NATIONAL DECUBITUS FOUNDATION RECEIVES QUALITY OF LIFE GRANT FROM
CHRISTOPHER REEVE FOUNDATION
Grant to have direct impact on people living with paralysis
Aurora, Colorado – The Christopher Reeve Foundation (CRF) announced today that the NATIONAL DECUBITUS FOUNDATION (NDF) – www.decubitus.org has been awarded a $4000 Quality of Life grant. The CRF awarded a total of $717,404 in Quality of Life grants to 90 nonprofit organizations around the world. Since 1999, when the Quality of Life program was conceived by the late Dana Reeve as a way for the CRF to help improve the day-to-day health and well-being of those living with paralysis, 1,163 grants totaling $9,220,980 have been awarded.
“The Christopher Reeve Foundation is proud to carry on Christopher and Dana Reeve’s amazing legacy and make a real difference in the lives of people living with paralysis, their families and communities,” said Kathy Lewis, president and CEO of the CRF. “Our Quality of Life grantees help thousands of individuals Go Forward to lead happier – and healthier – lives.”
Decubitus ulcers (bedsores) afflict those confined to bed and/or to a wheelchair for long periods; the paralyzed are, of course, especially vulnerable. The NDF has identified those few hospitals that have succeeded in substantially reducing their bedsore rate of incidence. An NDF study describes the best practices implemented by those hospitals. This grant will allow the NDF to disseminate this information to the approximately 1800 US hospitals with 100 beds or more, and to all State regulatory agencies. Implementation of these best practices will be urged through volunteer visits and/or phone calls as well as a follow-up survey.
“An astounding 16 percent of the US hospital population, on average, is suffering from pressure wounds at any one time. This figure has seen no improvement whatsoever over the past many years. These wounds cause immense suffering and are often the site of life-threatening infection,” said Edward H. Comfort, Ph.D., NDF Executive Director. “Something must be done! We thank the Christopher Reeve Foundation for making it possible for the NDF to take these important steps.”
Health Promotion grants, a special category of Quality of Life grants, are funded through a cooperative agreement with the Centers for Disease Control and Prevention (Cooperative Agreement number U10/CCU220379). Funding is awarded to non-profit organizations that address the needs of people living with paralysis caused by spinal cord injuries and other diseases and birth conditions that result in paralysis. Health Promotion grants strive to remove societal and environmental barriers that limit the abilities of individuals living with paralysis to participate in life activities. Participation in these activities improves physical and emotional health and prevents secondary conditions for persons living with paralysis.
CRF Quality of Life grants are awarded twice annually to programs or projects that improve the well-being of people living with paralysis, particularly spinal cord injuries. Awarded in 13 categories that span everything from health promotion to employment to sports and recreation, Quality of Life grants address many aspects of life, and are given to programs around the globe. For more information about the Quality of Life Program or the grant application process, please contact the Quality of Life department at 1-800-225-0292 or visit the CRF website at www.ChristopherReeve.org for a complete list of the Quality of Life grant recipients.
The Christopher Reeve Foundation is dedicated to curing spinal cord injury by funding innovative research, and improving the quality of life for people living with paralysis through grants, information and advocacy.
The National Decubitus Foundation is committed to the eradication of the hospital-caused bedsore, whether a result of patient beds, wheelchairs, or the operating table. Medical professionals are urged to visit the NDF message board at www.decubitus.org where they can respond to the pleas for help from the afflicted patient’s friends and relatives who never dreamt that their loved one ran the risk of such horror in the hospital that he or she depended on for healing.
For help with healing, please click on Links and go to the WOCN to find a nurse wound specialist in your area.
Conn. Atty Gen Acts on Bedsores
Proposes Hospital Reporting Penalties
Richard Blumenthal, Attorney General of the state of Connecticut, has proposed daily fines for hospitals that fail to report Stage 3 and Stage 4 bedsores to the Department of Public Health as required by Connecticut law. Fines would be levied for every day and for every case for which the required reporting fails to take place.
Attorney General Blumenthal, interviewed February 2007 on NBC30 in Hartford, Conn. by reporter Deborah Bogstie, stated that he was “absolutely appalled” at what he had learned of the bedsore situation at Milford Hospital, Milford, CT. But as readers of The Ugly Secret know, many by their own experience, the appalling sight he witnessed is a regular occurrence at nearly all of our nation’s hospitals.
The hospital was investigated by the Connecticut Dept of Public Health after com-plaint by the daughter of the victim, Naomi K. Press, her 85 year old mother who was allowed to develop a stage IV bedsore, then shipped to the nursing home to die. The hospital was cited for seven violations.
Also interviewed for the report was Prof. Lowell S. Levin of Yale University and consultant to the World Health Organization. Dr. Levin is author of the book Medicine on Trial: The Appalling Story of Ineptitude, Malfeasance, Neglect, and Arrogance. He called for daily oversight of hospitals with regard to their bedsore problem, and he stated that this was a “modest” proposal in view of the severity of the problem.
The NDF was asked to provide statistical information with regard to the extent of the bedsore problem as background for this special NBC30 report. Please send an email to info@decubitus.org if you would like to receive an emailed copy of this video.
-- New Jersey Requires Nursing Home Bed Upgrades
In April, New Jersey Governor Jon Corzine signed a bill requiring the state's nursing homes to provide residents with pressure-relieving mattresses that prevent bedsores.
The law gives the facilities three years to replace all their mattresses with pressure-redistribution mattresses. The new mattresses shift support of a patient's weight away from the areas where pressure ulcers -- commonly referred to as bedsores -- are most likely to occur.
Research shows that more than one in 10 nursing home residents develops bedsores, most often over bony, prominent surfaces, such as the elbow, heel, hip, shoulder, back and back of the head.
According to the text of the legislation, New Jersey nursing home patients have a higher incidence of bedsores than the national average.
The pressure ulcers often occur in patients who are immobile, resulting from lack of blood flow to the affected area. This causes the tissue to begin to break down, progressively creating sores that become portals for infections that are potentially fatal. Bedsores range from Stage 1, indicated by persistently red, unbroken skin to Stage 4, the most severe, in which open sores expose muscle and bone.
Treating one of these painful, often preventable, sores can cost between $38,000 and $55,000, according to national health care data.
The New Jersey law requires nursing homes to begin replacing mattresses a year after the bill's signing. Every time a home replaces a mattress, it must be with a pressure-redistribution mattress. By 2012, all mattresses must be replaced with bedsore-preventing types.
The bill's sponsors acknowledge that pressure-redistribution mattresses cost more up front, but they say an expected reduction in spending on bedsore treatment, combined with better health for nursing home residents, will more than make up for the additional initial costs.
State checks on why few medical errors being reported
By ERIC NALDER
HEARST NEWSPAPERS
The Washington State Department of Health is canvassing hospitals to determine why so few have reported medical errors under a state law that says reporting is mandatory.
In a new approach, the department may also randomly audit "adverse-event" logs at hospitals to determine if specific facilities are holding back from reporting medical errors to the state, according to an e-mail the department sent to hospital administrators and other healthcare professionals on Oct. 5.
A Hearst Newspaper investigation published in August highlighted the low reporting rate in Washington, along with other problems such as:
• The state legislature failed to appropriate enough money to hire a contractor, as required by law, to analyze medical error reports and suggest ways to prevent medical errors;
• The health department hasn't made any annual reports to the legislature on medical errors, as required by the law, because of the failure to hire a contractor;
• No Web site for reporting medical errors was created, as required by the law;
• The state's medical error reporting office is an under-funded one-person operation.
Democratic State Sen. Karen Keiser reacted to the Hearst investigation by saying she and a Republican colleague plan to introduce legislation that will put more teeth into the state reporting law. Though hospitals, birthing centers, prison medical facilities and inpatient psychiatric centers are required to report a list of 28 "adverse events", only two thirds of hospitals have made any reports, and none have been submitted by the other categories of facilities.
"Since adverse event reporting began in 2006, only 52 percent of health care facilities have reported adverse events to the Department of Health," said Linda Furkay, the health department's patient safety-adverse event officer, in the email sent to healthcare facilities. "Some of the non-reporting facilities may not have had an adverse event, and others may not be reporting as required in law."
National studies show that by now there should be thousands of reports, but in three years state records show only 548 had been received as of July, and, of those, 157 were "pressure ulcer" reports from two Seattle hospitals that conducted a campaign against bedsores..
Washington is among only a handful of states where medical error reporting is mandatory, but state lawmakers and the health department have taken a non-punitive approach to enforcement.
National Decubitus Foundation Selections for Cost-Effective Support Surfaces
NDF Study No. 3, "Reducing Pressure Ulcer Incidence through Braden Scale Risk Assessment and Support Surface Use", demonstrated that hospital investment in a supply of suitable support surfaces is able to both nearly eliminate pressure ulcers and result in cost savings (compared to funds spent on rental of very expensive support surfaces needed to provided a healing environment once pressure ulcers have been allowed to develop). The National Decubitus Foundation, in order to provide guidance to hospitals regarding selecton of suitable support surfaces for their investment, has initiated a program of evaluation and ranking of such surfaces for suitability.
Support surfaces are evaluated based on criteria of reported effectiveness based on published clinical studies, pressure reduction potential based on engineering analysis, and potential for cost savings. Engineering analysis is by the method of finite elements, able to derive stress and displacement distributions under a variety of patient load and size configurations.
Initial support surface selections are as follows:
1. ZoneAire by HillRom Corporation.
This was the support surface most often cited by those hospital incidence reduction programs reviewed in NDF Study No. 3.
2. Isoflex by Gaymar Industries, Inc.
This support surface was also shown to be effective in hospital incidence reduction programs reviewed in the NDF study.
3. Pegasus Airwave by Huntliegh Healthcare.
Dr. John L. Baeke, plastic surgeon, reports that he has used this surface over 16 year with more than 200 patients, none of whom has ever developed a pressure ulcer.
Support surface manufacturers wishing to have surfaces evaluated by the NDF for ranking should submit design and cost data to the National Decubitus Foundation, 4255 S. Buckley Rd. Ste 228, Aurora, CO 80013. Please call or write regarding fees for NDF analysis.
TIME TO PUT PRESSURE ON HOSPITAL ADMINISTRATORS AND OFF OUR PATIENT’S BUTTS (All Pressure Ulcers Are Preventable!)
by John L. Baeke, M.D.
A health problem of epidemic proportions is afflicting our elderly and incapacitated. An inexpensive solution exists, yet remains elusive because of special interests and flat out ignorance. I am referring to pressure ulcers. The medical literature, and more worrisome, the legal literature, have well documented the high risk rate for any patient to develop a pressure ulcer during the course of a hospitalization. Certainly, patients of nursing homes and extended care facilities are at highest risk, but even our finest medical centers should hang their heads in shame. As actor Christopher Reeve’s recent death even attests, wealth can not prevent what ignorance does wreak. I am told even our beloved President Reagan, died with a pressure ulcer as well.
The problem has many root causes.
First, most of us (this includes almost every health care practitioner and hospital administrator) are operating under the mistaken notion that every pressure-preventative mattress is equally efficacious. This belief has never been challenged, thus seems well embedded as a time-honored, universally accepted mantra. This attitude has unfortunately allowed health care facility administrators the luxury of believing that which ever brand of mattress system they place on their formulary will equally satisfy whatever moral obligation they might have to care for their infirmed. Therefore, the only factor apparently motivating the institution’s selection of pressure preventative mattress systems, is monetary. This is dangerous.
Second, physicians too often give little or no thought to pressure sore risk and prevention when authoring admission orders. Many attending physicians have tunnel vision when writing admitting orders, and fail to properly contemplate the patient’s needs for pressure relief. Many physicians are totally unaware of what the term “MDS” means, and where to find this important Minimal Data Set in the medical record or how to act on this information. Other physicians operate under the naive notion that the admitting nurse’s assessment can be faithfully relied upon to properly provide whatever measures are needed for pressure sore prevention, thus absolving them of further responsibility.
Third, too many nurses fail to show proper diligence when completing the important MDS or similar pressure risk assessment forms. Sadly, random audit of institutional medical records, often finds simple data entry to be absent or incorrect. Amazingly, elementary mathematical addition is even a problem for some who are completing Norton and Braden scales. Whether this is a result of staff being over burdened by the deluge of paperwork required by modern medical records, or because of too little manpower, these important data sheets are frequently being neglected. Then, even when the MDS or risk assessment forms have been properly completed, all too often the nursing staff will not act on that information. Weary hospital staff must resist the temptation of robotically entering data, without taking a moment to consider the nursing care plan these same MDS forms are designed to trigger. It is simply unconscionable for any health care facility to not timely and correctly complete the pressure sore risk assessment and then not immediately act on that determination. Yet this happens every day.
Patients at risk are still not being diligently turned. This critical function, is too often relegated to the least trained, least paid, and least motivated worker. Some nurses feel it beneath their dignity, preferring to delegate. Others neglect this duty, because of being overworked or merely fearing that in the process of turning, a soiled sheet might be discovered, thus creating more work. Still others will fail to seek proper assistance, as with the morbidly obese patient. Yet still, others who have truly honorable intentions, fail to understand basic concepts of off-loading, and then improperly turn the patient. Finally, others naively believe that some at risk patients should not be turned at all (for example; those on ventilators, those with orthopedic external fixators or those already on pressure-reducing mattresses). Egads!
Fourth, some institutions do not require q2 hour charting, conveying the message that with no oversight, this is a responsibility which lacks importance. Other institutions have designed records allowing proper q2 hour charting, yet do not perform any internal audit to follow up when dereliction of duty occurs.
And the most unforgivable sin of all, is “nursing's dirty little secret”. Charting that proper and timely patient turning occurred, when indeed, none was performed. Unfortunately, many times only the facility’s negligent employee, the injured patient and God, truly know what happened behind the closed door.
Fifth, far too many in the medical profession have received woefully inadequate and incorrect basic training as to pressure sore prevention and pathogenesis.
For example: True, there are various factors which may place an individual at increased risk for developing and healing a pressure ulcer. These include, immobility, incontinence, diabetes, vascular disease, malnutrition, smoking, neurological disorders, dementia, etc., etc., etc. It is a pervasive notion that individuals with any of these risk factors are predisposed to developing pressure ulcers, and little can be done to ward off the inevitable. THAT NOTION IS DANGEROUSLY WRONG! None of these physical maladies ever caused a pressure ulcer. Yet, a recent survey by Brandeis [Adv Skin and Wound Care. 2001; v14, n5] of members of various health care professions confirmed that the majority of respondents subscribe to this naive notion. Remember, there is a reason these wounds are called Pressure Ulcers and not Mystery Ulcers. That is because we know exactly what causes them.....PRESSURE. It matters not how many predisposing risk factors an individual might have. Provide an environment of no pressure, and there will never be a pressure sore. NEVER. I would invite any of my learned colleagues to share clinical examples of any patient who developed a pressure ulcer in spite of what could be proven as proper diligence with pressure relief. After years of hearing defense experts make this claim, no one has ever accepted my challenge of showing me one such example.
Most in the medical and nursing professions have been trained as to the clinical differences between Stage I to Stage IV ulcers. Unfortunately, most received this knowledge from flawed charts, one often sees posted on the walls at nursing stations. These colorful diagrams (provided by companies e.g. Calgon Vestal / Merck, ConvaTec and KCI, et. al.) erroneously convey the message that pressure sores initially begin with some surface injury to the skin (noted by erythema) and as the soft tissue damage extends, the wound then involves progressively deeper structures (i.e. fat then muscle). Except for the subgroup of “sheer type” pressure ulcer patients, this concept is unfortunately erroneous. However, I would imagine that most still subscribe to it today.
Pressure between a hard external surface (e.g. a conventional mattress) and a bony prominence (e.g. the ischium), dissipates in a funnel shaped pattern, with the highest intensity of pressure focused against the bony prominence. Furthermore, for a variety of reasons, the skin is the soft tissue structure most resistant to the effects of unrelenting pressure, i.e. the last structure to show signs of damage. What this means clinically, is that many pressure sores will have been developing for a long time before they have progressed to involve the skin. The practical implications is, when the skin becomes red many providers will treat the area as if a stage I wound, and merely rub the surface with some soothing lotion (just as instructed by the aforementioned charts), when in reality what is seen is often the tip of the Stage IV iceberg. The future of that wound has been cast, and no amount of rubbing or lotion will heal the damage.
Since the knowledge and technology exists to prevent nosocomial pressure ulcers either with mere diligent turning or proper mattress selection, then I have to believe ALL pressure ulcers are preventable. In other words, all pressure ulcers are caused by negligence.
Like many of you, from time to time I have been asked if a pressure ulcer could have been prevented. After many years as a plastic surgeon with a large wound care population, it occurred to me that my answer to this question, has always been the same, “Yes”. It mattered not whether the patient was a young paraplegic or elderly and demented; whether the patient was well nourished or found on the concrete in an alcoholic stupor; the result of my probing into the wound etiology always came to the same conclusion. The pressure ulcer(s) was (were) preventable. Upon reflection, I have been unable to contrive of any situation where a pressure ulcer was not preventable.
To me the litmus test for this belief is this: Hypothetically, if it could be proven that the patient in question would still have developed the same pressure ulcers even if (theoretically) suspended from the ceiling by strings (i.e. zero pressure), then either a) indeed the pressure ulcer was unpreventable, and/or b) the etiology of the wound was obviously something other than pressure. Since, I believe no patient would pass such a test, we must assume all pressure ulcers are preventable.
As stated above, not all of the responsibility for this problem rests at the hands of the front-line care givers. Many if not most health care institutions feel comfortable that they have adequately provided for the at-risk patient by merely providing pressure-reducing mattresses on their formulary. These mattresses at most, only provide temporary comfort to the patient, and at their worst, allow staff a dangerous sense of compassion. Ask yourself this,
If mere “pressure-reducing” mattresses were so effective, why do nursing protocols still have them turning patients while on these devices? It doesn’t seem to me that this expensive mattress has resulted in a net gain for the facility, over their standard hard mattress. Thousands of patients a year develop pressure ulcers, when resting atop popular pressure-reducing mattresses.
Pressure-reducing mattresses are not the same as Pressure-relieving (or zero-Pressure) mattresses.
I have used “zero-pressure” mattresses on well over two hundred patients, including my quadriplegic father. By physician order, I would even instruct the nursing staff to NOT turn my patients. What pressure relief has one gained if a wedged pillow is still jammed against the back? During the 16 years I have used the Pegasus mattresses, none of my patients have developed any pressure ulcers. None! Furthermore, I have had no hesitation to place patients supine on top of fresh skin grafts and flaps!!!
What can be done? Infirmed patients deserve a better product. Instead of a mere pressure-reducing mattress, these at-risk individuals should be resting on a pressure-relieving or zero-pressure mattress. What is the difference? A pressure-reducing mattresses does not offload the soft-tissue / bony interface by the critical capillary filling pressure. In other words, if a pressure-reducing mattress can not reduce the pressure to something less than ~ 15mm HG, the small vessels, especially those on the venous side of the microcirculatory loop, are still collapsed. A truly preventative mattress must therefore be pressure-relieving or zero-pressure. To my knowledge, only one such product exists, today. These were manufactured by Pegasus Airwave, Inc. of Boca Raton, FL. I am told they have the patent on zero-pressure technology. Pegasus manufactured two models of zero-pressure mattresses: the Renaissance and Biwave.
To look at a Pegasus mattress, one observes no apparent difference from more familiar brand name products. The key difference is that the transverse air cells in the mattress do not just passively deflate to some lower pressure, but rather they actively implode, thus collapsing the air cell and temporarily suspending that portion of the body between the two adjacent inflated air cells. This cycle alternates every few seconds. This process not only creates periods of zero pressure, but causes a reactive hyperemia, which further aids in healing wounds in those with established ulcers.
In the past few years, the corporate story of the Pegasus company is one of little fish eaten by bigger fish. Pegasus Airwave was acquired by Arjo, A..G. (Switzerland) who seemingly was acquired by Huntleigh HealthCare (United Kingdom) who was acquired by Getinge, A.B. (Sweden). None of this bodes well for the end-consumer. For patients and physicians wanting to promote sales and research of the Pegasus mattress, attempts to pierce the corporate veil have always been frustrating. Today, with three new corporate parents, little seems to have changed. A wonderful product; a not-so wonderful company.
Most facility administrators have never heard of the Pegasus Airwave or Huntleigh mattresses. Shame on Getinge, A.B.. The Pegasus mattress is available internationally, but the internal mechanisms of the company prevent any semblance of effective marketing in the United States. Current competitors such as K.C.I. ( San Antonio, TX) and Hill-Rom (Batesville, IN) site a lack of published research by Pegasus as evidence of their inferiority. Again, shame on Pegasus/Arjo/Huntleigh/Getinge for ignoring offers by physicians to partner with clinical research.
As attending physicians we should routinely order Pegasus Airwave mattresses (any of their models are satisfactory) for all our at risk patients. I am told that with Getinge, A.B.’s recent acquisition of Pegasus, that same technology is now embraced with their “Trinova” mattress (www.huntleighhealthcare.com). Even if this is off-formulary we physicians should order it by name. Well-meaning case managers and other hospital soldiers will attempt to substitute for other devices owned by the facility. No substitutions should be allowed.
My suggestion for individuals searching to purchase a zero-pressure mattress would be to preferentially locate a renovated Pegasus Renaissance or Pegasus Biwave mattress. I can attest, they are built like a tank, have idiot-proof controls (just an on/off switch) and work. The customer service people at Huntleigh (1-800-223-1218) are unpredictable and vary as to whether or not they have any reconditioned Pegasus mattresses available. I get the sense, they are wanting the public to forget that name. With some persistence, one ought to be locatable. As a last resort, consider eBay.
If you are a hospital administrator, consider this. Which will cost more, the rental of an off-formulary mattress or the out-of-court settlement for your next pressure-sore claim? With a Pegasus (or Trinova) mattress, you can tolerate the indifference of the unmotivated nurse’s aid.
I am not employed by Pegasus Airwave or Getinge. I have no financial interest nor own stock in either company. I receive no financial compensation from either company (although I should). Pegasus Airwave simply made the state-of-the-art mattress in pressure-ulcer prevention. They have a fine network of field representatives and service technicians, however, the company continues to be paralyzed by junior varsity corporate officers.
They are resistant to subsidizing research needed to publish in peer-reviewed journals. They are resistant to financing aggressive marketing campaigns, and they even turn a deaf ear to their small but extremely devote group of medical supporters.
With this apparently cavalier business philosophy, I fear the Pegasus Airwave/Getinge company is not long for this world. Our patients deserve this product, and if Pegasus Airwave/Getinge is not willing to better promote their product to penetrate the American marketplace, I hope that this company is acquired by another, who is more committed to the cause of pressure ulcer prevention.
One final word. In 1999, my father, Dr. John O. Baeke, was rendered a quadriplegic as a result of a subdural hemorrhage. For the next six years, he lived with me, while bed-ridden. If my wife and I were able to keep him free of any pressure ulcers while maintaining a full work load, certainly any hospital should be able to do the same.
I applaud the editor for allowing this possibly volatile commentary when other publications e.g. Advances in Skin and Wound Care are so apparently encumbered by ties to special interests that they can not publish a frank discussion, without placing a spin on this crucial subject.
Why are so few of us willing to go out on a limb and say, “Yes, all pressure ulcers are preventable”?
Bedsores, also called pressure ulcers, are a terrible problem in our nation's hospitals and nursing homes. Over 16% of the patients in an acute care hospital, on average, are suffering from this painful and life-threatening wound. The percentage of the elderly with bedsores is much higher.
One state has done something to confront the problem. New Jersey requires all nursing homes to replace innerspring mattresses with special pressure reducing surfaces over the next three years. Recognizing the seriousness of the problem, the New Jersey Assembly passed the measure 78 - 0.
Attached is a press release from the National Decubitus Foundation providing more information. I urge you to act to reduce the pain and suffering in this state caused by this medical error. Thank you.
Sincerely,
PRESS RELEASE
NDF Exhorts 49 States To Follow New Jersey
The scourge of bedsores is being confronted
Published on July 31, 2009
AURORA, CO
The National Decubitus Foundation (www.decubitus.org) is a 501(c)(3) tax-exempt public charity dedicated to the eradication of hospital-caused bedsores. Since its founding in 1996, the NDF has seen some amazing developments. The ongoing controversy concerning whether or not bedsores are preventable was resolved when Medicare declared pressure ulcers (bedsores) a “never event”, i.e. a medical error. This was followed by the decision by major insurers, including Medicare, to cease reimbursement to hospitals for expenses connected with treatment of pressure ulcers developed in the hospital.
The NDF published a study in the July 2008 issue of Advances in Skin & Wound Care showing that those few hospitals that had been able to reduce bedsore incidence far below the national average had adopted a common policy. They each evaluated all patients for pressure ulcer risk upon admission, then placed all at-risk patients on a special pressure redistribution support surface, designed to prevent bedsores. With the aid of a grant from the Christopher and Dana Reeve Foundation, the NDF was able to distribute this study to almost all acute care hospitals and to every state public health department.
Now the state of New Jersey has mandated that all nursing homes must replace all beds with these special pressure redistribution mattresses over the next three years. The vote in the New Jersey Assembly in favor of this measure was 78 – 0. The NDF urges New Jersey to also require that hospitals invest in a supply of these specialized beds sufficient to accommodate all at-risk patients. And the NDF urges all states to follow the New Jersey lead.
