WHY YOUR HOSPITAL BED MATTRESS LEAVES YOU IN A HOLE
I am often asked the question, "Why do I always end up in a hole in my hospital bed"? Not only is this uncomfortable and makes it much harder to reposition, but sinking into a hole in the mattress puts people at greater risk of pressure injuries, AKA Bed Sores.
This article explores how a hospital bed mattress can contribute to sinking and what you can do to help prevent it.
FOAM
1. Mattress Material & Design Issues
- Soft or Worn-Out Foam Mattresses – Over time, foam mattresses lose their firmness, resiliency, and ability to support body weight. This leads to excessive sinking and body impression.
- Memory Foam Compression – There are many densities of heat-activated memory foam. Some memory foam mattresses contour too much to the body, causing the patient to sink deeply.
- Low-Density Foam – Mattresses made with lower-quality foam may not provide adequate support, especially for heavier patients. Higher-quality foams are more resilient to repeated compression cycles, are more durable, last longer, and don't sag or leave a body impression.
- Low-Quality Foam Mattress Construction - Single-layer foam mattresses are not generally considered high-quality or as supportive and tend to sag more than high-quality multi-layer foam mattresses. The individual layers offer more support and comfort and are more resistant to sagging or body impression
ALTERNATING PRESSURE
2. Alternating Pressure Air Mattress Malfunctions
- Air Leak – Alternating pressure low-air-loss mattresses may deflate due to a leak, causing the patient to sink. Leaks can occur from a damaged bladder, hosing, or CPR valve.
High-quality alternating pressure systems use durable bladder material or self-sealing TPU.
- Obstruction of Air - The hosing in a lower quality system is easily kinked. A kink can obstruct air flow to the air chambers causing a person to sink. High-quality systems offer non-kinkable hosing.
- Weak, worn, or damaged pump - Over time the pump's output will naturally diminish. Dirt, dust, and especially cigarette smoke will greatly diminish air output to the point that the mattress will not support the patient.
- Power Failure – If the air pump loses power, the mattress will gradually deflate.
- Natural sinking due to body weight distribution or position - This can occur on almost all alternating pressure mattress systems. High-quality mattress systems offer an Automatic Fowler Function to help compensate and prevent sinking. Systems such as the Adapt Pro Elite offer this essential function.
GEL
3. Gel Mattress Issues
-Gel Migration – The Gel within Gel mattresses can be displaced with pressure. This causes the gel to migrate away from the body causing the patient to sink into a resulting hole. Semi-solid gels such as Gel-Flex found in the Prevent Elite by Blue Chip Medical do not migrate.
- Gel Bladder Leakage - Inside a gel mattress is a bladder filled with fluidized gel. The gel bladders are welded shut; however, on lesser-quality imported gel mattresses the welding often separates, causing the gel to leak inside the mattress.
MATTRESS OVERLAY
4. Mattress Overlays
- Substrate - Mattress overlays lay on top of an existing mattress. If the mattress is not in good shape and has a sag, the topper may conform to the sag or body impression, and the person will still be in a hole. The mattress overlay may help lessen the sagging but ultimately the overlay is only as good as the mattress.
- Alternating Pressure Pads (APP) - These pads can be excellent for adding alternating pressure to an existing new or properly functioning mattress. APP's should not be used on worn or sagging mattress systems as they will simply conform to the dip in the underlying mattress.
BED FRAME
5. Spring-Based Hospital Bed Frames.
A hospital bed frame plays a crucial role in supporting your body and maintaining your position. All hospital bed frames are acceptable for use with hospital mattresses, however, as the springs in a spring-based hospital bed frame lose tension, they sag. Furthermore, a position in bed can contribute greatly to sagging.
WEIGHT RATING OF THE MATTRESS
Even if the person's weight is under the weight capacity of the mattress, a person's body size and shape must be taken into consideration. NOTE: Both weight and body shape (where a person carries their weight) must be considered to determine if the mattress is appropriate. Body weight concentration of a 5', 250 lb person is much different than a 6', 250 lb person. Body weight concentration of a person that is either top, bottom, or stomach heavy can contribute to sinking to the mattress surface.
WHAT YOU CAN DO
- For all type of mattresses, ensure the weight rating of the mattress is appropriate to the patient weight.
- Take into consideration the patient's body shape and weight distribution.
FOAM
- Purchase a high-quality multi-layer foam mattress
- Replace old or worn mattresses that no longer provide support
- Replace a mattress that shows a lasting body impression on the surface.
GEL
- Knead the surface often to redistribute/smooth the gel removing body impression
- Purchase a gel mattress with a semi-solid gel such as Gel-Flex
ALTERNATING PRESSURE
- Check for leaks in the bladder and hoses. Repair or replace as needed
- Check the CPR valve for air loss. Repair as needed
- If there are no leaks in the bladders or hoses, the pump's output may be weakening. Repair or Replace
- Purchase a mattress with an Automatic Fowler Function
- Purchase a Uninterrupted Power Supply (UPS) to keep the mattress running and protect against air loss in a power failure
MATTRESS OVERLAY
- Do not use on a worn mattress
- Do not use on a mattress that shows a body impression
- Purchase a high-quality foam or foam/gel overlay
BED FRAME
- Ensure the frame is in good shape and does not sag with weight.
- Replace worn-out or damaged springs.
- Place additional support boards over the springs to minimize or eliminate sagging. This must be done in sections to allow full-range of motion in the frame.