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Mattress Management: Making a Difference in Financial and Clinical Outcomes Mary Oberg, MN, RN, CCM, CHTP , ARNP, Shawnee Mission Medical Center, Shawnee Mission, KS and Nancy Vaughan, MSN, RN, CWCN, Curative Health Service, Shawnee Mission, KS Escalating costs for bed rental, age of current hospital mattresses and increasing incidence of hospitalized acquired pressure ulcers were the catalyst for creating an interdisciplinary approach to mattress management at a large Midwest hospital. An interdisciplinary group was formed to examine current mattress usage and management. The group recommended numerous strategies that were implemented including replacement of mattresses, development of bed selection guidelines for high-risk patients and rental ordering processes were changed. Two hundred replacement mattresses were purchased. Purchase decisions were based on data collected related to the stage of pressure ulcer to be treated, patient comfort, cost, nurse perceptions, and ease of working with vendors. A new "Care of the patient with wounds" protocol was developed which included a Bed/Mattress Selection Grid for selecting rental beds for stage 3-4 pressure ulcers. Bed ordering was changed from a decentralized to centralized process. The results of these actions were significant. The pressure ulcer incidence study was repeated and the incidence decreased from 4% to 1% the following year. Expenditures for rental mattresses decreased 52.75% ($45,198 to $21,359). Consequently, mattress management has resulted in very positive financial and patient outcomes.

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