2/wk (Group 1) (P=0.007 comparing Group 3 to 1 and 2). Mean healing rates were also significantly greater for stage III/IV ulcers on Group 3 surfaces. Groups 1 and 3 had fewer hospitalizations and ER visits compared to Group 2 (P=0.01).

  • Air-Fluidized Therapy: Physical Properties and Clinical Uses
    Annals of Plastic Surgery | 2010

    This review describes the benefits and drawbacks of air-fluidized therapy compared to other support types in terms of factors known to impact skin breakdown: interface pressure, shear, friction, heat, and moisture. The clinical benefits of air-fluidized therapy include faster pressure ulcer healing, decreased rate of hospitalization and ER visits for long-term care pressure ulcer patients, and decreased mortality and increased comfort for patients with burns and inhalation injury.

  • Clinical Efficacy and Cost Effectiveness of Air Fluidized Therapy for Severe Pressure Ulcers
    Cuddigan JE, et al. | Remington Report | 2004

    This article describes how AFT is technologically different from Group 1 (Static devices / mattresses) and Group 2 (dynamic powered and non-powered mattress replacements and overlays). Using the healing rates described by Ochs, (2004) Cuddigan and Ayello model treatment costs for severe ulcers. They find a net savings of $39, 642 to heal a 49-cm2 stage III/IV ulcer when using AFT compared to Group 2 surfaces.

  • Eliminating Facility-Acquired Pressure Ulcers at Ascension Health
    Gibbons W, et al. | Joint Commission Journal on Quality and Patient Safety | 2006

    Data were collected on pressure ulcer incidence in 67 acute care facilities using the SKIN bundle. Pressure ulcer incidence decreased from >2% to <1% over a 14-month period, and no new stage III/IV facility-acquired pressure ulcers developed from August 2004 through February 2006.

  • Air Fluidized Therapy Use in Patients With Suspected Deep Tissue Injury - A Case Series
    Allen L, et al. | 2011

    Patients with suspected deep tissue injuries (sDTI) were placed on the Clinitron® Rite Hite® bed, treated with standard care, and assessed until resolution of their sDTI. Out of 5 patients and 10 ulcers, 4 healed before discharge, 2 remained at discharge, and 4 became Stage II ulcers. Patients placed on air-fluidized therapy had significantly less skin breakdown than expected.

  • The Effect of Using a Low-Air-Loss Surface on the Skin Integrity of Obese Patients: Results of a Pilot Study
    Pemberton V, et al. | Ostomy Wound Management | 2009

    This study assesses the impact of a new low-air-loss, continuous lateral rotation therapy bed in 21 obese, bariatric acute care patients. During this pilot study, pressure ulcers decreased in size from an average 5.2 cm2 to 2.6 cm2, and no new pressure ulcers developed.

  • Microclimate Management: So Much More Than Just Airflow
    Lachenbruch C | 2017

    This whitepaper discusses factors impacting the skin microclimate and describes the ideal combination of airflow, temperature, and surface material for preventing skin breakdown.

  • Pressure Ulcer Incidence and Progression in Critically Ill Subjects: Influence of Low Air Loss Mattress Versus a Powered Air Pressure Redistribution Mattress
    Black J, et al. | Journal of Wound, Ostomy & Continence Nursing | 2012

    This study evaluated the change in existing pressure ulcers and incidence of new pressure ulcers in surgical ICU patients using a new low-air-loss, weight-based, microclimate management (LAL-MCM) system compared to the standard SICU bed with an integrated, powered air pressure redistribution (IP-AR) surface. Incidence of supine pressure ulcers was 0% in the LAL-MCM group and 18% in the IP-AR group (P=0.046), despite more comorbidities in the patients in the LAL-MCM group.

  • Role of Bed Design and Head-of-Bed Articulation on Patient Migration
    Davis K, et al | Journal of Nursing Care Quality | 2015

    Repositioning patients in bed puts both patients and caregivers at risk.  Patients experience shear and friction which are risk factors for pressure ulcers, while caregivers who are repositioning patients are at risk for lower back injuries.  This study examined the influence of hospital bed design on patient migration. Over 180 trials, Bed A (Hill-Rom® Progressa® bed system) showed 85-86% (p< 0.001) less patient migration and 34% less torso compression compared to current alternatives.  Three in four subjects preferred the Hill-Rom® Progressa® bed system. The author concludes that optimal bed design should reduce patient migration which may lead to clinically significant reductions in health risks to patients and caregivers.

  • The Demographics of Suspected Deep Tissue Injury in the United States: An Analysis of the International Pressure Ulcer Prevalence™ Survey 2006-2009
    VanGilder C, et al. | Advances in Skin & Wound Care | 2010

    This article reports data from the International Pressure Ulcer Prevalence™ survey 2006-2009 in patients with suspected deep tissue injury (sDTI). Overall and facility-acquired pressure ulcer prevalence was constant in 2006-2008 and decreased by about 1% in 2009 (P<0.001). The prevalence of pressure ulcers identified as sDTI increased to 9% of all observed ulcers in 2009, a 3-fold increase, while the proportion of stage I and II ulcers has decreased and stage III and IV ulcers remained constant. This increase may be due in part to education of staging definitions.

  • A Pilot Study of Pressure Ulcer Incidence and Healing of Pressure Ulcers Comparing Subjects Placed on the LAL-MCM Mattress Versus a Standard Bed SICU Mattress
    Black J, et al. | 2010

    This study evaluated the change in existing pressure ulcers and incidence of new pressure ulcers in surgical ICU patients using a new low-air-loss, weight-based, microclimate management (LAL-MCM) system compared to the standard SICU bed with an integrated, powered air pressure redistribution (IP-AR) surface. Incidence of supine pressure ulcers was 0% in the LAL-MCM group and 18% in the IP-AR group (P=0.046), despite more comorbidities in the patients in the LAL-MCM group.

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