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Support Surface Standards Initiative (S3I)
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The National Pressure Injury Advisory Panel (NPIAP) is coordinating the development of a uniform terminology, test methods and reporting standards for support surfaces. The guidelines will provide an objective means for evaluating and comparing support surface characteristics. Test methods and reporting standards will improve the process of selection and procurement. Clinicians, patients and other users would benefit from having product information and test data presented in a consistent manner. In essence, standards will empower consumers. Standards will also serve as a product development guide for manufacturers and enhance quality assurance in the manufacturing process.

Support Surface Standards Initiative (S3I)

Founded in 2001 to fill the need for performance and reporting standards, the S3I was originally created as a three year project tasked with development of uniform terminology, test methods and reporting standards for support surfaces. With the affiliation with ANSI/RESNA, S3I became the official standards body for the United States. With this expanded role, the NPIAP has made S3I a continuing sub committee under the Research Committee with the charge to implement appropriate standards. Through S3I the NPIAP intends to improve industry understanding of the importance of the support surface body interface, and provide the tools necessary to improve the quality of life and the ultimate outcome for the bed bound individual.

Current Work Agenda of S3I

  • Test Development and Validation
  • Consumer Education on Support Surface Standards
  • ISO affiliation as a Standards Body


NPIAP’s Support Surface Standards Initiative (S3I) is pleased to share that Eight Standards for testing Support Surfaces are published by the American National Standards Institute / Rehabilitation Engineering Society of North America (ANSI/RESNA).  These standard tests include Support Surfaces Terms and Definitions, Immersion, Envelopment, Horizontal Stiffness, Heat & Water Dissipation, and Water Vapor Dissipation.

The five posters below elaborate on what these Standards involve as well as how they should be utilized to assist in the decision-making process of purchasing new mattresses and choosing specific support surface characteristics for specific patient populations. 


Click here to purchase standards from ANSI.

Click here to view current Standard for Testing Support Surfaces (American National Standards Institute / Rehabilitation Engineering Society of North America (ANSI/RESNA))

Best Practices for Cleansing, Disinfecting, and Care of Polyurethane Support Surface Covers

Terms & Definitions related to Support Surfaces

S3I Committees consensus to Deprecate the Term "High Specification Foam" Mattress 

S3I Meetings

S3I Participants: NPIAP expresses its heartfelt thanks to the companies and individuals that participate in the standards development process. Participation in the committee’s work often involves the use of personal vacation time, and a significant commitment of time and professional skills, freely donated to the cause by committee members.


Who can participate

The S3I is an open process so all interested parties are invited. The success of the initiative will depend on active participation of all stakeholder groups including consumers, clinicians, researchers, scientists, healthcare providers manufacturers, and policy makers.

To learn more about S3I membership please visit our support page.

The success of the Support Surface Standards Initiative (S3I) depends on active participation and representation of manufacturers, consumers, clinicians, researchers, healthcare providers, and policy makers.