Pressure ulcer dressings in critical patients: a cost analysis

Abstract

Objective:To assess the direct cost of dressings in pressure ulcer treatment. Method: This was a descriptive observational study conducted at an intensive care unit in the Northeast region of Brazil, between November and December 2015. Data were gathered using the Pressure Ulcer Scale for Healing and a form to characterize and assess costs. Values in Brazilian reais (BRL) were converted into U.S. dollars at the exchange rate of USD 0.26/ BRL. Univariate and bivariate analyses were conducted. Results: The sample consisted of 15 patients with at least stage 2 ulcers. There was a significant reduction in costs with dressing materials between the initial and final assessments (p=0.002), with a mean of USD 11.9 (±7.4). The most common topical treatments used were essential fatty acids and papain. Conclusion: Cost reduction was proportional to the stage of pressure ulcer. The role of nurses in creating evidence-based care plans is crucial to improve care management. DESCRIPTORSPressure Ulcer; Costs and Cost Analysis; Bandages; Nursing Care. Pressure ulcer dressings in critical patients: a cost analysisCurativos de lesões por pressão em pacientes críticos: análise de custos Los curativos de lesiones por presión en pacientes en estado crítico: análisis de costos

Custo da terapia tópica em pacientes com lesão por pressão

“…18 The prevalence of PU in the sacral region is explained by the difficulty in relieving pressure on bone prominences and the greater susceptibility of unequal weight distribution, which is associated with late assessment, the presence of risk factors, deficiencies in care and the availability of resources materials for performing dressings can influence to a greater degree of tissue destruction. 7,12 It is thus believed that evaluation of the lesion is essential to determine the clinical conditions of the patient, which assures to develop an adequate therapeutic plan, adopt adjuvant therapies, supervise the healing process and implement preventive measures. 19 The prevalence of hydrogel, calcium and sodium alginate, hydrocolloid, rayon gauze and silver topcoats such as hydro-fiber, activated carbon and polyurethane foam were assessed when evaluating the products used for the treatment of PU.…”

“…6,14 It is emphasized that in addition to the direct expenses that correspond to the resources used to perform the dressings, the presence of the injury involves indirect costs, being related to the loss of productivity and impact on the family income, the quality of life impairments and the overload of caregivers and of the health team. 7 It is necessary, in the face of high assistance costs, the organization of health services, aiming at preventing the development or progression of the injury, rational use of hospital materials and financial balance, without, therefore, safety and effectiveness of care.…”

“…[4][5] In this perspective, it is understood that, the application of economic fundamentals, in order to design the rational use of hospital resources, is fundamental and that the management of PU cost is a growing challenge for health institutions, being associated with an increase in the workload for nursing because it involves prolonged hospitalizations, using topical technologies and products for cleaning, debridement and humidity control, surgical procedures and adjacent therapies. [6][7] In this sense, the need to evaluate the effectiveness, efficiency and costs involved in the treatment of the lesion is demonstrated, since it allows to subsidize the clinical decision making and the management of the care. In this scenario, the nurse stands out as the leader and intermediary of the health team, who must improve their managerial skills and competencies, so as to provide the necessary resources for safety, effectiveness and quality of care.…”

Atuação do enfermeiro no cuidado a prevenção e tratamento de lesões por pressão

“…As lesões por pressão (LPP) constituem um dos principais eventos adversos potencialmente evitáveis que ocorrem nos serviços de saúde. Trazem como consequências, há o aumento dos gastos públicos e a diminuição da qualidade de vida do paciente (Silva et al, 2017). Nesta direção a LPP é caracterizada como um dano localizado na pele e/ou tecidos subjacentes, geralmente sobre uma proeminência óssea, resultante da pressão isolada ou combinada com forças de cisalhamento e/ou fricção, como também pelo microclima, nutrição, perfusão e condições do tecido (Npuap, 2018).…”

Pressure injury healing: a multiprofessional approach

“…PI causes a very significant impact on patients, families and the health system, because it is recurrent, incapacitating and with a severe repercussion on their quality of life, causing pain, suffering, increased length of stay and complications associated with basic diseases. 2 A multiprofessional approach is necessary to carry out to take care of the human being in all biopsychosocial aspects integrally and not only of existing injuries.…”