Understanding the key factors required for hybrid mattresses: analysis of a focus group (the Somlent Serene Hybrid Mattress)

Background: This paper presents the results of one area of a tripartite study; laboratory testing; focus group and clinical case series investigating the use and effectiveness of the Somlent Serene Hybrid Mattress. The prevention and management of pressure ulcers (PUs) has long been a key indicator of quality of care and a major focus for health care providers, as the ageing population continues to grow there is an increased risk of skin damage to this vulnerable patient group (Fletcher et al, 2015). Similarly, the quality of care delivered by health care professionals and the National Health Service Trust (NHS) is being monitored through the incidence of PUs e.g data collected via the NHS Safety Thermometer (Cooper et al, 2015). Adequate reduction of excessive pressure and/or shearing forces is essential to enable sufficient tissue perfusion for the successful prevention or healing of PUs. The use of support surfaces, including high quality foams, hybrids and alternating pressure air mattresses (APAMs), are an effective strategy for relieving/redistributing pressure (Moore et al, 2014). Hybrid support surfaces are a more recent technology in comparison to foams and APAMs which are becoming increasingly accepted as an alternative treatment option. Innova Care Concepts have launched their new ‘active’ Hybrid mattress, the Somlent Serene. The aim of this study was to explore and investigate perceptions of the mattress and its application in the clinical setting. Method: A qualitative approach was implemented using a focus group design. Key opinion leaders were invited to participate (n=5); an academic, infection control specialist and tissue viability specialists. Ethical approval to undertake and publish results was successfully received prior to the focus group. To stimulate discussion participants were asked “what their initial thoughts of the mattress were?” Subsequent questions followed to promote discussion. All information was recorded, transcribed verbatim and data was analysed thematically. All participants were assured of confidentiality and anonymity. Results and discussion: All participants admired its simplicity, ease of use, quietness and design. The fact the foam does not lie on top of the air cells was highlighted as good practice as it potentially reduced pressure and/or shearing forces. Four key themes were identified; patient suitability, unit cost per system, importance of inter-professional working and promotion of cost effectiveness. Patient suitability for hybrids was highlighted as participants discussed potential confusion of clinicians who often found it difficult to decide when a hybrid should be the mattress of choice. The development of an evidence based flow chart that would assist clinicians to make an informed choice was recommended to allow for the matching of clinical need with the appropriate mattress available to prevent avoidable pressure damage. The second major theme emanating was that of unit cost per system. In an economic climate that demands cost effectiveness and saving of money, costs of hybrids can be more expensive than other systems. It was suggested that research and evidence supporting each system should comprise of clear patient outcomes including the effect of hybrids on skin (prevention and management of skin damage); cost effectiveness; ease of use for the clinician; comfort for the patient and infection prevention qualities of the system. The importance of inter-professional working with mattress development emerged as another key theme. This multi-disciplinary group of participants was intentionally selected as infection control and tissue viability specialists do not always work collaboratively. Significant aspects of the hybrid mattress were identified, for instance strategies for preventing infection control risk. An additional theme was promoting cost effectiveness of the hybrid mattress. Ensuring appropriate equipment use whilst providing high quality care was identified. Participants suggested inclusion of a unique bar code on the mattress, cover and pump emphasising this could potentially prevent mattresses being misplaced, inappropriate use and act as a tool for audits. Conclusion: The consensus was that there is a place for hybrid mattresses in preventing and managing pressure damage effectively. The importance of TV and infection prevention working collaboratively with industry to develop an effective product was identified. The development of a flowchart guideline, supported by high quality evidence, was recommended for all heath care areas to access and refer to thus ensuring correct choice of appropriate equipment. Mattress choices for use in clinical practice should be based on research evidence assessing benefit, harm and cost effectiveness. Further research, in a clinical and laboratory setting, investigating the use of this Somlent Serene Hybrid mattress is currently being conducted, and will be reported at a later date

Exploring Key Factors Required for Hybrid Systems: Analysis of a Focus Group

Background: There is a continued focus in healthcare that NHS Trusts must make cost savings while ensuring quality and productivity is not adversely affected. It is essential that health care professionals have access to pressure reduction/redistributing equipment that is evidence based and can promote skin integrity via adequate reduction of excessive pressures and/or shearing forces. This paper presents the results of a focus group exploring perceptions of a new hybrid mattress and its application to clinical practice. Hybrid systems are increasingly being used in clinical practice to assist in the prevention and management of pressure ulcers (PUs). Innova Care Concepts have launched a new hybrid system, The Solment Serene. Methods: A focus group design was used involving 5 Tissue Viability Key Opinion Leaders including an academic, infection control and tissue viability specialists. All data was recorded and transcribed verbatim, data generated was analyzed thematically. Confidentiality and anonymity was assured. Results: Four key themes were identified; (1) patient suitability, (2) Ease of Use and Effectiveness, (3) the importance of inter-professional working and (4) Loss of Equipment - Promotion of cost effectiveness Conclusions: The consensus was that there is a growing place for hybrid systems in preventing and managing pressure damage effectively. Health and social care should work inter-professionally to improve patient outcomes. The development of a flowchart based on scientific evidence was recommended to assist in the decision making of appropriate equipment

Exploring Key Factors Required for Hybrid Systems: Analysis of a Focus Group

Background: There is a continued focus in healthcare that NHS Trusts must make cost savings while ensuring quality and productivity is not adversely affected. It is essential that health care professionals have access to pressure reduction/redistributing equipment that is evidence based and can promote skin integrity via adequate reduction of excessive pressures and/or shearing forces. This paper presents the results of a focus group exploring perceptions of a new hybrid mattress and its application to clinical practice. Hybrid systems are increasingly being used in clinical practice to assist in the prevention and management of pressure ulcers (PUs). Innova Care Concepts have launched a new hybrid system, The Solment Serene. Methods: A focus group design was used involving 5 Tissue Viability Key Opinion Leaders including an academic, infection control and tissue viability specialists. All data was recorded and transcribed verbatim, data generated was analyzed thematically. Confidentiality and anonymity was assured. Results: Four key themes were identified; (1) patient suitability, (2) Ease of Use and Effectiveness, (3) the importance of inter-professional working and (4) Loss of Equipment - Promotion of cost effectiveness Conclusions: The consensus was that there is a growing place for hybrid systems in preventing and managing pressure damage effectively. Health and social care should work inter-professionally to improve patient outcomes. The development of a flowchart based on scientific evidence was recommended to assist in the decision making of appropriate equipment

Examining local processes when applying a cumulative impact policy to address harms of alcohol outlet density.

One approach to addressing the negative health and social harms of excessive drinking has been to attempt to limit alcohol availability in areas of high outlet density. The Licensing Act (2003) enables English local authorities the power to implement a Cumulative Impact Policy (CIP) in order to tackle alcohol challenges. More than 100 English local authorities have implemented a CIP in one or more designated areas. We examined local licence decision-making in the context of implementing CIPs. Specifically, we explored the activities involved in alcohol licensing in one London local authority in order to explicate how local decision-making processes regarding alcohol outlet density occur. Institutional ethnographic research revealed that CIPs were contested on multiple grounds within the statutory licensing process of a local authority with this policy in place. CIPs are an example of multi-level governance in which national and local interests, legal powers and alcohol licensing priorities interface. Public health priorities can be advanced in the delivery of CIPs, but those priorities can at times be diluted by those of other stakeholders, both public sector and commercial

Who Among White Collar Workers Has an Opportunity for Phased Retirement? : Establishment Characteristics

Utilizing a new survey of employers, this paper examines how and why establishments differ in their willingness to permit an older full-time white-collar worker to take phased retirement. Phased retirement means that an older worker remains with his or her employer while gradually reducing work hours and effort. Although older workers often express an interest in phased retirement, actual occurrences are evidently rare. A possible explanation is that employers limit opportunities for phased retirement. The survey indicates that employers are often willing to permit phased retirement, but primarily as an informal arrangement. The results also indicate that opportunities for phased retirement are greater in establishments that employ part-time white-collar workers, allow job sharing, and have flexible starting times. Opportunities tend to be more limited in establishments where white collar workers are unionized, and where the establishment is part of a larger organization

Occupational Therapists\u27 Perceptions of Sensory Processing Evaluation Methods

Background: This study aimed to obtain occupational therapists’ (OTs) experiences and perspectives on current evaluation tools who work with clients with sensory processing challenges in their clinical settings. Method: This research was a mixed-method study. Data was collected from surveys (n = 11) which had a mix of nominal, interval, close-ended, and open-ended questions. Following survey completion, participants were given the option to complete a semi-structured interview (n = 2) consisting of open-ended questions to clarify survey responses and gather additional information about their experiences. Results: The results indicated a high number of various barriers and limitations found in both the current sensory-based evaluation and assessment tools. In both qualitative and quantitative analysis, the evaluation setting had three major subthemes: time factor (100%), client factor (72.7%), and environmental factor (27.3%). Participants also revealed a lack of neurodiversity (81.8%), strength-based (27.3%), and normative criteria-based (72.7%) assessment tools in current clinical settings. High utilization of collaboration and support were also noted. Interprofessional team (54.6%) and mentor/supervisor (63.6%) would always connect and support their evaluation process, whereas caregivers (72.7%) would occasionally collaborate and be included (45.5%) within the evaluation process. Conclusion: Evaluating and assessing clients with sensory processing challenges is a complex process and does not fit inside a structured rigid medical model. OTs need high support to better assist their clients and caregivers.https://soar.usa.edu/otdcapstonessummer2023/1029/thumbnail.jp

Distribution and History of the Roseate Spoonbill (Platalea ajaja) in Arkansas

The Roseatte Spoonbill (Platalea ajaja) is a rare bird in Arkansas and was not reported from the state until 1959, when it was seen in southwestern Arkansas. By use of online sources for citizen science, we elucidate the history of occurrence and present analysis of seasonal distribution of this bird in Arkansas. Individuals arrive in Arkansas as early as April, observations peak in August, and the birds may remain to late October when colder weather promotes southward migration. Most observations are of a few birds, but a maximum of 128 has been counted at one location and time. Most of the birds seen had not developed breeding plumage so were believed to be younger birds migrating northward in spring and summer to forage. The birds have been observed in 28 counties, but most observations have been in Chicot and Desha Cos. of southeastern Arkansas, bordering the Mississippi River. Several other wading birds such as storks, herons, egrets, and ibis have been reported as associates in flight or foraging. Nesting was discovered for the first time in 2020, in Ashley Co. of southeastern Arkansas

Novice Teachers: Do They Use What We Teach Them?

Teacher educators frequently engage in some rather agonizing soul searching regarding their effectiveness in preparing preservice teachers. Students pass through their classes, go on to other classes, and eventually they are in the real world of the classroom. Teacher educators seldom get direct feedback from students as to the relevance or the value of the instruction they received. Lacking this feedback, teacher educators who teach from a whole language perspective frequently question whether students actually use the instructional strategies they were taught in their reading courses, or whether they choose the more traditional basal reader approach