Support surfaces play a critical role in healthcare, influencing patient health outcomes and hospital finances. Yet, these surfaces are often an underestimated source of risk within facilities. A Cambridge University Press study of beds and mattresses in four U.S. hospitals uncovered that support surface damage is more widespread than previously recognized. Some facilities reported damage rates exceeding 70%. This raises concerns about patient safety as hospitals continue using outdated, compromised surfaces.
Neglecting support surfaces can lead to patient complications, including healthcare-associated infections (HAIs). According to the CDC, 1 in 31 patients will get an HAI, with an estimated 75,000 deaths each year. The most common HAIs are pneumonia, central line-associated bloodstream infections, catheter-associated urinary tract infections and surgical site infections. Not only do these conditions contribute to larger health risks, but they also carry a significant financial burden; the estimated cost of treating HAIs in the United States is $28 billion to $33 billion annually. The potential patient and financial risks tied to these issues underscore the importance of maintaining and replacing worn surfaces. Addressing surface damage quickly can also improve patient comfort and overall satisfaction of their healthcare experience.
Hospitals face mounting pressure to improve patient safety and manage expenses. Investing in innovative support surfaces manufactured with advanced materials is no longer an option, but a necessity.
The Impact of Innovative Materials
Support surface materials must balance a variety of needs, including durability, patient comfort and infection prevention. Traditional top cover materials often degrade with use and exposure to harsh disinfectants, causing cracks and tears and removing the waterproofing of the material. This damage can lead to fluid ingress, compromising internal surface components and creating a breeding ground for harmful bacteria. Patients may also be unknowingly resting on others’ bodily fluids, increasing the risk of HAIs and pressure injuries. Studies show 50% of acute care support surfaces are compromised within 3.8 years—well before their expected five or greater year lifespan.
Investing in advanced support surfaces that integrate technology can minimize risk of damage, reduce the frequency of full-surface replacements and improve patient safety. An example of such technology is microclimate management to help increase thermal control, breathability and evaporative capacity for patient comfort and pressure injury prevention. Another advancement is vertical cell technology within air cells, to maximize immersion and envelopment, which distributes pressure more evenly across the patient’s body for pressure injury prevention. Also, utilizing highly durable, chemically resistant materials can help top covers withstand repeated exposure to strong cleaning agents, minimizing the risk of cross-contamination leading to HAIs.
Built to Last
In addition to material innovation, advanced construction techniques can help support surfaces last longer. Beyond the importance of top cover construction, innovation can extend to the secondary barriers beneath it. These barriers provide a medical-grade, breathable and stretchable film to protect internal components and ensure continued durability and performance, even if the outer layer sustains damage. Rather than relying on a single layer of protection, an additional barrier serves to further ensure fluids do not contaminate the inner core of the support surface.
Traditional surfaces have sewn seams, punching thousands of holes into the fabric. These perforations let fluids seep in, leading to contamination, compromised structural integrity and reduced longevity. In contrast, advanced construction uses Radio Frequency-welded seams, joining fabrics with a stronger bond without holes. By minimizing microbial infiltration, the entry points for moisture, bacteria and other contaminants are virtually non-existent.
The Cost of Compromised Surfaces
Hospitals that fail to proactively manage surface integrity face financial and clinical consequences. A recent study found hospitals using traditional, outdated support surfaces saw replacement rates as high as 74% within five years, compared to a 0% full-replacement rate for facilities using advanced surfaces. The significant financial burden of these replacements, combined with the increased cost of treating HAIs and pressure injuries, highlights the need for innovation.
On average, the cost of replacing a support surface is nearly $1,500, while replacing just a top cover on a support surface is approximately $200. To put this in perspective, a 400-bed hospital using outdated surfaces could spend over $400,000 in unit replacement costs over five years. By switching to innovative materials and construction, that cost can drop to $13,600 by only replacing damaged top covers. The return on investment of innovative support surfaces should be a top consideration when healthcare facilities evaluate their equipment.
Looking Ahead: The Future of Support Surface Innovation
As the healthcare industry evolves, so must the equipment and materials used. Healthcare facilities need to look beyond initial purchase costs and consider the long-term benefits of investing in innovative support surfaces. Selecting surfaces based on durability can lead to increased patient safety and surface lifespan. With technology innovations such as highly chemically resistant top cover fabrics, secondary barriers, and RF-welded seams, support surfaces can withstand the daily demands of patient care, but more importantly, better protect patients from harm.
About Kristen Thurman, PT, MPT, CWS
Kristen is a master’s-prepared physical therapist and a certified wound specialist through the American Board of Wound Management. She is currently the Vice President of Product Management and Clinical Affairs for Agiliti. Kristen is a current Panel Member and past board liaison, of the National Pressure Injury Advisory Panel (NPIAP) as well as the Chair of the Support Surface Standards Initiative (S3I) Committee. Kristen has presented at national and international conferences and is published in the areas of wound care, support surfaces and pressure injury prevention.
