Preventive techniques greatly reduce pressure ulcers

Working together to reduce the occurrence of pressure ulcers in patients throughout various care settings, members of the New Jersey Hospital Association's Pressure Ulcer Collaborative have reported a 70 percent reduction in the incidence of new pressure ulcers after nearly two years of applying shared best practices and preventive techniques.

Each year, pressure ulcers, commonly known as bed sores, affect more than 1 million patients and residents in nursing homes and hospitals nationwide. Costs associated with pressure ulcer treatment exceed $1.3 billion. More importantly, the human toll of pain, depression, altered self-image, infection and increased mortality is immeasurable.

The NJHA Collaborative, which first met more than 22 months ago to develop and share standardized preventive strategies, is comprised of 150 hospitals, nursing homes and home care agencies. The 70 percent reduction in the incidence of pressure ulcers was reported from data that was tracked from September 2005 through May 2007.

Of the 150 organizations taking part, 48 reported achieving results of no new pressure ulcers for a period of three months or more. In addition, data released at a daylong conference of participants held today in Princeton showed that the prevalence of existing pressure ulcers as patients moved from one care setting to another was reduced by 30 percent.

Pressure ulcers, usually located around bony areas of a patient's body, are lesions or skin and tissue breakdowns caused by unrelieved pressure or friction against the body. They can range from simple redness and irritation to extensive destruction of tissue, muscle and bone.

"The results show that we were able to achieve measurable, significant improvement in the quality of care provided to patients with respect to pressure ulcer prevention across care settings," said Aline Homes, RN, NJHA senior vice president of clinical affairs. "When caregivers communicate and work together, they can learn from each other and improve patient outcomes."

Common improvement techniques used by staff at hospitals, nursing homes and home care settings alike included: complete skin evaluation within eight hours of admission; evaluation of the risk of skin breakdown using the internationally respected Braden scale; implementation of preventive strategies, such as proper positioning and use of assistive devices; and ongoing observation of the condition of patients' skin, particularly for those identified as being at high risk for developing a pressure ulcer.

"These hospitals, nursing homes and home care agencies put aside competitiveness and openly shared their experiences with each other," said NJHA President Gary Carter. "That type of communication and cooperation led to everyone benefiting in the long run. The results of that sharing speak for themselves."

Participating organizations met regularly for education and information sharing sessions with nationally recognized experts in the field, hosted by NJHA, and then took proven best practices back to their facilities to lead their wound care teams and continue the work with their partners in other healthcare settings. The Collaborative is expected to continue sharing data and gathering results this fall. Various national organizations and quality improvement agencies have now inquired about the success of the NJHA-led initiative.

Added Theresa Edelstein, NJHA's vice president of continuing care services: "Improved collaboration and teamwork between healthcare professionals across various settings allowed for more seamless transitions in care as the patients moved across different care settings. This give-and-take was a huge part of the project's success."

Founded in 1918 and based in Princeton, NJHA provides its members with advocacy, data collection and analysis, continuing education and communication.