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Clinical Research
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A bundled approach to pressure ulcer prevention including pressure-reducing surfaces reduces facility-acquired pressure ulcers Heidt C, MSN, RN, CNAA, Pechulis K, BSN, RN, Drew J, MSN, RNCS, Pfleger K, BSN, RN, VanGilder C, BS, MT, CCRA, Underwood-Memorial Hospital, Woodbury, NJ Introduction: Underwood-Memorial Hospital is a 305 bed community hospital. In 1993 the first prevalence ulcer survey yielded a higher than national average result. Significant long-term strategies were initiated, including staff education, prevention protocols, documentation of Braden risk scores and skin assessments, and nutrition evaluations for at-risk patients. A reduction of facility acquired (FA) pressure ulcers was achieved using a bundled approach for prevention Methods: After discovery of a pressure ulcer prevalence of 20.3% (national levels 11.1%), a process improvement team initiated policies, products, protocols and documentation tools for pressure ulcer prevention. Education was performed and monthly prevalence surveys documented results. After several years, results approached the national benchmark and surveys were performed quarterly. The hospital set a facility-wide goal of 5% FA prevalence by 2003. Process improvements were supplemented with capital monies to replace the old hospital mattresses over 3 years span. The VersaCare A.I.R.TM bed system was purchased, plus other treatment and basic foam surfaces. Results: Overall, the hospital FA pressure ulcer rate was reduced to 5.5% in 2005. The medical/oncology unit received the VersaCare A.I.R.TM bed system for all patients. FA prevalence decreased from 10%, and 7% (4th Quarter 2004, and 1st quarter 2005) prior to bed replacement to 0%, and 0% FA ulcer prevalence in 2nd and 3rd quarters of 2005. No other significant changes were made during this period of time, and the census has remained relatively constant. Hospital-wide, cost savings of $225,000 were also achieved in the operational budget by reducing rental bed therapy surfaces Discussion: Part of an aggressive program to manage FA pressure ulcers is the provision of pressure relieving surfaces. Through our commitment to the capital purchase of VersaCare A.I.R.TM bed systems, we have demonstrated its effectiveness in decreasing FA pressure ulcers and operational costs. |
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