A comprehensive approach cuts pressure ulcers in half

The strategy cut the ulcer rate by 69% by the end of the first year.
The strategy cut the ulcer rate by 69% by the end of the first year.

A team of nurses in Indianapolis cut the rate of hospital-acquired pressure ulcers by 50% and saved about $700,000 a year by introducing new products, interventions  and incentives.

The study was published this spring in the American Journal of Critical Care. Results were based on investigations at Eskenazi Health Center that wrapped up in 2014.

"Before we started this, nurses knew it was an issue, but had the mindset that pressure ulcers were expected with a critical care patient; it was fine as long as the patient survived," study co-author Christina Dunn, RN, told Medscape Medical News.

The team launched “Save Our Skin” in January 2013, looking to cut the intensive care unit's 45 pressure ulcers in 2011 in half by 2014. Certain comorbidities, such as diabetes, drug abuse and traumatic injury, make it challenging to completely avoid pressure ulcers, Dunn said, but the team found strategies that worked. 

Nurses devised a Braden algorithm, revised the skin care protocol, placed resource books in patient rooms and trained colleagues. The hospital began using fluidized positioners, documented wounds with a new camera and added different wound care dressings. The team also offered incentives and posted incidents.

By the end of 2013, the team saw its pressure ulcer rate drop by 69%, even though patient load had increased by 22%.