Mattresses (Pressure Care)

A specialised pressure care mattress refers to an overlay/mattress or bed system specifically designed to reduce the risk of pressure injury. 

Where there is a clinical need for a specialised pressure care mattress DVA will provide either:

• a mattress/overlay to fit a client’s existing bed (all sizes including single, king single, double, queen, king and bariatric); or
• a mattress/overlay to fit the electric adjustable bed being used/prescribed. 

A standard style mattress is a mattress that is not specifically designed to reduce the risk of pressure injury.  DVA will only consider the supply of a standard style mattress if the client has a clinical need for an adjustable electric bed funded through DVA (refer to RAP National Guidelines for Adjustable Electric Beds).

Please note: 

• DVA does not supply mattresses for managing chronic musculoskeletal pain.
• DVA does not replace a standard mattress.
• Mattresses are not provided for comfort.
• DVA does not provide items with heating, cooling, vibration or massage.
• Specialised pressure care mattresses are not provided for companion beds.
• If the client decides to buy a new bed base(s) to fit a new mattress set up, DVA will not reimburse the cost of the new bed base(s).
• Clinical justification is required for replacement of DVA funded mattresses if required within a five (5) year period.     

The DVA client must have an assessed clinical need and a:

• Gold Card; or
• White Card with an accepted condition relating to the clinical need for the equipment.

If the client is a resident of a Residential Aged Care Facility (RACF), the provision of a suitable mattress is the responsibility of the RACF.  If a client clinically requires a pressure care mattress and the aged care home is not funded to provide the personalisation or customisation required, the assessing health provider can submit a request for prior approval to DVA, with adequate clinical justification for the personalisation/customisation. 

Receiving aids and appliances through DVA does not preclude DVA clients from accessing support through other government services such as the National Disability Insurance Scheme (NDIS) and the Department of Health’s Home Care Packages.  Aids and appliances can be provided by multiple programs, as long as there is no duplication of the same aid or appliance.  

Prescribing

Pressure care mattresses must be prescribed by a suitable assessing health provider.  For this type of item, these include:

• Occupational Therapist (OT);
• Registered Nurse (RN); or
• Physiotherapist.

Pressure care mattresses are provided through a DVA contracted supplier, and as such prior approval is generally not required for Gold Card Holders. Prior approval is required under the following circumstances:

• When being prescribed for White Card holders; or
• When the prescribed item is non-contracted.

A comprehensive assessment needs to be conducted by a suitably qualified assessing health provider to determine the clinical need for the pressure care mattress. 

Clients must have a clinical need for a specialised pressure care mattress, as identified through the administration of a validated pressure injury risk assessment scale.      

A pressure care mattress should be prescribed as part of an overall pressure management program which includes, but is not limited to,  correct positioning, frequent changes in position, appropriate skin care strategies, use of continence appliances. 

The assessing health provider should recommend and prescribe the most suitable on-contract mattress to meet the DVA client’s clinical need, in consultation with the DVA client or their representative.   

Equipment should be trialled to determine the mattress is appropriate to meet the client’s clinical needs. 

1. The suitably qualified health provider should complete the direct order form: D0992 – Mobility and functional support order form.
2.  Follow the below steps depending on the client's eligibility:
   1. If the client is a Gold Card holder and the request is for a contracted adjustable bed – send the completed form directly to the DVA contracted supplier. Details are provided on the order form.
   2. If the client is a White Card holder and the request is for a contracted adjustable bed - ring DVA on 1800 550 457 or email at rapgeneralenquiries [at] dva.gov.au (RAPgeneralenquiries[at]dva[dot]gov[dot]au) to check eligibility under the client’s accepted condition(s).  If the client has an accepted condition relating to the clinical need for the equipment, send the completed form with supporting documentation directly to the DVA contracted supplier. Details are provided on the order form. The supplier will seek prior approval if required from DVA. 
   3. For non-contracted mattresses or other prior approval requests, send the completed form with supporting documentation to the DVA contracted supplier. Details are provided on the order form. The supplier will then seek prior approval from DVA. 

The supporting documentation that should be forwarded with the prior approval request should include:

• Clinical conditions for which the pressure care mattress is being prescribed.
• A copy of the validated pressure injury risk assessment scale.
• If other interventions to address pressure risk have been implemented prior to this request.
• Where and how the mattress/overlay will be used.
• Whether a trial of the mattress has been undertaken.
• Any additional ancillary equipment that may be required with the mattress (see Ancillary equipment below).
• If the DVA client and/or carer requires advice and training on the use and care of the mattress/overlay.  

Additional information

The suitably qualified assessing health provider must also prescribe any ancillary equipment that is required in conjunction with the pressure care mattress.  These items can be ordered on the same direct order form as the pressure care mattress.   

Ancillary equipment for adjustable beds includes, but are not limited to, items such as:

• bed stick (AB08)
• bedside rail (AB09)
• monkey bar / self-lifting stand (AB12)
• pressure mattress pump (AB19)

Risk assessments should be undertaken prior to the prescription of bed sticks and bed rails, as supported by OT Australia’s Position Statement.