Support Surfaces Highlighted in New U.S. National Pressure Ulcer Advisory Panel Standards

The United States National Pressure Ulcer Advisory Panel (NPUAP) hopes to approve new standards tests that may help prevent pressure injuries in bed-bound individuals.


Pressure ulcer avoidance and management remain among the less glamorous, yet highest impact issues facing healthcare providers as populations age. With their incidence being associated with significant additional care needs and prolonged hospital stays, pressure ulcers cost embattled providers huge amounts of money each year. Yet, despite the fact that they have been recognised through the ages, efforts to reduce the incidence of what are almost all avoidable injuries have only yielded modest results and in recent years have even hit the buffers in some developed countries.

Founded in 2001 as a three-year project to fill the need for performance and reporting standards, S3I was tasked with development of uniform terminology, test methods and reporting standards for support surfaces. After formally affiliating with ANSI/RESNA in 2011, S3I became the official standards body for support surfaces in the United States. NPUAP made S3I a continuing subcommittee so it could continue its ongoing work implementing appropriate standards. Its work is a vital part of NPUAP, whose goal is to improve industry understanding of the importance of the support surface body interface, and provide the tools necessary to improve the quality of life and the ultimate outcome for patients who are bed-bound.

Comprised of 43 medical professionals across various sectors, the S3I subcommittee met in April and approved four new standards tests and submitted them to the Rehabilitation Engineering and Assistive Technology Society of North America and the American National Standards Institute (RESNA/ANSI). These standards tests include the areas of microclimate management, envelopment/immersion, and sliding resistance/friction.

If RESNA/ANSI votes to approve these standards tests, they will become national standards.

Expert comments

Evan Call, MS, CSM, co-chair of S3I stated; “These Standards provide the opportunity to refine measurements of microclimate performed on complex care support surfaces (mattresses), and for the first time, the ability to measure envelopment, which is one of the most critical elements of force redistribution. The last of these new standards gives us the ability to measure the forces a support surface applies to the tissue of an occupant as they move on or through the surface after the Head of Bed is elevated. This shear type force is of particular interest when working with patients at significant risk of pressure injury to the sacral region.  We are also very excited that the updated list of Terms and Definitions is well underway.”

Source: NPUAP

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