Smart Patient Mobility Monitoring – The Next Generation of Pressure Ulcer Prevention Surfaces

Despite ongoing improvements in pressure ulcer (PU) prevention, the clinical burden of PUs still remains high, with a 32% increase in PU incidence occurring between 2012/13 and 2017/18 and an annual cost increase of 8-9% per annum within wound care (Guest et al, 2020). It has
been suggested that one way to break these incidence plateaus is to use continuous patient monitoring in order to provide a level of on-going risk assessment and to enable better decision making that is informed
by patient needs (Brienza, 2020; Nixon et al, 2019).

Nevertheless, PU incidence levels vary for a variety of reasons e.g. difficulty in training staff to categorise PUs correctly or conduct a comprehensive risk assessment and prevention plan. Clinical Practice Guidelines recommendations (EPUAP/NPIAP/PPPIA, 2019) advise the development and implementation of ‘a risk-based prevention plan for individuals identified as being at risk of developing pressure ulcers’. One of the principal factors of risk assessment tools is the mobility or immobility of the patient; therefore, individual care plans should consider the patient’s
immobility level. A recent study concluded that some patients
are incorrectly assessed due to immobility. 30% of patients are assumed to have mobility in their sleep (Gattinger et al, 2017; Zimmermann, 2015);
however, in reality, they are immobile during this time and at risk of developing a PU, highlighting that immobility is variable. To capture mobility correctly, this would require 24-hour patient observation,
which is not possible in most care settings.

Smart monitoring systems, such as Dyna-Form® SMARTresponse® and SMARTassist™ can deliver value by offering a continuous risk assessment and a timely intervention, by discreetly and constantly monitoring for patient functional movement every hour. If functional movement is not detected, the Dyna-Form® SMARTresponse® will send an “Alert
Me” notification to the clinician with the option of either remotely or automatically stepping-up patient care, from a static mattress to an alternating dynamic mattress, to begin a 1-in-2 cycle and provide effective pressure relief therapy. This reduces the amount of time a patent spends in
bed without pressure relief. Furthermore, a “Bed Exit” alert can also be activated on the Dyna-Form® SMARTresponse® system. If activated, and in the event of a bed exit, the care provider is directly sent an alert.

All information associated with the Dyna-Form® SMARTresponse® pump is recorded on Direct Helathcare Group’s latest software addition,
SMARTassist™. SMARTassist™ combines a mobile app and desktop site to provide users with both a real-time and historic record of actions from any registered SMARTresponse® control unit, including patient movement, activation of SMARTresponse® features, which therapy mode the control unit was placed in, via what method (manual or automatic), control unit
warnings and all associated references and notes (e.g. skin assessment outcomes). This information can be utilised to support the patient’s care pathway and/ or support any root cause analysis (RCA).

To conclude, SMARTresponse® provides bespoke and individualised pressure redistribution and pressure relief in a single support surface, and can play a role in determining patient repositioning, with consideration for the individual’s level of mobility, by constantly monitoring patient movement. With the focus on clinical choice, SMARTresponse® empowers
healthcare providers to achieve earlier intervention in pressure ulcer prevention, offering easy implementation for individuals at risk of developing pressure ulcers, helping to ensure best use of clinical
resources to deliver more responsive patient care, improve patient outcomes and contribute to cost-savings (Fletcher et al, 2017).


Brienza D (2020) Translating Aetiological Knowledge into Support Surface Science.

EPUAP 2020 Virtual Conference Abstract. European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel and Pan Pacific Pressure Injury Alliance (2019) Prevention and Treatment of Pressure Ulcers/Injuries: Quick Reference Guide. Emily Haesler (Ed.)

Fletcher J, Tite M, Clark M (2016) Real-World Evidence from a Large-Scale Multisite Evaluation of a Hybrid Mattress. Wounds UK

Gattinger et al (2017) Mobility data as a basis for case reviews – information on dementia and sleep disorders. Nursing 7

Guest J, Fuller GW, Vowden P (2020) Cohort Study Evaluating the Burden of Wounds to the UK’s National Health Service in 2017/2018: Update from 2012/2013. BMJ Open 10(12): e045253

Nixon J et al (2019) Pressure Relieving Support Surfaces for Pressure Ulcer
Prevention (PRESSURE 2): Clinical and Health Economic Results of a Randomised Controlled Trial. eClinicalMedicine 14: 42-52

Zimmermann (2015) Underestimated length of stay. Nursing 9