Apollo Dynamic Mattress Clinical Evaluation Large scale patient study on the appropriate use of Apollo dynamic mattress system and the impact of a ‘step down’ discharge decision tree on clinical practice. Authors: Linda Kemp-Sheridan, Tissue Viability CNS. MSc, PGCert Ed, NMP, BSc (Hons), RGN Sarah Westcott, RGN RSCN Product Support Specialist Drive DeVilbiss Healthcare Ltd
Introduction The Hillingdon Hospitals NHS Foundation Trust provides services from both Hillingdon Hospital and Mount Vernon Hospital. The Trust has a turnover of around £222million employs over 3,300 staff. They deliver healthcare to the residents of the London Borough of Hillingdon, and increasingly to those living in the surrounding areas of Ealing, Harrow, Buckinghamshire and Hertfordshire, giving them a total catchment population of over 350,000 people. In line with the Trust Quality and Safety Improvement Strategy 20162021 to reduce the number of hospital acquired pressure ulcers through improved education and appropriate utilisation of specialist equipment, a programme of education was developed and the dynamic system Apollo by Drive DeVilbiss Healthcare was chosen in 2016 as the pressure relieving mattress of choice across the Trust sites. Greater demands are being placed on healthcare organisations to implement cost effective strategies for pressure ulcer prevention and it is important to understand which types of patients can benefit from different types of support surfaces1. Pressure ulcer prevention is therefore a high priority for patients admitted to hospital who are particularly vulnerable. Not only have the majority of patients sustained a fracture following a fall but many are elderly, have multiple comorbidities and many have a diagnosis of dementia. All of these factors increase the risk of pressure ulcer development2. The aim of pressure ulcer prevention strategies is to reduce either the magnitude or duration of pressure between the patient and his or her support surface or both3. Stepping down from dynamic mattresses onto static foam mattresses was not routine practice because of the patients’ sustained level of risk. A step down decision tree was implemented to encourage and provide clarity on support surface decision prior to discharge. The Tissue Viability Nurse Linda Kemp-Sheridan developed and introduced the ‘step down decision tree’ protocol to be implemented 48 hours prior to discharge with the aim of enhancing the patients longer term experience of support surface selection in the community setting4. The Apollo mattress system from Drive DeVilbiss Healthcare is a powered dynamic mattress that has additional manual comfort control settings to allow adjustment of internal cell pressures resulting in optimum pressure redistribution. The mattress has a 2:1 cycle of 10 minutes which provides pressure relief to the tissue by provide cyclic loading to the skin, so that each area of skin experiences pressure only intermittently. The Apollo alternating dynamic system features zoning with narrower cells in the heel section and this study aimed to identify pressure ulcer to heel outcomes in order to measure the effectiveness of this mattress feature in an acute setting.