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Hospital-acquired pressure ulcers

New protocol reduces HAPUs by 69%

A new research paper has demonstrated how a comprehensive ulcer prevention programme can significantly decrease hospital-acquired pressure ulcers (HAPUs). The study was conducted in an adult intensive care unit (ICU) at Eskenazi Health, Indianapolis, Indiana, US, between 2012 and 2013, and published in the American Journal of Critical-Care Nurses.

A new research paper has demonstrated how a comprehensive ulcer prevention programme can significantly decrease hospital-acquired pressure ulcers (HAPUs). The study was conducted in an adult intensive care unit (ICU) at Eskenazi Health, Indianapolis, Indiana, US, between 2012 and 2013, and published in the American Journal of Critical-Care Nurses.

The research paper, ‘Use of a Comprehensive Program to Reduce the Incidence of Hospital-Acquired Pressure Ulcers in an Intensive Care Unit’, emphasises that hospitals who adopt a standardised protocol for the prevention and treatment of HAPUs may see potential cost benefit of such prevention.

Rachel Culpepper

“This study validates the need for a comprehensive, proactive, collaborative prevention programme in hospitals,” said Rachel Culpepper, Registered Nurse at Eskenazi Health. “Although it is difficult to isolate the effects of individual programme components, silicone foam dressings can complement an existing pressure ulcer prevention programme, and are believed to contribute to the reduction in HAPUs.”

The paper notes that HAPUs are a costly and largely preventable complication occurring in a variety of acute care settings. Because they are considered preventable, stage III and IV HAPUs are not reimbursed by Medicare. As a result, the researchers assessed the effectiveness of a formal, year-long HAPU prevention program in an adult intensive care unit, with a goal of achieving at least a 50% reduction in 2013, compared with 2011.

The programme included use of Braden scores, a revised skin care protocol, fluidised repositioners and silicone gel adhesive dressings (Allevyn Life). In addition, considerable efforts were made to educate and motivate staff and encourage them to be more proactive in detecting patients at risk of HAPUs, according to the paper.

Outcomes

At the end of the first year, the prevention programme demonstrated a 69% decrease in HAPUs (n=17; 3% of patients in 2013 vs n=45, 10% of patients in 2011), despite a 22% increase in patient load. The potential cost saving as a result of this decrease was approximatelyUS $1 million.

A comprehensive, proactive, collaborative ulcer prevention program based on staff education and a focus on adherence to protocols for patient care can be an effective way to reduce the incidence of HAPUs in intensive care units.

“Our experience indicates that a comprehensive, proactive, collaborative prevention program based on staff education and a focus on adherence to protocols for patient care can be an effective way to reduce the incidence of HAPUs in the ICU,” the papered concludes.

Allevyb Life (Smith&Nephew)

Allevyn Life, a silicone foam dressing also indicated for the treatment and prevention of pressure ulcers, developed by Smith & Nephew, was introduced to the protocol as part of the standard prevention method three months into the programme.

“Smith & Nephew has a strong heritage of innovation in advanced wound management. By sharing the meaningful data results, we hope to increase awareness and emphasise the importance of prevention programmes for hospital-acquired pressure ulcers,” said Dr Bert Slade, MD, Chief Medical Officer, Advanced Wound Management, Smith & Nephew. “Our mission is to support healthcare professionals to improve lives of patients. We welcome these findings and strongly believe they will help healthcare providers, clinicians and administrators to better manage the clinical and economic burden of HAPUs in similar settings worldwide.”

To access this paper, please click here