Exploring Continuous Pressure Monitoring to Inform Decisions for Pressure Injuries in the Community: Secondary Analysis Using a Mobility and Pressure Exposure Algorithm

ABSTRACT

Frailty in community-dwelling individuals often leads to prolonged periods in bed or sitting, increasing their risk of pressure injury development. The Quality Improvement project ‘Pressure Reduction through cOntinuous Monitoring In the community SEtting’ (PROMISE) implemented the use of continuous pressure monitoring (CPM) to inform interventions. A secondary analysis of PROMISE data involving 17 patients was examined before and after the intervention. A novel algorithm using duration and magnitude of pressure signatures at the buttock area was estimated from the CPM data and an algorithm based on the sigmoid relationship between pressure and time was used to categorise risk pre- to post-intervention. The CPM intervention helped inform changes in support surface, posture and mobility advice. Duration and magnitude of pressure signatures revealed a high degree of inter-subject variability. At baseline 35% of (6/17) patients spent prolonged periods with potentially harmful interface pressures (high to very high exposure). Trends of improvements post-PROMISE intervention were observed, with 24% (4/17) in these higher exposure categories. This study demonstrated how CPM could be used to inform interventions for individuals living with pressure injuries in the community. An algorithm was used to understand trends in posture, mobility, and pressure exposure, showing some improvement pre- to post-intervention.