Week 3 | Pressure Redistribution and Offloading (17180-SP)

Image of reclining patient on bed.

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Topics

Topics for Discussion

  • People
  • Beds and support surfaces
    • Components
  • Terminology

Types of beds/surfaces and mechanism of action

  • Indications and contraindications
  • Seating options

Selecting appropriate surfaces/beds

  • Components
    • Frames
    • Surfaces
      • Standard Surface
      • Specialty Surface
        • Mattress Overlay
        • MRS (mattress replacement system)
        • Integrated Bed System

Issues To Consider

  • Decide on features needed
  • Compare like features
  • Check warranties
    • Prorated
    • Non-prorated
  • Shop the price

Specialty Surface Types per NPUAP Guidelines - (www.npuap.org)

  • Airfluidized –surface feature providing pressure redistribution by forcing air through beads – uses immersion and envelopment
  • Alternating Pressure – surface feature providing pressure redistribution via cyclic changes in loading and unloading
  • Low Airloss – surface feature providing flow of air to manage microenvironment of skin

Nursing Responsibilities

  • Assess and understand the individual’s needs
  • Evaluate hydration status of the person
  • Check to ensure device is functioning properly
  • Assess patient position
  • Look at potential for “bottoming out”
  • Move to another surface/bed as needs change
  • Document fully the type bed used and results

Use of Lateral Rotation Surfaces

  • Provides rotation about a longitudinal axis
  • Characterized by degree of patient turn, duration and frequency
  • Designed as an assist for pulmonary toilet

Bariatric Products

  • Bed Frames
    • Reinforced to support up to 1,000 pounds
    • Wider to allow turning side-to-side, rails may tilt out
    • Built-in scales
    • May change into chair position
  • Other Bariatric Selections
    • Transporters
    • Pads for floating for turn assist

Seating Options

  • Many options – chairs, cushions
  • Nurses/PT work together
  • Teach patient to check for proper working order

Note - Surface may need to change as patient condition changes. All patients need to be turned routinely, regardless of surface type!

Facility Financial Responsibilities

  • Medicare A covered patient
    • Hospitals and SNF’s must provide
    • For routine LTC, daily reimbursement based on RUGS
  • Medicare B covered patient –
    • Determine home coverage – depends on insurance

Objectives for Learning Outcomes

After completing this session, you will be able to:

  1. Describe the main types of surfaces and beds. 
  2. Discuss how each type mechanically works. 
  3. Contrast various surfaces and use for a variety of patient needs. 
Course summary
Available: 
04/07/2017
Expires: 
07/02/2018

Betty Hanrahan, MSN, CNS, ARNP-BC, CWCN-AP, CWS, FACCWS, CFCN
Certified Wound Care Nurse; Co-Director, Wound Management Education Program (WMEP) and Wound Management Fundamentals Course (WMFC), Continuing Nursing Education, University of Washington School of Nursing, Seattle; Fellow, College of Certified Wound Specialists

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