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Fall Reduction in a Behavioral Health Setting Inpatient fall rates have been a concern at Beckley Appalachian Regional Hospital (Beckley ARH) for many years. In 2015, a project was launched in order to evaluate and trend the falls that occurred in the Behavioral Science Center (BSC)...

How to Reduce Pressure Injuries in the ICU by More than 10% A level 2 trauma center in the Southeastern U.S. purchased new mattresses for their facility with a “one size fts all” approach. The chosen surface was an alternating pressure redistribution surface with a foam overlay. Two years...

Low Air Loss Support Surface Selection in the Neonatal and Pediatric Population More than 50 percent of pressure injuries (PIs) occurring in the pediatric and neonatal population are directly related to medical devices. Skin integrity alteration in the pediatric population causes physical pain for the child...

Practice Changes to Decrease Patient Falls as well as Prevention/Treatment of Pressure Injuries Falls with injury continue to be a costly burden to health care facilities and patients. The purpose of this project was to evaluate a low bed to reduce both the number of falls and the severity of injuries from those falls. Current practice...

Pressure Injury Prevention Using Low Air Loss in the Burn ICU Low air loss support surfaces have been used for the prevention and treatment of pressure injuries (PI), formerly pressure ulcers, for many years. Incidence rates for an intensive care unit (ICU) may be as high as 38 percent. The risk factors...

Prevent Pressure Ulcers in High-Risk Infants in the PICU Immobilized critically ill pediatric patients are at risk for developing pressure ulcers. The most common area for infants to develop pressure ulcers is on the occipital area due to weight distributions. Open heart surgery patients are...

Rehabilitation of a Person with Obesity and Post-Operative Hemiparesis Healthcare workers have among the highest on-the-job injury rates, according to the U.S. Centers for Disease Control and Prevention. Accreditation and reimbursement pressures are encouraging healthcare facilities to focus on...

A Review of High-Risk Children on Crib Mattresses Designed to Support Skin Integrity Identifying children at risk for skin breakdown has improved as the organization has engaged in national efforts to improve awareness and promote education among all staff. Children are identified either at admission or early in the...

Skin Prevention for Manual Prone Therapy in ARDS The purpose of this project was to decrease the amount of skin breakdown in patients who received prone therapy after being diagnosed with severe acute respiratory distress syndrome (ARDS). ARDS is characterized by acute...

Thinking Outside the Box: Use of Low Air Loss in the Neonatal and Pediatric Population The purpose of the project was to identify and develop guidelines for multiple uses of powered low air loss (LAL) within the neonatal and pediatric population at a Magnet Designated Children’s Hospital. Diaper dermatitis is one of the most...

Use of Immersion Therapy Mattresses with Low Air Loss to Facilitate Healing of Post Myocutaneous Flaps Historically, the use of support surfaces in the treatment of myocutaneous flaps resulting from Stage IV pressure ulcers on the torso has been limited in our hospital to air fluidized therapy. The WOC nurses were asked to find an...

Zero Incidence of Pressure Ulcers: Changing the Paradigm of Nursing in the Emergency Department Pressure ulcers are a universally recognized indicator for the quality of nursing care. In 2008, the Center for Medicare and Medicaid Services established new guidelines which significantly changed the acute care approach to one of...

The Advantages of Green Support Surfaces More chemicals are used in healthcare than just about any other industry. While immediate exposure may come in the form of everyday cleaning products, numerous hidden chemicals can be found in construction materials, healthcare...

Air Support Surfaces for Spinal Cord Patients Spinal precautions are a common set of protocols used to care for the most critical trauma patients—especially those with suspected spine and/orneurological injury. EMS workers often use hard C-collars to align and stabilize the neck and a...

CLRT and Percussion/Vibration for Pulmonary Support The typical patient needing pulmonary support is vented, sedated, and unable to cough or deep breathe on their own. This may lead to additional complications, including higher risk for ARDS or pneumonia. Today’s ICU bed frames and/or...

The Continuing Challenge of Pediatric Obesity Pediatric obesity is a serious problem in the United States—with a growing number of children and adolescents considered overweight or obese. The Centers for Disease Control and Prevention (CDC) reports the following statistics for children...

Controlling Microclimate: the Weather on Your Patients' Skin A friend recently attended a conference in San Diego and sent along a photo of a local weather report which included a Microclimate Forecast.1 We shared a laugh by text, as San Diego seems like an odd place for such a complicated forecast...

COVID PTSD The COVID-19 pandemic has caused heightened levels of stress among healthcare workers—and now there is growing concern about the long-term psychological efects, including post-traumatic stress disorder (PTSD). Before COVID, about 22%...

Detecting Pressure Injuries in Non-Caucasian Skin One of the most challenging areas in pressure injury (PI) prevention and treatment is the detection of PIs among patients with non-Caucasian skin. Certified wound nurses often have extra training and experience in this area, but most staff...

Exploring the Unique Bed Frame Needs of Post-Acute Care Average lengths of stay at LTAC (long-term acute care) or inpatient rehab facilities could be 25 days or more, and LTC residents may live there many years. Patients and residents in post-acute settings are often older, sicker, and have more...

Infection Control and Prevention through Fabric Technology In 2013, the U.S. Food and Drug Administration (FDA) warned about the infection control risks of damaged hospital mattress top covers.1 A 2018 study published in the New England Journal of Medicine noted that hospital-acquired infections...

More Hospitals Establishing Specialized Emergency Departments As many as one half of all hospital admissions begin in the emergency department (ED), and CDC data shows that visits by patients older than 65 increased by more than 25 percent between 2005 and 2015.1 The idea of specialty EDs emerged in...

Pediatric Pressure Injuries: Different Needs for Smaller Bodies The care and prevention of pressure injuries (PI) in adult patients is well researched—with best practices, tools, and resources readily available. But with childhood obesity rates now at 19% and pre-term babies at high-risk for PI, there...

Preventing a Challenging Side Effect of Pediatric ECMO A highly-specialized life-support tool. A modified, long-term heart-lung bypass machine. A hopeful last chance. These all describe ECMO (extracorporeal membrane oxygenation). Simply put, physicians turn to ECMO when all other...

Proning Patients as a COVID-19 Treatment In the early weeks of COVID-19—before fully understanding the illness’s complexities and nuance—prone positioning became a clear treatment preference among ICU and COVID unit caregiver teams. But doing it correctly, without risk...

Redefining Support Surface Terms and Definitions The Support Surface Standards Initiative (S3I) is the official industry standards body within the National Pressure Ulcer Advisory Panel (NPUAP). S3I develops terminology, test methods, and reporting standards for medical support surfaces...

Restraints Then and Now: How Viewpoints and Policies Have Changed The debate over restraints in patient care goes as far back as the 1840s, when British Parliament established a commission to abolish restraint usage. Meanwhile, American mental health professionals used restraints as normal...

RNs/PTs in the ICU In the ICU, nurses and physical therapists (PTs) quickly learn the stark diferences not only in their patient care priorities, but also in the ways they communicate. Of course, they always share at least one thing in common: a mutual goal of getting...

Understanding and Preventing Bed Rail Entrapment Entrapment is defined as an occurrence involving a patient who is caught, trapped, or entangled in a hospital bed system. Since 1997, the U.S. Food and Drug Administration (FDA) has published and updated its guidance to reduce...

Understanding When a Foam Mattress Alone Isn’t Enough When it comes to pressure injuries (PI), prevention is key. The right foam support surface—including convertible mattresses with added therapies—can make all the difference. Unfortunately, there is no agreement among clinicians, researchers...

The Unique Skin Challenges of COVID-19 Positive Patients The National Pressure Injury Advisory Panel (NPIAP) recently released a position statement on the effects of COVID-19 on the skin, which appears to create a perfect storm for unavoidable pressure injuries (PI) in the critically ill patient. This...

Automated vs. Manual Proning of Patients with ARDS The possible benefits of prone positioning, or “proning”, were first researched in 1974 in studies on the effects of sedation and paralysis on the diaphragm. The hypothesis was that patients in a prone position would exhibit a better expansion...

Avoiding Skin Breakdown During CLRT The development of nosocomial pneumonia in intensive care unit (ICU) patients is one of the most important safety issues in critical care. Continuous lateral rotation therapy (CLRT) is often used to rescue the lungs, but the shearing effects can...

Bariatric Sensitivity Training: Providing Dignified Care to All Patients More than 77.6 million adults in the US suffer from obesity, and as many as 112,000 deaths are associated with the disease. Coupled with this health crisis is the fact that weight bias remains very socially acceptable in North America culture...

The Importance of Early Mobility Historically, ICU patients were thought to be in too much pain or too sick to be awakened while on mechanical ventilation. As a result, immobile patients were not moved by the healthcare team. It was common for patients to remain...

Preventing PIs in the Acute Burn Population: The Role of Low Air Loss A review of recent burn care text outlines the risk of complications for patients in the acute phase as well as rehabilitation. While risks include seemingly more critical issues such as permanent disfigurement, disability and serial surgeries...

SPHM: Dynamic Approaches to Practice Patterns In 2014, more than 11,000 registered nurses (RNs) suffered injuries while assisting patients and performing their jobs. Every day, nurses and other caregivers suffer debilitating pain and often career-ending musculoskeletal disorders due to...

Suicide in the Emergency Department In 2015, more than 44,000 people took their own lives, making suicide the tenth leading cause of death in the U.S. It was the second leading cause of death among individuals aged 15-34. There were more than twice as many suicides (44,193)...

Surfaces Accross the Continuum of Care Choosing the right therapeutic support surface for a patient at risk for pressure injury (PI) is an area where consistency must be maintained across the patient care continuum. The prevalence of hospital- (or facility) acquired pressure...

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