Costs and Acceptability of Two Special Overlays for the Prevention of Pressure Sores

Abstract

In a randomized clinical trial, 187 adult patients with chronic neurologic conditions who were at a high risk of developing pressure sores were assigned for 3 months to either an alternating air (AA) mattress overlay or a silicore (S) mattress overlay. Costs associated with each overlay were calculated and compared by adding depreciation and yearly expenses related to maintenance, operation, and repair for 148 patients who completed the trial. Acceptability was measured by questionnaires and interviews involving 45 of the patients' primary nurses and a sample of 40 patients (20 from each overlay group). The annual cost of the AA overlay was 54% more than that of the S overlay. Although most nurses (more than 74%) believed that both overlays helped prevent pressure sores and deter their progression, many (more than 56%) would not recommend either type to other facilities or to patients at home due to specific negative features. Implications for manufacturers, investigators, clinicians, and administrators are identified.

Pressure-Redistributing Support Surface Use and Pressure Ulcer Incidence in Elderly Hip Fracture Patients

“…Powered PRSSs generally cost hundreds or thousands of dollars to rent or purchase, whereas nonpowered PRSSs generally cost only a few dollars. The burden to patients, including discomfort, noise, and sleep disturbance, and the burden to healthcare providers due to mechanical unreliability is also generally greater for use of powered support surfaces than nonpowered support surfaces 22–24 . Given this differential in burden, it is of particular interest to determine whether powered PRSSs are more effective at preventing pressure ulcers than nonpowered PRSSs and to determine whether using any PRSS is more effective than not using a PRSS.…”

“…The burden to patients, including discomfort, noise, and sleep disturbance, and the burden to healthcare providers due to mechanical unreliability is also generally greater for use of powered support surfaces than nonpowered support surfaces. [22][23][24] Given this differential in burden, it is of particular interest to determine whether powered PRSSs are more effective at preventing pressure ulcers than nonpowered PRSSs and to determine whether using any PRSS is more effective than not using a PRSS. This study used data from a large cohort of older adults with hip fracture, a population with a high incidence of pressure ulcers, 2,25-28 to compare the rates of incident pressure ulcers stage 2 or higher (IPUs) associated with use of powered PRSSs, nonpowered PRSSs, and no PRSS.…”