Static Air Support Surfaces to Prevent Pressure Injuries: A Multicenter Cohort Study in Belgian Nursing Homes

J Wound Ostomy Continence Nurs. 2016 Jul-Aug;43(4):375-8. doi: 10.1097/WON.0000000000000244.


Purpose: The aim of this study was to investigate the incidence and risk factors for developing pressure injuries (PIs) in patients placed on a static air support surfaces: mattress overlay, heel wedge, and seat cushion.

Design: Multicenter cohort study.

Subjects and setting: The sample comprised 176 residents; their mean age was 87 (SD = 6.76) years; their mean Braden Scale score was 14 (SD = 2.54). The study was performed on a convenience sample of 6 nursing homes in Belgium.

Methods: Data were collected on 23 care units. The primary outcome measure, cumulative PI incidence (category [stage] II-IV) over a 30-day observation period, was calculated. Pressure injury occurrence was defined according to the 2014 European and US National Pressure Injury Advisory panels, Pan Pacific Pressure Injury Alliance classification system.

Results: The PI incidence for category (stage) II-IV was 5.1%. Six residents (3.4%) developed a category II PI, and 3 (1.7%) developed a category III PI; no category IV ulcers occurred. No significant risk factors for category II-IV PIs were identified using multivariate logistic regression. Time of sitting in a chair was found to be a risk factor for development of nonblanchable erythema (category I PI) (odds ratio = 21.608; 95% confidence interval [CI], 20.510-22.812; P = .013). The median time to develop a category II-IV PI was 16 days (interquartile range = 2-26). The interrater reliability between the observations of the researcher and nurses on-site was almost perfect (0.86; 95% CI, 0.81-0.91).

Conclusion: We found a low incidence of PIs when using a static air overlay mattress for patients at risk in a nursing home population. Static air support surfaces, alongside patient-tailored patient repositioning protocols, should be considered to prevent PIs in this patient population.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Air Movements*
  • Beds / standards*
  • Belgium
  • Cohort Studies
  • Equipment Design / standards
  • Female
  • Humans
  • Logistic Models
  • Male
  • Nursing Homes / standards
  • Nursing Homes / trends
  • Pressure Ulcer / prevention & control*
  • Risk Factors