Continuous bedside pressure mapping technology fails to prevent bed sores in acute settings

Continuous bedside pressure mapping technology proves effective in reducing interface pressures and preventing pressure injuries, according to a recent randomized clinical trial. The study published in JAMA Open Network evaluates the efficacy of this technology in minimizing interface pressure and the incidence of pressure injuries.

The clinical trial conducted by Chester Ho and colleagues at the University Of Calgary, Canada at a tertiary acute care center aimed to assess the effectiveness of continuous bedside pressure mapping (CBPM) technology in reducing interface pressure and the incidence of pressure injuries (PIs).The study, which took place from December 2014 to May 2018, utilized a parallel, 2-group randomized design.

The participants included adults who were partially or completely dependent on bed mobility. Statistical analysis of the data was conducted from September 2018 to December 2022.During the trial, the nursing staff utilized visual feedback from CBPM technology for a duration of 72 hours. The main outcomes and measures examined were the absolute number of sensing points with pressure readings exceeding 40 mm Hg, the mean interface pressure across all sensing points under the patient's body, the proportion of participants with pressure readings greater than 40 mm Hg, and pressure-related skin and soft tissue changes.

The findings of the study were:

● Out of the total 678 patients initially recruited for the study, a final analysis was performed on 260 participants assigned to the control group and 247 participants in the intervention group.

● In the control group, 151 (58.1%) were male, with a mean age of 61.9 years and a standard deviation (SD) of 18.5.

● The intervention group comprised 147 (59.5%) male participants, with a mean age of 63.6 years and an SD of 18.1.

● When comparing the two groups, it was found that the absolute number of sensing points with pressures exceeding 40 mm Hg was 11,033 in the control group, while in the intervention group, it was 9,314.

● This difference was not statistically significant (P = .16). In terms of mean interface pressure, the control group had a value of 6.80 mm Hg (SD: 1.63), whereas the intervention group had a slightly lower mean of 6.62 mm Hg (SD: 1.51).

● This difference was also not statistically significant (P = .18).

● The proportion of participants with pressure readings greater than 40 mm Hg was found to be the same in both the control and intervention groups, with a value of 99.6%.

These findings indicate that there were no significant differences between the control and intervention groups regarding the absolute number of sensing points with excessive pressure, mean interface pressure, or the proportion of participants with pressure readings above the threshold. It suggests that the use of continuous bedside pressure mapping technology did not result in substantial improvements in these outcome measures compared to the control group. Further research and interventions may be required to identify more effective strategies for reducing interface pressures and preventing pressure injuries in clinical settings.

Reference:

Ho, C., Ocampo, W., Southern, D. A., Sola, D., Baylis, B., Conly, J. M., Hogan, D. B., Kaufman, J., Stelfox, H. T., & Ghali, W. A. (2023). Effect of a continuous bedside pressure mapping system for reducing interface pressures: A randomized clinical trial. JAMA Network Open, 6(6), e2316480. https://doi.org/10.1001/jamanetworkopen.2023.16480