The Cost of Pressure Injury Prevention

Singh, Charleen; Shoqirat, Noordeen; Thorpe, Lee

doi:10.1016/j.mnl.2021.11.003

Cited by 4 publications

(13 citation statements)

References 13 publications

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“…With the decrease in PI rates, there is a ripple effect in decreasing operational burden which includes direct and indirect costs 4 7 10–16. Indirect costs include the time spent investigating and reporting HAPIs 25.…”

Section: Discussionmentioning

confidence: 99%

“…Next the organisation spent resources to acquire products identified by the gap analysis as lacking and developed the process. The products to prevent PIs have a depth of research to support evidence-based nursing practice while improving operational efficiency and work life quality 1–10…”

Section: Methodsmentioning

confidence: 99%

“…The process easily identifies which patients benefit from the products and nursing interventions that are part of the pressure injury prevention bundle (PIPB) 3 5 7 8. The PIPB consists of appropriate pressure relieving support surface, turn and position overlay, foam bordered dressings, moisture management with moisture wicking fabric, peri-care and attention to devices and implementation timeline 3–17. Products to offload pressure and protect from shear, friction and moisture were standardised throughout the organisation and made available on all units as part of the PIPB (table 2).…”

Section: Methodsmentioning

confidence: 99%

“…Currently, PIs cost healthcare US$3.3 billion to US$11 billion annually while chronic PIs have an estimated annual cost of US$22 billion 3. The high cost and incidence of PIs continue to exist despite nurse scholars suggesting appropriate evidence-based nursing interventions to prevent certain PIs 3–6. We compared best evidence-based practices from the literature with our current practices to identify gaps in practice 5.…”

Section: Introductionmentioning

confidence: 99%

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Sustainable pressure injury prevention

Singh,

Shoqirat,

Thorpe

et al. 2023

BMJ Open Qual

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The quality department used adaptive leadership and the plan-do-study-act cycle to decrease pressure injury (PI) rates. After identifying gaps, the pressure injury prevention bundle was developed and implemented to bring evidence-based nursing practice to frontline nurses. Organisational rates of PI was followed for 4 years (2019–2022) and a smaller subset of 88 patients were followed in the prospective arm. Using statistical analysis, the decrease in PI rates (90%) and severity is significant (p<0.5) and sustained compared with the year prior to interventions.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Sustainable pressure injury prevention

Singh,

Shoqirat,

Thorpe

et al. 2023

BMJ Open Qual

Self Cite

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“…Pressure injuries/pressure ulcers (PIs/PUs) are developed by unrelieved pressure that disrupts blood supply to the capillary network, impeding blood flow . Difficulty in healing and pain increases hospital costs and prolongs hospital stay for patients, especially the elderly. − As the population ages around the world, the number of bedridden elderly and the utilization rate of related medical facilities increase, which leads to an increased incidence of PIs/PUs. − In the US, the annual expenditure on treating PIs/PUs was reported to be $26.8 billion, resulting in nearly 6 × 10 4 people’s death . Therefore, the prophylaxis and management of PIs/PUs is a challenge that needs to be addressed urgently .…”

Section: Introductionmentioning

confidence: 99%

Piezoelectric Hydrogel for Prophylaxis and Early Treatment of Pressure Injuries/Pressure Ulcers

Guan

et al. 2022

ACS Biomater. Sci. Eng.

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Pressure injuries/pressure ulcers (PIs/PUs) are a critical global healthcare issue and represent a considerable burden on healthcare resources. Prevention of PIs/PUs is the least costly approach and minimizes the patient suffering compared with treatment. Besides, sustained tissue load alleviation and microenvironment management are the most crucial properties for dressings in PI/PU prevention. Hydrogel dressings have attracted a lot of attention to prevent PIs/PUs because of their unique mechanical properties and ability to manage the microenvironment of skin. However, auxiliary prophylaxis and early treatment of PIs/PUs remain a challenge and an acute clinical demand. Here, we report on an electroactive hydrogel with large stretchability (∼380%) and skinlike ductility, and Young's modulus (0.48 ± 0.03 MPa) matches that of human skin (0.5−1.95 MPa). The hydrogel displayed piezoelectric properties and mechanical−electric response stability and sensitivity. Our results indicated that the hydrogel was able to promote in vitro angiogenesis under piezoelectric stimulation and exhibited biocompatibility, which has the potential for forming fine vessels at the damaged sites of PIs/PUs. Furthermore, finite element analysis and pressure dispersion experiments demonstrated that the hydrogel was suitable for preventing PIs/PUs by redistributing force, reducing tissue distortion, and maintaining the microenvironment for skin. This work offers a new strategy for designing and evaluating the dressing for prophylaxis and the early treatment of PIs/PUs.

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Enhanced Skin Assessment Methodology to Detect Early Tissue Damage and Prevent Pressure Injuries

Pittman,

Otts,

Mulekar

2024

Journal of Wound, Ostomy &Amp; Continence Nursing

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PURPOSE: The purpose of this study was to evaluate a skin assessment technique, subepidermal moisture (SEM) assessment, to assess, identify, and prevent pressure injuries (PIs) in critically ill adults. DESIGN: This was a retrospective, descriptive, comparative research study. SUBJECTS AND SETTING: The sample comprised 69 critically ill adults; their mean age was 58.8 years (SD 18.1 years). The majority were male (n = 40, 58%), 29 (42%) were African American (AA), and 36 (52%) were White. The study setting was a surgical trauma intensive care unit (STICU) in a southern US Gulf Coast academic level I trauma hospital. Data were collected from September to November 2021. METHODS: We conducted a retrospective medical record review of subjects who had undergone SEM assessment. We also collected demographic and pertinent clinical information, including Braden Scale cumulative scores and subscale scores, documented PI prevention interventions, and PI occurrence and characteristics if developed within 7 days of SEM measurement. We also evaluated whether PI prevention interventions were appropriate. To examine nurse perception of the SEM device, we conducted a web-based survey of nurses providing care in our facility’s STICU. Comparison of responses was done using Fisher’s test or Chi-square test, and the mean responses from groups were compared using t test. RESULTS: Thirty-five (57%) subjects had a sacral SEM delta ≥0.6; 14 (40%) were AA; 20 (57%) were White; and 11 (31%) had a hospital-acquired PI (HAPI) or present-on-admission (POA) PI. Among the 14 HAPI and POA PI subjects with sacral SEM delta, 11 (79%) had sacral SEM delta ≥0.6. Among 26 AA subjects with sacral SEM delta, 5 had a HAPI or POA PI, and of those, 4 (80%) had sacral SEM delta ≥0.6. A significant and negative correlation was observed between cumulative Braden Scale scores on day 2 and sacral SEM delta (r = −0.28, P = .03) and R heel delta (r = −0.29, P = .03) scores, indicating higher PI risk. Of the 35 patients with a sacral SEM delta ≥0.6, 24 (69%) subjects did not have appropriate PI prevention interventions. Nurses (n = 13) indicated that the SEM device was easy to use and helped them perform an accurate skin assessment on patients with darker skin tones. CONCLUSIONS: This study demonstrates that SEM technology is beneficial to address racial disparities in skin assessment, enhance skin assessment accuracy beyond existing PI care, improve the accuracy of risk assessment, and promote appropriate location-specific PI prevention interventions.

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The Cost of Pressure Injury Prevention

Cited by 4 publications

References 13 publications

Sustainable pressure injury prevention

Sustainable pressure injury prevention

Piezoelectric Hydrogel for Prophylaxis and Early Treatment of Pressure Injuries/Pressure Ulcers

Enhanced Skin Assessment Methodology to Detect Early Tissue Damage and Prevent Pressure Injuries

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