The Mölnlycke Health Care blog
Growing body of evidence supports pressure ulcer prevention using multi-layer silicone dressings
We find ourselves repeating the same information time and again: pressure ulcers (PU) are an ongoing challenge for hospitals and have high incidence rates in some organizations. Hospital-acquired pressure ulcers increase costs, increase morbidity and even contribute to mortality in some vulnerable patients. We discuss the causes and conditions (pressure, shear, friction1, microclimate2). We discuss guidelines and processes to reduce incidence and improve risk assessment and detection rates. We create and implement protocols to reduce the incidence of pressure ulcers. We undertake clinical studies, which we repeat, and find time and again, that there are effective prevention methods and strategies (read the review of numerous studies in this monograph).
The body of evidence is worth discussing repeatedly, and the prevention message is worth repeating because the problem of pressure ulcers continues to exist: the population is aging, obesity rates are rising, as are a range of chronic diseases, such as diabetes. In short, patients – and more of them – are sicker when they come to our hospitals. With regard to pressure injuries, we need to continually search for better ways of preventing these injuries. We have to critically analyse the emerging clinical and scientific evidence for improving ways to protect our patients from developing these preventable wounds.
Just as the message bears repeating over time, the path of gathering clinical evidence takes time. At the Royal Melbourne Hospital (RMH) in Australia, we recently published outcomes from our five-year PU prevention program in the publication Wounds International3. The findings highlighted a marked decrease in the prevalence of hospital-acquired PUs, from 6.6 percent in 2010 to 6 percent in 2012 to 2.5 percent in 2014.
What do these results mean? The results demonstrate the effectiveness of a multifaceted program of PU prevention based on the translation of research evidence, targeted education and clinical practice change. They also show the importance of examining and improving clinical processes and governance. Our work was a multi-phase process that took place over five years, which included multiple pressure ulcer prevalence surveys, monthly incidence monitoring, the conduct of a large randomized controlled trial (RCT) and subsequent cost-benefit analysis, revision of our clinical policies and an institution-wide communication process.
Looking at the combined evidence over time, a clear pattern emerged: prevention is possible, the scientific, clinical and health economic evidence support the conclusion that the occurrence of PUs can be significantly reduced.
The results of the full five-year study are available for reading. Take a look.
>> Results from a five-year pressure ulcer prevention project in an Australian university hospital
- Levy, A., Frank, M.B., Gefen, A. The biomechanical efficacy of dressings in preventing heel ulcers. Journal of Tissue Viability 2015.
- Gefen A. J Tissue Viability. 2011 Aug;20(3):81-8. doi: 10.1016/j.jtv.2010.10.002. Epub 2010 Nov 5. http://www.ncbi.nlm.nih.gov/pubmed/21115351.
- Santamaria, N., McCann, J., O’Keefe, S., Rakis, S., Sage, S., Tudor, H., Ng, A.W., Morrow, F. Clinical innovation: results from a 5-year pressure ulcer prevention project in an Australian University. Wounds International 2015;6(3):12-16.