In introducing a new mattress into practice it is important to evaluate its performance from both the patient's and nurse's perspective. A total of 20 patients admitted to the integrated medical unit were recruited and nursed on a new pressure-relieving mattress offering two modes of pressure relief (Duo). All patients had been recently admitted to hospital and were considered to be 'at very high risk' of developing a pressure ulcer, with an initial Waterlow score > 20. Data were collected on admission, mid-point (three to four days) and study exit (seven days). The primary objective was to investigate the condition of patients' skin and the mode of choice for pressure relief. The secondary objective was to investigate reasons for nurses' and patients' choices. Structured interviews were conducted with the patient, ward nurse and research nurse whenever possible. Nineteen patients maintained or improved their skin condition during the evaluation.