Waffle mattress over ICU bed?

[Szbeylik]

Hello All,

I need advice. At my previous employer, it was standard procedure to remove waffle mattresses from under the patient as soon as they arrived and were placed to the alternating pressure ICU bed. Which makes sense, as the waffle mattress nullifies the benefits and features of an expensive high functioning bed.

At my new employment however, people religiously place a waffle mattress over ICU beds and swear by it being better for the patients because the ICU beds are "too hard". I tried to explain this to someone who nearly wrote an incident report on me for not using a waffle mattress on a patient with advanced Multiple Sclerosis, who was already in the alternating pressure ICU bed. I work in a rural hospital where the latest trends in evidence based practice are not always readily available and implemented, so I'd like some feedback to see what others do in other hospitals...

Thanks for for your time!

[Okami_CCRN, BSN, RN]

Our current standard of practice is to have the least amount of linens/apparatus on the bed as possible as it takes away from the pressure changes/air flow to the patient.

This is a pretty good review of literature regarding bed surfaces for patients

Identifying the Right Surface for the Right Patient at the R... : Journal of Wound Ostomy & Continence Nursing

I would also recommend speaking with a WOCN regarding what is appropriate for a patient based on their condition. Many times the ICU bed is more than enough (we use a Hill-Rom Total Care Sport bed)

[MunoRN, RN]

Unless the mattress and bed and truly ancient, you definitely shouldn't be using a waffle mattress over an ICU bed, since that negates most of what the bed is doing to protect their skin. They should have a bed rep from their supplier they can ask about this, or a wound care nurse will usually set them straight if there are any on staff.