September 16, 2020

Research Study Compares the Effect of Hospital Linens on HAPI

Trial examines cotton versus synthetic fiber linens

20-NUR-90339241-Research-Silk-Like-Sheets-CQD-650×450

Each year, more than 2.5 million people in the U.S. develop hospital-acquired pressure injuries (HAPI), according to the Agency for Healthcare Research and Quality. Although there are many causes, in laboratory studies researchers found that different types of fabrics were associated with changes in skin moisture, friction, shear and temperature that may predispose patients to pressure injury.

Advertisement

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Mary Montague-McCown, DNP, APRN, ACNS-BC, CWOCN, spearheaded a research study at Cleveland Clinic on the effect of hospital linens on HAPI. “The purpose of the study was to see if linens made out of silk-like fabric could prevent pressure injuries from occurring,” says Montague-McCown, Manager APRN/PA of the Wound Care Consult Team at Cleveland Clinic.

Study design and methods

The cluster randomized controlled trial took place on five adult medical intensive care units. Each MICU was randomly assigned to standard cotton fiber or synthetic fiber linens for six months; then, after a 14-day washout period, they were switched to the alternate group for an additional six months.

All patients admitted to one of the five units after the study began were included in the trial, with more than 3,000 patients in the study. For the first two months of the study, nurse researchers rounded on the MICUs daily and conducted patient chart audits to obtain information on pressure injuries, which were documented using the National Pressure Injury Advisory Panel’s staging classification system.

Advertisement

“When we were confident that the nurses were documenting correctly and assessing skin for alterations properly, nurse researchers did not go up to the units every day,” says Montague-McCown. “We relied on clinical nurses’ documentation to determine who developed pressure injuries and who did not.”

Trial findings and implications

Montague-McCown says that when the research team launched the study, she hypothesized that the synthetic fiber linens could be impactful because the silk-like, smooth sheets affect the microclimate, thereby reducing shear force that contributes to HAPI. “The big finding was that there were no differences in pressure injury rates between synthetic and cotton linen groups,” she says.

After analysis, Montague-McCown speculated that the reason there were no significant differences between the two groups could be due to nurses’ adherence to evidence-based protocols related to HAPI and implementation of rigorous preventive interventions. “Our ICU leaders and all ICU caregivers are accustomed to high-acuity patients and are proactive in putting measures in place to prevent HAPI. Nurses are trained in accurate interpretation of skin changes and know what actions to take, or who to contact when unsure of next steps,” she says. “Facilities such as hospital ICUs with few long-term patients or lower overall acuity and nursing homes that may not have adequate resources or robust prevention protocols in place may benefit from the silk-like sheets.” However, Montague-McCown adds that a randomized controlled trial would need to be conducted to learn if benefits would be present in specific settings.

Advertisement

Related Articles

Headshots of Woodward and Blankemeier
March 13, 2024
Home Care: Moving Beyond the Hospital (Podcast)

Nurses play pivotal role in patients’ ability to recover in the comfort of their own homes

Head shot of nurse Dena Salamon
February 29, 2024
Speaking Up in the Perioperative Setting (Podcast)

Advocating for patient safety is imperative in fast-paced surgical settings

Nurse laughing with elderly patient
February 21, 2024
What to Consider When Choosing a Wound, Ostomy and Continence Nursing Education Program

Advice for those pursuing a WOC nursing career

23-NUR-3955494-NN-CLABSI-reductEfforts-RTmeAuditProcess-CQD-kc_650x450
December 26, 2023
Nurse-Led Effort Pays Off by Reducing CLABSIs

Redesigned protocols enhance infection-prevention measures

23-NUR-3991019-NN-Rsrch-BasicDiabetesKnowledge-OutptntNurses-CQD_650x450
December 13, 2023
Study Highlights Gap Between Real and Perceived Diabetes Knowledge in Outpatient Nurses

Longevity in healthcare, personal experiences may provide caregivers with false sense of confidence

23-NUR-4101309-GrowingTheForensicProgram-CQD_650x450-1
November 22, 2023
Behind Closed Doors: Forensic Nurses Approach Victims With Empathy and Precision

Specialized team prioritizes trauma-informed care and evidence collection

23-NUR-3955502-NN-Plan-of-careVisitsBenefitsTeamApproach-CQD_650x450
November 20, 2023
Improving Teamwork, Morale and Outcomes with Plan-of-Care Visits

Collaborative approach leans on expertise of nurses

23-NUR-3955467-NN-TeamBirthModel-CQD_650x450
October 30, 2023
Nurses Champion New Patient-Centric Model of Labor and Delivery Care

TeamBirth aims to improve outcomes by facilitating collaboration between patients and caregivers

Ad