Cost-effective management of pressure-relieving equipment in a large teaching trust

A pressure area care equipment service was initiated in a large teaching trust (approximately 1000 beds). A stock of over 200 mattress overlays and replacements was purchased and a mattress coordinator was appointed. The coordinator supplies and retrieves pressure-relieving equipment to and from wards, monitors the equipment daily when in use and records all occurrences of malfunction and mismanagement. Out of hours, mattress provision is the responsibility of the night nursing service. Equipment purchase is guided by interpretation of published controlled trials and the Trust's internal data on equipment reliability. Maintenance support is provided on-site by a half full-time equivalent medical technical officer. This approach was associated with a reduction in cost to the Trust and a consistent reduction in pressure ulcer incidence in those areas of the Trust which use it (not in those who do not). The cost of approximately 157,000 Pounds per annum compares favourably with expenditures reported in the past for some other (generally smaller) trusts of the order of 500,000 Pounds to 900,000 Pounds for rental of pressure-relieving equipment alone.