Pressure ulcer prevention

Results from a five-year pressure ulcer prevention project in an Australian university hospital

By: Mölnlycke Health Care, August 9 2016Posted in: Pressure ulcer prevention

Clinical innovation: results from a five-year pressure ulcer prevention project in an Australian university hospitalPressure ulcer (PU) prevention is an area within healthcare that poses ongoing challenges for clinicians, but which is also the focus of a growing body of evidence demonstrating the efficacy of prevention protocols.

The Royal Melbourne Hospital (RMH) in Australia recently published details of the outcomes from its five-year PU prevention program in the publication Wounds International.1 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. The program involved multiple interventions coordinated by the hospital's Skin Integrity Committee.

The results demonstrate the effectiveness of this multifaceted program of PU prevention based on research and education. But the process by which these results were achieved is equally compelling. In 2010, RMH restructured its wound management governance approach (becoming the aforementioned Skin Integrity Committee), involving more representatives who provide direct patient care as well as employees from materials management and procurement. One of the largest aspects of the committee's work was to focus on reducing and preventing hospital-acquired PUs. To do so, the committee needed to determine the prevalence of PUs, from which prevention strategies could be developed.

Clinical innovation: Growing body of evidence

During the first phases of the committee's work, in 2011, a PU prevention research program was developed to examine the potential benefits of prophylactic dressings to prevent PU in high-risk patients. In early 2013, a large randomized controlled trial was completed and demonstrated the effectiveness of multi-layer foam dressings with Safetac® as a component of standard preventive strategies in the prevention of PUs. This was followed by a cost-benefit analysis, the results of which were also in support of the use of prophylactic dressings. At the same time, scientific evidence was emerging elsewhere to show how the protective mechanisms of these dressings work to help prevent PUs.2,3 By 2013, it was clear from the available evidence that prevention was indeed possible and improving clinical care and adherence to guidelines, as part of redesigning the hospital’s whole approach, could significantly reduce the occurrence of PUs.

Taking steps to PU prevention

Clinical innovation: results from a five-year pressure ulcer prevention project in an Australian university hospitalLearn about the multidisciplinary team's five-year process and the initiatives they introduced to reduce hospital-acquired PUs by downloading the full research article (4 MB pdf, opens in a new window)

References

  1. 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.
  2. Gefen, A. How do microclimate factors affect the risk for superficial pressure ulcers: a mathematical modelling study. Journal of Tissue Viability 2011;20(3):81-88. 
  3. Levy, A., Ben-Or Frank, M., Gefen, A. The biomechanical efficacy of dressings in preventing heel ulcers. Journal of Tissue Viability 2015; http://www.journaloftissueviability.com/article/S0965-206X(15)00002-9/fulltext (external link, opens in a new window).
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