Letter of Justification
Updated August 28, 2026
Letter of Justification
Palm — Letter of Justification
Clinical justification template for procurement of the Evergreen Palm powered surface.
Last updated August 28, 2026
The Palm surface is designed to prevent and manage skin injuries using alternating pressure and micro low air loss technologies. With its 'Auto-Detect' feature, it requires little set-up and maintenance and is ideal for all patient care environments. Below are the Clinical Application and the Clinical Justification Statement per product feature:
Product Feature: Alternating Pressure Therapy
Description
- Cyclical inflation/deflation of cells to provide continuous pressure redistribution
- 1 in 3 air cells slowly deflate for greater surface contact and comfort
- Smooth cell design to reduce friction and shearing as cells inflate and deflate in a smooth motion
Clinical Application
- Enhanced pressure redistribution reduces sustained pressure on any one area of the body.
- Reduced contact decreases risk of pressure injury development in high-risk bony areas (sacrum, coccyx, greater trochanters, scapulas, etc.)
- Reduced potential for shear and friction due to gentle 1 in 3 alternating cell air pressure and smooth cell design.
- Increased body surface contact and slow pattern of inflation reduces a client’s sense of movement & discomfort leading to quality of sleep and healing.
Clinical Justification Statements
- Constant pressure redistribution reduces peak pressure points on high-risk bony areas reducing pressure injury development or worsening of existing sores.
- Alternating air flow pattern promotes blood flow to high-risk tissues to ensure greater oxygenation and healing.
- Stability of the surface while still allowing cell inflation/deflation promotes skeletal alignment & positioning and allows for undisturbed sleep to promote tissue regeneration.
- Comfort and stability reduce agitation and movement related to discomfort to reduce constant shear and friction leading to tearing of the skin.
Product Feature: Micro Low Air Loss Therapy
Description
- Constant flow of air (8 litres/minute) to maintain constant temperature and reduce humidity
Clinical Application
- Constant air flow to reduce humidity and maceration of the skin leading to increased risk of skin breakdown.
- Maintained metabolic rate by reducing heat buildup and body temperature
Clinical Justification Statements
- Management of microclimate to maintain skin condition and reduce potential for development of new wounds.
- Promotion of skin integrity through reduced moisture buildup.
Product Feature: ‘Auto-Detect’
Description
- Inflation is automatically calibrated based on the load (body weight & surface area)
- Reduces set up & maintenance challenges
- Product is ready to use upon delivery
Clinical Application
- Surface is automatically set to optimize pressure so the client is protected immediately after being transferred into bed.
- No need for constant monitoring and adjustments by trained healthcare staff.
Clinical Justification Statements
- Client’s skin is protected immediately after delivery of the product with no risk of developing skin breakdown while waiting for staff to determine and adjust air pressure.
- Reduced cost related to set up and ongoing monitoring of surface by healthcare professionals.
Product Feature: Bottoming-out Protection through cell-on-cell design
Description
- Lower air cells remain inflated to reduce risk of “bottoming out”
Clinical Application
- Skin and bony prominences are protected from contacting bed deck and hard surfaces, reducing risk of increased pressure.
- Increased protection of sacrum, coccyx and Ischial tuberosities when client is in an upright/sitting position (Fowler position).
- Additional skin protection during caregiving activities and turning where pressure against the surface is affected.
Clinical Justification Statements
- Skin and bony areas are protected from contact with hard surfaces reducing risk of worsening skin issues and development of further pressure injuries.
- Clients are able to be turned or change position (side lying, sitting, foot elevation etc.) in bed without risk of increased pressure on bony and high-risk areas.
Product Feature: 8” Surface Depth
Description
- Designed for use with most homecare and hospital beds and side rails
Clinical Application
- Suitable for immersion and increased body surface contact reducing peak pressure areas
- Protection from entrapment risk
Clinical Justification Statements
- Surface depth suitable to allow full body surface contact and immersion to reduce pressure points on high-risk areas leading to skin breakdown.
- Protection from entrapment risk
Product Feature: ‘StaticPillow’ - motionless head section
Description
- Air cells in the head section of the surface are motionless to promote head and neck positioning and reduce potential disturbance to the client
Clinical Application
- To promote rest and healing, the head area is motionless to reduce sleep disturbances.
- Greater stability promotes head positioning, breathing, and swallowing.
- Stable head position reduces perceptual feedback for clients with vestibular challenges or those agitated by surface movement.
- Stability (and related sense of comfort) increase patient compliance and acceptance of surface use.
Clinical Justification Statements
- Stability at the head section allows for optimal head positioning to promote breathing and swallowing.
- Reduced movement of the head reduces vestibular cues and promotes greater quality of sleep and promotion of healing.
- Increased client compliance results from the sensation of stability and security.
Product Feature: ‘EasyCover’ for infection control
Description
- Cover is easily removed for cleaning/disinfecting without removing the entire surface
- Zippers are easily manipulated and covered with a protective flap
- Mattress surface can be laundered to ensure no cross contamination of the surface between multiple patient use
Clinical Application
- Covers are quickly and easily removed to ensure minimal disturbance and patient handling requirements.
- Ensuring additional cover availability reduces the need for clients to be transferred off the surface while cover is laundered.
- Full surface laundering reduces risk of contamination in multiple patient use situations (rental, facility equipment pools etc.).
Clinical Justification Statements
- Easy cleaning/disinfecting of covers and mattress surface ensures infection protection.
- Ease of cover removal reduces patient handling/transfer requirements and additional risk of skin damage.
Product Feature: Constant Low Pressure (CLP) Therapy/Static Therapy
Description
- Air cells maintain a lower pressure. This greater client immersion delivers a constant and comfortable level of pressure redistribution.
Clinical Application
- Increased protection of skin and bony prominences (sacrum, coccyx and ischial tuberosities, greater trochanters) due to maintained air pressure, for those clients who cannot tolerate alternating cell movement or air loss functions due to pain and agitation or additional medical equipment.
- Skin protection during caregiving activities
- CLP mode is beneficial for palliative clients to maintain skin protection while reducing painful movement.
Clinical Justification Statements
- Skin and bony prominences are protected from contact with hard surfaces reducing risk of worsening skin issues and development of new pressure injuries.
- Clients can be turned or change position (side lying, sitting, foot elevation etc.) in bed without risk of increased pressure on bony and high-risk areas.
- Maintained skin protection and wound management for clients with multisystem or palliative conditions where movement is disruptive and painful.
Product Feature: Pulsate Therapy
Description
- Inflation/deflation of cells simultaneously to create a pulsating motion to promote the movement of fluids through the body
Clinical Application
- Pulse action mimics body movement to promote circulation of blood and interstitial fluid throughout the body.
- Promotion of blood flow to ensure oxygen delivery to compromised tissues and development of wound healing.
- Reduced risk of edema leading to stretching of compromised skin.
Clinical Justification Statements
- Pulsation therapy promotes fluid movement throughout the body where clients have limited active movement and/or are in bed for long periods.
- Improved blood flow and oxygenation of tissues promotes wound healing.
- Promotion of cardiac and pulmonary function to encourage wound healing and decrease risk of further pressure injury development.
- Optimal skin protection for clients with multisystem or palliative conditions.
Product Feature: Low Noise Pump
Description
- Quiet pump decreases irritation and promotes a desirable sleep environment
Clinical Application
- Reduced sound from the pump promotes better quality sleep, reduced agitation and associated movement potentially damaging to tissues.
Clinical Justification Statements
- Quiet sleep environment promotes sleep and restoration of tissues. Decreased agitation and associated movement reduces risk of tissue damage due to shear and friction.
The examples of statements provided are suggestions based on general product applications. Specific clinical justifications should be based upon individual client physical and functional assessments.