An exploration of nursing home residents' experiences of a non-powered static air mattress overlay to prevent pressure ulcers

Knowledge and Attitudes Toward Pressure Ulcer Prevention Evidence-based Guidelines among Nursing Students at Jazan University, Saudi Arabia

BACKGROUND

Pressure ulcers (PUs) are a common global problem. They affect health-care costs and patient health because of increased morbidity and mortality rates. Critically ill patients are more prone to acquiring PUs than other patients. As the prevalence of PUs is high in Saudi Arabia, more attention is required for PU prevention. Nurses' knowledge and attitudes toward PU prevention are crucial.

AIMS

This study aimed to assess the knowledge and attitudes of nursing students regarding PU prevention evidence-based guidelines.

SETTING AND DESIGN

This descriptive, cross-sectional study was conducted among nursing students at Jazan University.

MATERIALS AND METHODS

Data were collected using an electronic questionnaire.

STATISTICAL ANALYSIS USED

Data were entered, coded, and analyzed using the SPSS version 23.

RESULTS

A total of 378 participants were included. The mean age was 22.4 ± 3.4 years, and the mean knowledge score was 7.6 ± 2.64 (range = 0-16). Of the participants, 365 (96.6%) and 13 (3.4%) were considered to have poor and good knowledge about PUs, respectively. Only 72 (19%) correctly identified a lack of oxygen as the cause of PUs; other participants answered malnutrition and moisture. Conversely, 200 (52.9%) participants indicated that recent weight loss below patients' ideal weight increases the risk for PUs. Concerning knowledge about preventive measures, 64 (16.9%) participants correctly answered that a backward sitting position, with both legs resting on a footrest, can reduce the amount of pressure. Meanwhile, 169 (44.7%) participants correctly selected thick air cushion as a means to reduce the magnitude of pressure when patients are sliding down on a chair. Some participants answered that PUs can be reduced if patients are mobilized. Seventy-two (19%) participants indicated that patients laying on a visco-elastic foam mattress should be repositioned every 2 h to reduce the duration of pressure. Age, year of education, training experience, and department were not significantly associated with knowledge about PUs (P = 0.333, P = 0.370, P = 0.700, and P = 0.810, respectively).

CONCLUSIONS

The general knowledge and attitudes toward PUs of the nursing students at Jazan University were poor. Nevertheless, they had an average knowledge level regarding PU prevention. Age and training experience were not significantly associated with knowledge about PUs.

Effect of mattress bedding layer structure on pressure relief performance and subjective lying comfort

Mattresses' pressure relief performance and comfort largely affect sleep quality. Mattress filling materials have been proven to affect the interface pressure distribution and comfort, but the effect of mattress structure is unclear. In this paper, the interface pressure distribution and subjective comfort of 10 subjects were assessed in the different bedding layer structures of mattresses, after mattress support performance was tested. The results show that the mattresses with bedding material hardness gradually increasing from the top layer to the bottom layer (BMH-ITTB) structure have a softer surface layer, a better support core layer, and higher fitness. This enables the mattress to achieve a better decompression effect. The low-pressure area (PAI_≤0.67kPa) increased, while the high-pressure area (PAI_≥2.67kPa and PAI_≥4.00kPa), maximum pressure (P₉₅), average pressure (P₅₀), and pressure index (PI) decreased. This also enables the mattress to achieve higher subjective comfort scores.

Repositioning mattress: how a lateral tilt position reshapes the prevention of pressure ulcers in bedridden patients

Pressure ulcers have been part of tissue damage without effectiveness in medical, surgical, and intensive care units. This study aims to focus on developing lateral tilt positions for effective pressure ulcer relief for bedridden patients. A repositioning mattress was placed in the side-lying left lateral tilt position (15°, 30°, 45°), sheering (0.680, 1.323, 1.870), interface pressure (2.550, 2.290, 2.830), and placed at 1.5 m long piece of polyethylene rubber. The design strength was set at 6000 N and 2100 mm x 1105 mm (σt,0,d = 42, σc,0,d = 34). The design shows the greatest supine position at 30°, 1.323, 2.290, pressure load (Δp0 = 1.125 (1820) ≈ 2050 psi, Δp3000 = 1.125 (620) ≈ 700 psi), tensile stress (σt,0,d (MPa) = 42), compressive stress (σc,0,d (MPa) = 34), and FOS (σt,0,d = 42, σc,0,d = 34). The factor of safety illustrated that the 30° lateral tilt position is more consistent in repositioning for pressure ulcer prevention compared to the supine-to-tilt region. Further, an application of repositioning mattresses was developed to test in bedridden patients with tissue ulcers in nursing homes.

What is the better choice for nurses? Alternating air pressure mattresses versus static air mattresses to prevent pressure ulcers in elderly hospitalized patients: A protocol for systematic review and meta-analysis

BACKGROUND

Evidence on the comparative effectiveness between commercially available support surfaces in preventing pressure ulcer development is lacking. The purpose of this study was to compare the efficacy and safety of alternating air pressure mattresses (AAPMs) versus static air mattresses to prevent pressure ulcers in elderly hospitalized patients and to provide evidence for clinical practice.

METHODS

The electronic databases of Cochrane Library, EMBASE, PubMed, and Web of Science will be searched in April 2022 using the following key terms: "pressure ulcers," "support surface," and "pressure mattresses," for all relevant studies. Only English publications are included. The primary outcome is the incidence of pressure ulcers; secondary outcomes include patient satisfaction, cost, and other bedridden complications. The Cochrane risk of bias tool will be independently used to evaluate the risk of bias of included randomized cohort studies by 2 reviewers. A modified version of the Downs and Black tool is adopted to evaluate the quality of nonrandomized cohort studies. All outcomes are pooled on random-effect model.

RESULTS

We hypothesized that group with AAPMs will provide better therapeutic benefits compared with control group.

CONCLUSIONS

It is worthy to critically review the evidence of the assessment of AAPMs and static air mattresses to inform clinical practice.

OSF REGISTRATION NUMBER

10.17605/OSF.IO/MYPZ2.