Support surfaces are an integral part of any plan of care for the prevention and treatment of pressure ulcers. A wide array of surfaces, including overlays, mattresses and beds, are available in the United States. Having a variety of choices is clinically important, but choosing from the many alternatives is complicated by the lack of information about support surface characteristics and the inconsistent manner in which this information is reported. A means to measure and compare support surface characteristics will facilitate this process.
The medical model of support surface provision involves several parties including the patient, his/her health care practitioners, a vendor who sells the technology, and the manufacturer of the technology. All these parties will benefit from the development of support surface standards with the patient benefiting most directly. Clinicians are the patient’s primary source of information about support surfaces and they have an obligation to provide adequate information upon which to base an informed support surface selection. To date, much of the advice regarding products available from clinicians is anecdotal; it is a sum of their clinical experience and information garnered from manufacturers and vendors. The range of products on the market places a heavy burden on clinicians to keep abreast of new technology, so they would benefit from a mechanism to objectively match a support surface’s characteristics to the needs of their patients. Vendors would benefit from standards by being able to clearly describe products across manufacturers in a manner understood by clinicians and patients. Cushion testing standards would aid manufacturers by guiding new product development and redesign of existing products. Standards would provide a means of product comparison, thereby targeting gaps in market needs. In addition, standards will promote quality assurance within manufacturing processes.
There are tradeoffs to many support surface features, so the purpose of standards is not to evaluate which surface is better or worse, rather, standards will place characteristics along a continuum to allow people to determine an appropriate clinical match. Because no one support surface is best for all people, standards will help define performance and characteristics to make selection more informed.