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beds, head molding, high-risk infants, interface pressure, mattress, prematurity, pressure ulcer, skin ulcer



  1. Turnage-Carrier, Carol MSN, RN, CNS


PURPOSE: The aim of this study was to determine interface pressure between the occiput of healthy premature infants and 5 different bed surfaces used in special care nurseries.


SUBJECTS: Thirteen healthy premature infants comprised the convenience sample enrolled 1 to 3 weeks prior to discharge.


DESIGN: A quasi-experimental design was used with the dependent variable being the interface pressures obtained under the occiput and the independent variables as the bed surfaces.


METHODS: Order of bed surfaces was randomized and standardization of the infant positioning and measuring procedure maintained. Measurements were made between the infant's occiput and the bed surface and interface pressures recorded in millimeters of mercury. The 5 bed surfaces were standard crib mattress with or without foam, gel donut, gel mattress, and water pillow.


MEASURES: Interface pressure measurements were obtained using the Mini-Texas Interface Pressure Evaluator (Mini-TIPE, Tee-Kay Applied Technology, Inc, Stafford, Texas).


RESULTS: A 1-way blocked analysis of variance was conducted to evaluate the relationship between the mattress surfaces and the interface pressure measurements. A significant difference in the mean of the interface pressures among the 5 mattress bed surfaces was determined, F4,46 = 33.267, P < .001, with the lowest being the foam overlay. The standard crib mattress had the highest interface pressure that exceeded 100 mm Hg. Post hoc comparisons showed a significant difference between the standard crib mattress with and without foam and the other surfaces.


CONCLUSIONS: Interface pressure is an important consideration when choosing a support surface for premature infants susceptible to tissue compromise and head molding. Variations in interface pressures between neonatal bed surfaces are apparent. Comparison studies of interface pressures using these and other neonatal bed surfaces will be valuable in determining appropriate products for both premature and neonatal populations with lengthy intensive care stays.