Mattresses (Pressure Care)

AB14 (Mattress - Pressure Care)

 [refer to RAP Schedule]

Mattresses (pressure care) help the client to safely and independently use their bed by reducing the risk of a pressure injury. If the client’s DVA accepted condition increases their likelihood of developing a pressure care injury, a mattress (pressure care) may be the solution.

Mattresses (pressure care) include the following:

Specialised pressure care mattress

• An overlay/mattress to fit either a clients’ existing bed (all sizes including single, king single, double, queen, king and bariatric) or the electric adjustable bed being used/prescribed designed to help reduce the risk of a pressure injury for the client.

Standard style mattress

• A mattress that is not specifically designed to reduce the risk of pressure injury, supplied only in tandem with an Adjustable Electric Bed through DVA;
• 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 mattresses or bed bases with heating, cooling, vibration or massage features
• Specialised pressure care mattresses are not provided for companion beds; and
• If the client decides to buy a new bed base to fit a new mattress set up, DVA will not reimburse the cost of the new bed base.

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.

Please note, 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, so long as there is no duplication of the same aid or appliance.

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

Prescribing

Mattresses (pressure care) must be prescribed by a suitable assessing health provider, this includes:

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

Prior approval is required under the following circumstances:

• When the client is a White Card holder
• When the prescribed mattress (pressure care) is not on DVA contracting arrangements; or,
• When the request is for more than one mattress (pressure care).
   

An assessment must be conducted by a suitably qualified assessing health provider to determine the clients’ clinical need for a mattress (pressure care). The assessing health provider should consider whether the client:

• Has a clinical need for a specialised pressure care mattress, based on a validated pressure injury risk assessment scale.
• Has a pressure management program in place, which may include (but is not limited to) correct positioning, frequent changes in position, appropriate skin care strategies, and the use of continence appliances.
• Is able to undertake a trial to determine the mattress (pressure care) most appropriate to meet their clinical needs.

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.

1. An initial assessment must be conducted by a suitably qualified assessing health provider to determine the clients’ clinical need. The assessing health provider must complete the direct order form via the D0992 – Mobility and functional support order form.
2.  Depending on the client's eligibility, proceed to:
   1. If the client is a Gold Card holder and the request is for a contracted mattress, 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 mattress, call DVA on 1800 550 457 or email at rapgeneralenquiries [at] dva.gov.au (RAPgeneralenquiries[at]dva[dot]gov[dot]au) to check client eligibility. 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 from DVA, if required.
   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.
3. The DVA contracted supplier selected on the trial form will supply the mattress (pressure care) prescribed by the assessing health provider, and approved by DVA (if prior approval is required).

The following supporting documentation must be forwarded with the prior approval request:

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

Additional information

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

Ancillary equipment for mattress (pressure care) includes, but is not limited to:

• Bed stick (AB08)
• Bedside rail (AB09)
• Monkey bar / Self-lifting stand (AB12); or
• 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.