Families are still being sold low-cost bubble overlays for patients who are clearly at high risk of PI, including frail older adults, patients following stroke or orthopaedic surgery, bedbound patients, and patients with existing skin compromise.
The problem is not that every bubble overlay is inherently unsuitable. The problem is that a low-specification overlay is often supplied without an adequate assessment of the patient’s actual pressure-injury risk or the performance required from the support surface.
Placing an inexpensive air overlay on top of an old domestic mattress does not automatically create an appropriate pressure-redistributing system.
Support-surface selection should be based on the individual patient’s clinical needs, including mobility, ability to reposition, skin and tissue condition, existing pressure damage, continence and moisture exposure, shear, body habitus, heel risk, medical condition, and overall level of pressure-injury risk.
A product should not be selected simply because it is marketed as a ”pressure mattres” or because it is affordable.
The clinical concern is false reassurance. Families may reasonably believe that pressure care has been addressed because an air mattress or overlay has been purchased, while the patient may still be inadequately supported and exposed to sustained pressure over vulnerable areas such as the sacrum, heels, hips and shoulders.
This is particularly concerning in patients who are immobile, frail, unable to reposition independently, or already showing evidence of skin or tissue compromise.
In home assessments, we regularly see patients using low-specification overlays that are not appropriate for their level of risk. The family has often purchased the product in good faith, believing it provides the level of protection required.
The issue is therefore not simply the cost of the mattress. It is the absence of appropriate clinical assessment and correct support-surface selection.
Pressure-injury prevention requires an individualised plan. The support surface is one component of that plan and does not replace repositioning, heel protection where indicated, skin assessment, moisture management, nutritional assessment, and ongoing review.
The objective is to provide a support surface appropriate to the patient’s actual clinical risk and needs.
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