Quantifying and Visualizing the Pressure Distribution of In-Bed Positions to Reduce Pressure Injury Risk.
Tim M N van Helden, Sarah L Versnel, Lisa Arkes and 3 others
PMID 41718025WHAT IT FOUND
Raising the head of bed increased sacral pressure, while raising the feet in a semi-Fowler position lowered peak pressure by about 20% on a pressure-redistributing mattress.
Nurses can use pressure maps to show that bed angle changes sacral pressure.
Key findings
01Peak pressure on the sacrum rose when the head of bed was raised and fell when the feet were also raised in a semi-Fowler position.
02On the mattress with adequate pressure redistribution, semi-Fowler positions reduced median pressure by 20% compared with the same head angle without leg elevation.
03Lateral rotation decreased sacral pressure but increased trochanter pressure, and the change was not consistent across participants.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study used healthy volunteers, not patients at risk for pressure injuries, so it does not show what happens in frail, immobile, or device-laden patients. It measured pressure only, not pressure injury occurrence, pain, tissue damage, or clinical outcomes. No bed linen or incontinence pads were used, although these can change how a mattress redistributes pressure. The participants were mostly young and lean, and body composition affected pressure. Individual posture and slouching could change pressure more than the bed setting, so average pressure maps may not predict one patient's peak pressure. The mattress with poor redistribution had air cushions that made side-lying results inconsistent.
Declared interests
The study was funded by Erasmus MC. The supplied text does not report a conflicts-of-interest statement.
The easy way to misread this
Do not conclude that these positions prevent pressure injuries. The study measured pressure in healthy volunteers, not patients, and did not report pressure injury outcomes. Also, the flat position had lower pressure than the semi-Fowler position on the mattress with adequate pressure redistribution, so semi-Fowler is mainly a way to reduce pressure when the head of bed must be raised.