Rosalyn Jordan, RN, BSN, MSc, CWOCN, WCC

Do you have any guidance about the type of linen to use on support surfaces with a resident who is high-risk for pressure ulcer development?

There is one great rule of thumb: “less is best.” 

The National Pressure Ulcer Advisory Panel introduced this concept several years ago. Therefore, use less while providing resident comfort and dignity but ensuring that moisture and drainage are controlled. Repositioning devices also should be considered. On the other hand, the use of specific linen types and amount should be a match to the technology of the support surface. 

Recent studies completed in a laboratory indicated that the amount and type of linen and pads typically used for incontinence increased the interface pressure that was measured using a mechanical measuring device. In another study that also focused on the effect of moisture related to linens and incontinence pads on a low-air-loss support surface, it was found that there was a decrease in moisture-vapor transmission on a low air loss support surface. Consequently, “less is best.” Limit the use of linens and even incontinence pads on support surfaces.

Sheets and pads are not all alike. Most sheets change texture as they are used and laundered; some are fitted and some are not. Reusable pads are different from pads that are discarded. Some incontinence pads are designed to specifically use with low air loss mattresses. It is always important to match the use of linens and pads to the instructions from the manufacturer. Many manufacturers will provide in-services to staff or you may call to obtain the information.

For at-risk residents, use the type and amount of linens and pads recommended by the manufacture and ensure the support surface is performing correctly. Also ensure that quality care is provided for the resident.