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Expert spotlight: Alleviate the pressure of your facility’s mattress purchase

Nurse Leader Weekly, January 12, 2009

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This week, expert Karen S. Clay, RN, BSN, CWCN, defines the characteristics of pressure-reducing mattresses to help you make an educated purchase.

Q: My facility is planning on purchasing static pressure-reducing mattresses. Do you have any recommendations on what to look for?

A: Most hospitals have replaced, or are in the process of replacing, standard mattresses with static pressure-reducing mattresses, usually made of high-density foam. But not all mattresses are created equal. Hospitals spend thousands of dollars each year to purchase foam-replacement mattresses, and too often decisions are made based exclusively on cost comparison. Instead, decisions should be based on knowledge of the characteristics of foam in the context of effective pressure reduction. When purchasing mattresses, ask about base height, density, indentation load deflection (ILD), and contours, defined as follows:

• Base height measures foam from its base to where the convolution begins-not the peak of the convolution. The base height should generally be 4 inches.
• Density, the weight per cubic foot, measures the amount of foam in the product and reflects its ability to support the patient's weight. Recommended density is 1.3-1.6 pounds per cubic foot.
• ILD measures the firmness of foam and is determined by the number of pounds needed to indent it to a depth of 25% of the thickness with a circular plate (e.g., in the case of a 4-inch foam mattress, ILD would measure the number of pounds needed to make a 1-inch indentation). ILD indicates the ability of the foam to distribute the mechanical load. The goal is to have a low ILD (an ILD of approximately 30 pounds is recommended).
• ILD ratio, recommended to be 2.5 or greater, reflects the relationship between conformability and support. A relationship of 60% ILD: 25% ILD is needed (e.g., if 30 pounds makes a 1-inch depression, then at least 75 pounds would be needed to make a 2.4-inch depression in the same foam).
• Contour is the surface of the foam, which may be in either slashed, smoothed, or egg-crate design.

Editor's note: Do you have a question for our experts? Email your queries to editor Keri Mucci at kmucci@hcpro.com and see your name in print next week! In the meantime, head over to our Web site and view a growing collection of advice from our experts.

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