Support Surface Algorithms - How Confused is Your Team?

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Matching the right type of therapeutic support surface to a patient’s individual needs can be challenging for clinical staff tasked with pressure injury treatment and prevention. Several assessment and management algorithms have been developed to guide clinicians through the decision process. However, these guidelines often fail to meet the desired goals because of inconsistencies in how the tool is implemented across departments and clinical teams.

There are many good reasons for a care institution to adopt an evidence-based algorithm for choosing the therapeutic surface best suited to individual patient needs, such as the one developed by the Wound Ostomy and Continence Nurses (WOCN) Society. While wound and ostomy care specialists are well equipped to advise other clinical staff in these areas, the WOCN may not always be available when patient care decisions need to be made. Having a clinical staff who have been thoroughly trained in the use of a well-designed therapeutic support algorithm can streamline care helping to prevent the confusion and delays that often occur in these situations. 

  • The first step in adopting a facility-wide algorithm for choosing a therapeutic support surface is to designate one individual, such as an advanced practice nurse or clinical resource specialist, who will be responsible for providing clinical expertise, support, and leadership for the project.

  • Next, the target audience for the tool should be identified, and their current knowledge and learning needs assessed. In most cases, these stakeholders will include nursing staff, physicians, and physician assistants, as well as physical and occupational therapists. 

  • An interdisciplinary steering committee made up of members of this group will then create short and long term goals and assign timelines and responsibilities.  The design of the implementation program should include clearly stated goals and objectives, outcome measures, and evaluation criteria.  

  • The committee should also identify or acquire the necessary educational materials such as facilitator guides, slide presentations, workshop activities and learning assessment tools, quick reference guides, chart documentation checklists, and mobile device resources.


To succeed, the algorithm training and rollout should have the complete support of the hospital administration which can include committing to extra staffing to allow clinicians to devote time to the educational activities.  In addition, a best practice champion should be identified in each unit to help support and guide other staff throughout the implementation and beyond. Resource materials, decision-making tools, should be readily available for clinical staff to access at any time. There should also be plans in place for educating newly hired staff and conducting staff-wide refresher courses at regular intervals.

Related: See our resource on pressure injury prevention & treatment in healthcare facilities.

The all-encompassing Airisana alternating pressure mattress and support system combines unique air delivery and pressure management programming that helps customize PI prevention and treatment to each patient’s needs. Airisana is designed to improve several issues associated with current therapies and surfaces by controlling skin deterioration due to pressure and moisture and reducing acclimatization of the patient to the surface. The easy-to-use control unit puts control back in the hands of nursing staff and safely facilitates the multiple disciplinary care the patient often needs. Click here to learn more about the Airisana Therapeutic Support Surface.

Learn More About Airisana

Pressure Injuries

Michelle Daniels
Michelle Daniels is the Managing Director, TPF & TSS Brands for Encompass Group. She can be reached at

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