Getting pressure ulcers to zero . . . Collaborative Care in action
Research shows that pressure ulcers negatively impact a person's quality of life, lengthen hospital stays (often doubling it) and cost the system to treat (estimated net costs range from $44,000 - 90,000).
The good news is that pressure ulcers are preventable.
The really good news is that the Region has developed a prevalence and incident toolkit (P & I toolkit) to help you reduce pressure ulcers. Tools such as data collection forms, data submission forms, patient letters, project management tools are available. Click here to access it (Intranet access required).
Prevalence is the number of persons within the hospital population who, on that given day, present with a pressure ulcer. This includes all people, regardless of whether it the pressure ulcer developed during their hospital stay or if they arrived with the wound.
Incidence is the number of new cases occurring over a given time period. Pressure ulcer incidence is considered the marker of quality care within a facility, and is usually more accurate data when compared to prevalence alone.
The Regional Wound Care Committee relied on a collaborative process to not only develop the toolkit, but also to create a plan to support comprehensive education on pressure ulcer prevention, to increase the uptake of wound care best practice guidelines within the region, coordinate among teams, and to improve patient care that was all based on regional data.
The plan? To standardize the prevalence and incidence process for sites within the Region. A prevalence and incidence is a combination of two studies done consecutively (approximately one week between), providing fundamental data on patients with an existing pressure ulcer and on those who acquired a pressure ulcer during their stay (Davis, C. et al, 2001). Along with providing a complete baseline pool of data from which future education programs can be built and to which future prevalences and incidences can be compared.
This work has positively impacted over 2083 people at nine sites (Riverview Health Centre, Health Sciences Centre, Concordia Hospital, Seven Oaks General Hospital, St. Boniface Hospital, Deer Lodge Centre, Misercordia Hospital, Victoria Hospital, Grace General Hospital) who were assessed during the November 2014 prevalence and incidence process.
Long term care also captures their pressure ulcer data in their MDS programming and home care is able to track this data in their RAI data. The current average snap shot incidence rate for the Region (some sites still returning data) is 2.33 per cent. Sites incidence rates range from 0 to seven per cent.
The ultimate goal? Getting our incidence of pressures ulcers down to zero!
Further resources
The zero pressure ulcer campaign
References
Carlson, P., & Dudziak, S. (unknown). Decreasing the Incidence of Internally Acquired Pressure Ulcers in LTC, 3M and Revera Living.
Lyder, C., et. al. (2012). Results from the National Medicare patient safety monitoring system study, Journal of American Geriatric Society, 60(9), 1603-1608.
Theisen, S., Drabik, A., & Stock, S. (2011). Pressure ulcers in older hospitalized patients and its impact on length of stay: a retrospective observational study, Journal of Clinical Nursing, 21, 380-387.