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Visco MultiZone Evaluation Case Series

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Visco MultiZone Evaluation Case Series

Danielle Longthorn, Home Manager and Allyson Sanderson, Regional Senior Nurse, HC-One Care Homes

 

Background

The Harvest Healthcare Visco MultiZone mattress is an enhanced static mattress comprising varying density visco-elastic memory foam “Zones” across key areas of the mattress. The zones allow for higher levels of pressure relief around the sacral and feet areas whilst providing firmer support to the head, back and behind the knee, ensuring superior pressure redistribution across the entire body. The Visco MultiZone mattress is complete with a vapour-permeable, four-way stretch, water-resistant cover, which is machine washable up to 95 ºC. Suitable for very high-risk residents weighing up to 27 Stone (177 kg) and with pressure ulcers up to a category 2.

Method

A five-resident evaluation of the Visco MultiZone was commenced across four nursing units within the HC-One care homes. Prior to the evaluation, all five residents were on alternative castellated, very high-risk memory foam mattresses. Residents had an initial clinical assessment, mid-point assessment at five weeks and the final assessment at ten weeks when the trial was completed.

Data collected included age, sex, past medical history, skin condition, continence status, weight, BMI and mobility. Using the Waterlow tool, the risk of pressure ulcer development was determined to ensure the suitability of the Visco MultiZone and a dependency score was assigned to each resident, with 1 being low and 4 very high.

Initial Assessment

Resident 1

A 92-year-old female with a history of Type II Diabetes, Hypertension, Atrial Fibrillation, Heart Failure and Vascular Dementia. There was the presence of introguinous dermatitis under the right breast, but otherwise, the skin was healthy and intact, with no history of pressure damage. She was taking a normal diet and fluids, weight 51.2kg, BMI 22.1 and a Waterlow score of 22. She was fully mobile and repositioned herself independently but tended to sit for long periods of time. She was continent with a dependency score of 3.

Resident 2

A 96-year-old female with a history of Hypertension, Chronic Kidney Disease, Osteoarthritis, and considered frail with previous falls and a fractured neck of femur. There were skin tears to both the right and left legs, but the skin was otherwise healthy and intact, with no history of pressure damage. She was taking a normal diet and fluids, weight 47.5kg, BMI 20 and a Waterlow score of 19. The resident was immobile, being transferred with a hoist and repositioned 4 hourly. She was continent but presented with a UTI at the initial assessment and a dependency score of 3. She was using a memory foam pressure-relieving cushion in conjunction with the Visco Multizone.

Resident 3

A 92-year-old male with a history of Dementia, Epilepsy, Rheumatoid Arthritis and considered frail. His skin presented as dry and was treated with Hydromol, but otherwise intact, with no history of pressure damage. He was taking a normal diet and fluids, weight 59.15kg, BMI 19 and a Waterlow score of 20. He was independently mobile but tended to sit for long periods of time and declined the use of a pressure-relieving cushion. He was continent and had a dependency score of 1.

Resident 4

An 88-year-old male with a history of Spinal Stroke, Vascular Dementia, previous falls and considered frail. Presented with dry skin, which was being managed with derma cream, and bruises were visible on the left hip and right arm due to a recent fall. No history of pressure damage. He was taking a normal diet and fluids, weight 51.25kg, BMI 22 and a Waterlow score of 18. He was mobile but tended to lie in bed most of the day, continent and a dependency score of 4.

Resident 5

A 65-year-old male with a history of Chronic Obstructive Pulmonary Disorder, Tuberculosis, Bronchiectasis and Type II Diabetes. His skin presented as dry and was treated with Zerobase, but otherwise intact, with no history of pressure damage. He was taking a normal diet and fluids, weight 45.2kg, BMI 19 and a Waterlow score of 18. He was independently mobile and continent and had a dependency score of 2. He was using a memory foam pressure-relieving cushion in conjunction with the Visco MultiZone.

Mid-Point Assessment (Week 5)

A five-resident evaluation of the Visco MultiZone was commenced across four nursing units within the HC-One care homes. Prior to the evaluation, all five residents were on alternative castellated, very high-risk memory foam mattresses. Residents had an initial clinical assessment, mid-point assessment at five weeks and the final assessment at ten weeks when the trial was completed.

Data collected included age, sex, past medical history, skin condition, continence status, weight, BMI and mobility. Using the Waterlow tool, the risk of pressure ulcer development was determined to ensure the suitability of the Visco MultiZone and a dependency score was assigned to each resident, with 1 being low and 4 very high.

Final Assessment (Week 10)

The final assessment was performed at week ten. Resident 1 had been admitted to the hospital during the period since the mid-point assessment following a fall, which left red marks on her back; these were still present. Her BMI had reduced to 20.7, and Waterlow increased to 23, but the MultiZone continued to be a suitable support surface. Resident 3 had also sustained injuries to his back following a fall. However, these were healed before the final assessment. There were no other clinical changes to note at the end of the evaluation. Clinicians reported the mattress with the performance of the MultiZone mattress and found it easy to clean and compliant with organisation infection prevention and control policies.

Resident feedback was overall good. Three residents provided favourable comments, such as “It was good, comfortable,” “It was comfortable,” and “I’m sleeping well.” One resident mentioned that she “did not like it,” though this was also her opinion regarding the previous mattress. Another resident was unable to comment; however, clinicians observed that she appeared comfortable, with no changes noted in her sleeping pattern.

Conclusion

Even though it was a small cohort of residents, the trial was considered a success due to the data presented in this case study. Both resident and clinician feedback has been positive, with mattress comfort and resident sleep quality highlighted. The Harvest Healthcare Visco MultiZone has now replaced the alternative castellated, very high-risk memory foam mattresses across the HC-One care homes with guidance information developed by Harvest Healthcare for the organisation.

Harvest Healthcare will continue to collect clinician and resident feedback to ensure the MultiZone continues to perform effectively and to support new product development in the future.

 

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Balmoral Mattress / Harvest 2 Pump

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Balmoral Mattress Post-Market Clinical Performance Review

 

1.0 Background

Harvest supplies pressure-reducing mattresses (static and dynamic) to the health and social care sector within the UK. The company is committed to ensuring that the equipment it manufactures is subjected to post-market clinical follow-up (PMCF). Audits undertaken within the care provision sectors have sought to establish how the equipment functions in the real-world setting compared to laboratory/on-site testing. This document provides results and findings from audits undertaken between August and December 2022 in the Care Home Sector where the Balmoral Active Mattress is in use and has been compiled by an Independent Nurse Advisor / Educator on behalf of Harvest Health Care.

2.0 Findings

Data is provided for 82 residents in 11 independent care homes, however, it should be noted that not all data elements are available for all 82 residents due to the complexities of collecting audit data within the care home environment.

2.1 Age, Waterlow Score, and Weight

The age of the resident was available for 67 of the residents for whom audit data was available. The average age of residents nursed on the Harvest Balmoral mattress was 78 years, with the oldest resident at 103 years and the youngest resident was 39 years old. Waterlow scores for those who were managed on the Balmoral mattress ranged from WS 7 (not at risk) to WS42 (Very High Risk), with the average Waterlow score being 21 (Very High Risk). For the Waterlow data set, data was available for 78 of the 82 residents included in the audits. Weight ranges of those using the Balmoral mattress ranged from 38kg to 114.7 kg with an average weight of 63.3kg. Those with a weight of 38kg would usually be deemed to be extremely frail, and those with a weight of > 100kg in such an elderly population are likely to have high BMI and are most likely to be overweight or obese.

Figure 1 – Descriptive statistics for Age, Waterlow and Weight

2.2 Resident Mobility and Comorbidities

The audits undertaken by the independent clinical advisor also reviewed the mobility levels and comorbidities for each resident who was using the Harvest Balmoral. Findings are shown in Figures 1 and 2. Figure 1 shows that 92% of residents who were nursed on the Balmoral mattress had either poor mobility (required hoist or wheelchair, but were able to make some independent movements in bed) or were completely immobile (reliant on staff for all repositioning), with the remaining 8% able to mobilise with some assistance. The most common comorbidities (Figure 2) for those residents who were nursed on the Balmoral mattress, included (a) a history of Cerebral Vascular Accident (CVA 20%), (b) Dementia and/ or cognitive impairment (38%) and (c) Diabetes (33%).

Fig 1                                                               Fig 2

2.3 Development of Pressure Ulcers

In total, during the audit period there were 8 residents who were being nursed on the Balmoral pressure mattress who had existing pressure ulcers.

• One resident had developed a category 2 pressure ulcer to their elbow, but the care home staff believed that this had developed due to the resident leaning on the chair and was therefore not associated with use of the mattress.

• Another resident had 2 category 2 pressure ulcers to their heels, but these had developed due to direct contact between the resident’s heels and a specialist chair footplate, so again this was not deemed to be associated with use of the Harvest Balmoral mattress.

• A further 6 residents with pressure ulcers; Category II (1 resident); Category III (2 residents) and Category IV (2 residents) had been admitted to the care home with pressure ulcers and were being nursed on the Harvest Balmoral mattress as part of a package of care to prevent further pressure ulcers and to expedite healing of these existing pressure ulcers. In all of these cases, the resident’s wounds were showing signs of ongoing improvement.

• Those with a history of pressure ulceration (3 residents) but were now ulcer free had healed whilst using the Balmoral mattress and had remained healed and ulcer free during their time using the mattress

3.0 Summary

Post-market clinical follow-up on the Harvest Balmoral Alternating Mattress was undertaken between August and December 2022 using an independent clinical advisor to undertake the audit and collate the data. A Total of 12 Independent Care Homes which used Harvest pressure-reducing mattresses were visited by the Independent Clinical Advisor (11 of these Care Homes had a total of 82 residents who were using the Balmoral alternating mattress) and a review of equipment in use within the care home was undertaken at each site. Whilst on site the Independent Nurse Advisor was provided with anonymised information for each of the residents to enable the collation of real-world PMCF performance data for the Harvest Balmoral Mattress.

Data collected so far suggests that the Harvest Balmoral Mattress performs well for prevention of pressure ulcers in the 24-hour care home provider environment for elderly residents (where regular repositioning and continuous support via carers is available), with low, medium or high weights, those who are at very high risk of pressure ulceration and those with comorbidities such as Diabetes, CVA and Dementia or Cognitive impairment.

It also suggests that the mattress performs well for those with pressure ulcers of Category II, III or IV and can also be used for those with a history of previous pressure ulceration to prevent further ulceration, although the numbers of residents where this was observed during the audit was small (n=3).

Harvest Healthcare aims to continue to collect this PMCF data via collaborative working with care home providers to increase the number of residents audited and to provide robust post-market clinical follow-up data.

Report compiled by:

N Morton
Independent Nurse Advisor / Educator
RGN, BSc Hons Nursing, MSc Wound Healing and Tissue Repair, PG Cert HE

04/01/2023

 

For more information please visit the Harvest Healthcare website

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