NPUAP Revamps Terms for Support Surfaces

On Jan. 29, 2007, the Support Surface Standards Initiative of the National Pressure Ulcer Advisory Panel issued new terms and definitions in an attempt to better classify support surfaces.

One of the major obstacles the NPUAP seeks to overcome is doing away with terms like "pressure relief" and "pressure reduction" that falsely surmise what support surfaces do for users. The new term, "pressure distribution," better describes what the devices on the market actually do.

In addition, terms like "decubitus ulcer," "bed sore" and "pressure sore" are out. The NPUAP prefers "pressure ulcer."

To better classify the technology currently on the market, the organization has also distinguished between active and reactive surfaces.

"An active surface moves on its own; it replaces dynamic," explains Abbey Daniels, CEO of SenTech Medical Systems. "If the surface moves even without a patient on it, such as alternating pressure, that is considered an active surface. Other things such as foam, gel, a lot of the combination air/foam products that are out there, those are reactive surfaces. They are considered reactive if they only move in response to a patient being placed on (the surface) or moved on there.

"Under an active and reactive surface, then there are different features," she continues. "For example, there may be low-air loss, and low-air loss is a feature that could be in either an active or a reactive surface, and terms that if (clinicians) understand the benefit of that feature to that patient's condition can make a more informed decision."

But just what do these new classifications mean for providers?

David Brienza, who was a NPUAP board member for the past six years and helped initiate the project to develop support surface standards, says the new terms and definitions are hopefully better than the current classifications approved by the Centers for Medicare & Medicaid Services (CMS).

"What we assume will happen is that if the community as a whole adopts these terms and definitions, then Medicare as part of that community will also adopt them," says Brienza. "And the descriptions of support surfaces that they use will hopefully match what's been accepted by the community at large — the users, clinicians and manufacturers and everyone else involved."

If that were to happen, technology that currently receives little to no reimbursement could make headway in the market, offering better clinical outcomes for users.

Establishing new terms and definitions is only the first step in revamping the way beds and support surfaces are viewed by CMS. NPUAP is also working to develop test methodology to prove the clinical efficacy of support surfaces.

"Technology is all around us and it is improving every day and becoming more and more advanced," says W. Darren Hammond, MPT, CWS, director, Department of Training and Education, The ROHO Group Inc. "This technology is being incorporated into new designs of support surfaces, new monitoring of extrinsic risks such as pressure and shear, and also being used to better research the variations of technology that already exists to better understand the limitations of certain products and the superiority over other products. Patients and, more importantly, clinicians need to utilize this new technology if the evidence supports its superiority over pre-existing products."

Already the industry understands the value of support surfaces in treating and preventing pressure ulcers.

"From the healthiest to the sickest individual, preventative care should be considered for everyone," says Hammond. "There are various levels of support surfaces for everyone and they need to be utilized across all care settings."

It is only by using the technology to prevent the onset of pressure ulcers that a significant reduction to health care costs can be achieved.

To download a copy of the definitions, visit NPUAP's Web site at < ahref="http://www.npuap.org" target="_blank">www.npuap.org. For more information on support surfaces and the impact on the health care setting, check out the March issue of Home Health Products for the article, "Pressure Rescue: The Right Bed & Support Surface Might Save Lives and Reduce Costly Hospitalizations, But Is CMS Listening?"

This article originally appeared in the February 2007 issue of HME Business.

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