The Effectiveness of a Pressure Ulcer Intervention Program on the Prevalence of Hospital Acquired Pressure Ulcers: Controlled Before and After Study

Mallah, Zeinab; Nassar, Nada; Badr, Lina Kurdahi

doi:10.1016/j.apnr.2014.07.001

Cited by 75 publications

(75 citation statements)

References 59 publications

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“…For example, some patients develop a HAPI during their admission, while others present to hospital with a pre‐existing PI; known as a community‐acquired pressure injury (CAPI) (Graves & Zheng, ). Considerable research is published on HAPI prevalence (Bredesen, Bjøro, Gunningberg, & Hofoss, ; Mallah, Nassar, & Kurdahi Badr, ; Miles, Fulbrook, Nowicki, & Franks, ; Moore et al, ) which some claim ranges between 1%–27% (Graves & Zheng, ); however, a lack of consistent methods for determining prevalence, as recommended by the EPUAP (Defloor et al, ) means reported prevalence can vary widely. Less is known about the numbers and profiles of patients admitted to hospital with a CAPI (Graves & Zheng, ; Hahnel et al, ); estimated at 6%–26% (Asimus & Li, ; Corbett, Funk, Fortunato, & O'Sullivan, ; Keelaghan, Margolis, Zhan, & Baumgarten, ; Sardo et al, ).…”

Section: Introductionmentioning

confidence: 99%

Pressure injury prevalence and predictors among older adults in the first 36 hours of hospitalisation

Latimer

Chaboyer

Thalib

et al. 2019

Journal of Clinical Nursing

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Aims and objective To describe the prevalence and predictors of pressure injuries among older adults with limited mobility, within the first 36 hr of their hospital admission in Australia. Background Pressure injuries are significant health, safety and quality of care issues for patients and healthcare organisations. The early implementation of the recommended pressure injury prevention international clinical practice guidelines is a way to reduce hospital‐acquired pressure injuries. There is a paucity of evidence on the number of older persons who are admitted hospital with a pre‐existing pressure injury. Design Prospective correlational study conducted in eight tertiary referral hospitals across Australia. Our sample comprised of 1,047 participants aged ≥65 years with limited mobility, drawn from a larger Australian pragmatic cluster randomised trial. Methods Using the STROBE statement, observational data were collected on participants’ age, gender, presence of a pressure injury, Body Mass Index score, number of comorbidities and place of residence. These variables were analysed as potential predictors for pressure injuries within the first 36 hr of hospitalisation. Results From our sample, 113/1047 (10.8%) participants were observed to have a pressure injury within the first 36 hr of hospital admission. Age, multiple comorbidities and living in an aged care facility predicted the prevalence of pressure injury among older people within the first 36 hr of hospitalisation. Conclusions Our findings confirm that older adults, those with multiple comorbidities and individuals living in aged care facilities are more likely to come to hospital with a pre‐existing pressure injury or develop one soon after admission. Relevance to clinical practice Many older patients come to hospital with a community‐acquired pressure injury or develop a pressure injury soon after admission. This highlights the importance of the early detection of pressure injuries among older persons so that timely management strategies can be implemented along with the potential to reduce unnecessary financial penalties.

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Section: Introductionmentioning

confidence: 99%

Pressure injury prevalence and predictors among older adults in the first 36 hours of hospitalisation

Latimer

Chaboyer

Thalib

et al. 2019

Journal of Clinical Nursing

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“…Furthermore, they require lasting treatment and are associated with high rates of morbidity, mortality, and costs (1) , especially those related to dressings.…”

Section: Introductionmentioning

confidence: 99%

Pressure ulcer dressings in critical patients: a cost analysis

Silva

Bezerra

Costa

et al. 2017

Rev. esc. enferm. USP

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Objective:To assess the direct cost of dressings in pressure ulcer treatment. Method: This was a descriptive observational study conducted at an intensive care unit in the Northeast region of Brazil, between November and December 2015. Data were gathered using the Pressure Ulcer Scale for Healing and a form to characterize and assess costs. Values in Brazilian reais (BRL) were converted into U.S. dollars at the exchange rate of USD 0.26/ BRL. Univariate and bivariate analyses were conducted. Results: The sample consisted of 15 patients with at least stage 2 ulcers. There was a significant reduction in costs with dressing materials between the initial and final assessments (p=0.002), with a mean of USD 11.9 (±7.4). The most common topical treatments used were essential fatty acids and papain. Conclusion: Cost reduction was proportional to the stage of pressure ulcer. The role of nurses in creating evidence-based care plans is crucial to improve care management. DESCRIPTORSPressure Ulcer; Costs and Cost Analysis; Bandages; Nursing Care. Pressure ulcer dressings in critical patients: a cost analysisCurativos de lesões por pressão em pacientes críticos: análise de custos Los curativos de lesiones por presión en pacientes en estado crítico: análisis de costos

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“…In a database of 710 626 patients in adult critical care, step-down, medical, surgical, and medical/ surgical units, 3.6% of all patients and 7.9% of those considered at risk had hospital-acquired pressure ulcers (HAPUs; ie, pressure ulcers noted ≥ 24 hours after admission) develop. 2 In acute care settings, the estimated incidence of HAPUs varies widely (eg, from 0.4 to 12% 3 and from 3.3 to 53.4% 4 ).…”

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confidence: 99%

“…7 Standard recommendations for prevention 8 have helped to drive down the incidence of HAPUs, but room remains for further improvement. 3 Formal multifactorial prevention programs are an additional tool that reduces the prevalence of HAPUs. 3,9 It is also important to take advantage of new technology.…”

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confidence: 99%

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Use of a Comprehensive Program to Reduce the Incidence of Hospital-Acquired Pressure Ulcers in an Intensive Care Unit

Swafford

Culpepper

Dunn

2016

American Journal of Critical Care

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Background Hospital-acquired pressure ulcers (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. Objectives To assess 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. Methods Planning for the prevention program began in 2012, and the program was rolled out in the first quarter of 2013. Program components included use of Braden scores, a revised skin care protocol, fluidized repositioners, and silicone gel adhesive dressings. Efforts were made to educate and motivate staff and encourage them to be more proactive in detecting patients at risk of HAPUs. Results Incidence of HAPUs in the unit was reduced by 69% (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 approximately $1 million. Conclusions 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.

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The Effectiveness of a Pressure Ulcer Intervention Program on the Prevalence of Hospital Acquired Pressure Ulcers: Controlled Before and After Study

Cited by 75 publications

References 59 publications

Pressure injury prevalence and predictors among older adults in the first 36 hours of hospitalisation

Pressure injury prevalence and predictors among older adults in the first 36 hours of hospitalisation

Pressure ulcer dressings in critical patients: a cost analysis

Use of a Comprehensive Program to Reduce the Incidence of Hospital-Acquired Pressure Ulcers in an Intensive Care Unit

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