Evid Based Nurs 10:23 doi:10.1136/ebn.10.1.23
  • Economics

Alternating pressure mattresses were more cost effective than alternating pressure overlays for preventing pressure ulcers

 Q What is the relative cost effectiveness of alternating pressure mattresses and alternating pressure overlays for preventing pressure ulcers in hospital patients with limited mobility?



randomised controlled trial (RCT).


10 hospitals in the UK.


1972 patients ⩾55 years of age (mean age 75 y, 64% women) admitted to vascular, orthopaedic, medical, or elderly care wards in the previous 24 hours, with an expected hospital stay of ⩾7 days and limited activity and mobility (Braden scores of 1 or 2) or existing grade 2 pressure ulcer. Elective surgical patients were included if they were expected to have limited mobility for ⩾3 days postoperatively. Exclusion criteria included ⩾ grade 3 pressure ulcer, planned admission to intensive care ward after surgery, sleeping at night in a chair, and weight <45 kg or >140 kg.


alternating pressure overlay (n = 990) or alternating pressure mattress (n = 982) for duration of ward stay or until mobility improved to a Braden score of 3 or 4.


pressure ulcer free days (time to development of a new pressure ulcer ⩾ grade 2), length of hospital stay, hospital costs.


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