Evaluating support surfaces for patients in transit through the accident and emergency department

Little attention has been given to pressure area care for patients admitted via the accident and emergency department (A & E) in UK hospitals, despite evidence that they may wait for considerable periods on hard surfaces, placing them at risk of tissue damage. The literature was searched, and in the absence of existing guidelines to evaluate the suitability of the standard hospital trolley for use with emergency admission patients, criteria were developed by consensus among stakeholders with relevant expertise who were employed in an acute NHS hospital trust. Audit of the existing patient support surfaces using these criteria revealed deficiencies in all of them. Some of the problems identified were related to deterioration of the equipment; others were related to its design. The criteria were used to inform the purchase of new equipment, and a system of auditing to improve pressure area care for emergency admission patients has been established in the trust. The initiative has also drawn attention to significant omissions in the literature relating to pressure area care, including the need to evaluate patient comfort and inclusion of consumer views.