Definition

Pressure ulcers are defined as a "localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear."([FOOTNOTE=European Pressure Ulcer Advisory Panel and National Pressure Ulcer Advisory Panel. Prevention and treatment of pressure ulcers: quick reference guide. Washington DC: National Pressure Ulcer Advisory Panel; 2009.],[ANCHOR=],[LINK=])

Incidence and Costs

In the U.S., pressure ulcers affect an estimated 2.5 million patients per year with approximately 60,000 patient deaths attributed to pressure ulcer complications.([FOOTNOTE=Berlowitz D, Lukas C, Parker V, et al. Preventing pressure ulcers in hospitals: A toolkit for improving quality of care. April 2011. Agency for Healthcare Research and Quality, Rockville, MD. Available at:],[ANCHOR=http://www.ahrq.gov/sites/default/files/publications/files/putoolkit.pdf.],[LINK=http://www.ahrq.gov/sites/default/files/publications/files/putoolkit.pdf]) The healthcare costs associated with pressure ulcers are approximately $11 billion dollars.([FOOTNOTE=Russo A, Steiner C, Spector W. Hospitalizations related to pressure ulcers among adults 18 years and older, 2006. HCUP Statistical Brief #64. December 2008. Agency for Healthcare Research and Quality, Rockville, MD. Available at:],[ANCHOR=http://www.hcup-us.ahrq.gov/reports/statbriefs/sb64.pdf.],[LINK=http://www.hcup-us.ahrq.gov/reports/statbriefs/sb64.pdf])

Risk Factors

Pressure ulcers can develop in as little as two to six hours, indicating that early and continuous monitoring of at-risk patients is of critical importance.([FOOTNOTE=Lyder CH, Ayello EA. Pressure Ulcers: A Patient Safety Issue. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr. Chapter 12.],[ANCHOR=],[LINK=])

Prevention and Treatment

Strategies for preventing pressure ulcers include the use of appropriate support surfaces, frequent repositioning of the patient, optimizing nutritional status, and moisturizing sacral skin.([FOOTNOTE=Ayello EA, Lyder CH. A new era of pressure ulcer accountability in acute care. Adv Skin Wound Care. 2008;21(3):134-140.],[ANCHOR=],[LINK=])

Patient Turning

Patient turning every two hours has become standard practice as studies have found that patients turned every two to three hours had fewer ulcers.5,([FOOTNOTE=Norton D, McLaren R, Exton-Smith A. An investigation of geriatric nurse problems in hospitals. Edinburgh UK: Churchill Livingstone; 1975.],[ANCHOR=],[LINK=])

Conclusions

Studies indicate that rigorous implementation of comprehensive pressure ulcer care bundles can reduce the incidence of these events, improving patient safety and reducing cost of care. Despite the evidence, compliance with prevention protocols remains suboptimal.

Solution: Vital Sync™ Monitoring and Clinical Decision Support (CDS) Solution

Remotely monitor patient turn-time compliance according to your hospital's turn-time protocols with the Vital Sync™ patient repositioning feature.