The cost of pressure ulcer prevention and treatment in hospitals and nursing homes in Flanders: A cost-of-illness study

Demarré, Liesbet; Verhaeghe, Sofie; Annemans, Lieven; Hecke, Ann Van; Grypdonck, Maria; Beeckman, Dimitri

doi:10.1016/j.ijnurstu.2015.03.005

Cited by 66 publications

(48 citation statements)

References 24 publications

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“…Meanwhile, the USA study was undertaken at two large inner city hospitals, with numerous local nursing homes in their catchment (Keelaghan et al, ); similar to our study settings. Older adults living in aged care facilities generally have complex healthcare needs (Demarré, Verhaeghe, et al, ), tend to require repositioning assistance (Keelaghan et al, ) and depend on others for their care (Cohen‐Mansfield & Jensen, ). Furthermore, the rising cost of nursing home care has seen a reliance on paraprofessionals such as assistants in nursing to deliver residents’ care, with suggestions that staff skill mix is closely linked to care quality (Dellefield et al, ).…”

Section: Discussionmentioning

confidence: 99%

Pressure injury prevalence and predictors among older adults in the first 36 hours of hospitalisation

Latimer

Chaboyer

Thalib

et al. 2019

Journal of Clinical Nursing

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Aims and objective To describe the prevalence and predictors of pressure injuries among older adults with limited mobility, within the first 36 hr of their hospital admission in Australia. Background Pressure injuries are significant health, safety and quality of care issues for patients and healthcare organisations. The early implementation of the recommended pressure injury prevention international clinical practice guidelines is a way to reduce hospital‐acquired pressure injuries. There is a paucity of evidence on the number of older persons who are admitted hospital with a pre‐existing pressure injury. Design Prospective correlational study conducted in eight tertiary referral hospitals across Australia. Our sample comprised of 1,047 participants aged ≥65 years with limited mobility, drawn from a larger Australian pragmatic cluster randomised trial. Methods Using the STROBE statement, observational data were collected on participants’ age, gender, presence of a pressure injury, Body Mass Index score, number of comorbidities and place of residence. These variables were analysed as potential predictors for pressure injuries within the first 36 hr of hospitalisation. Results From our sample, 113/1047 (10.8%) participants were observed to have a pressure injury within the first 36 hr of hospital admission. Age, multiple comorbidities and living in an aged care facility predicted the prevalence of pressure injury among older people within the first 36 hr of hospitalisation. Conclusions Our findings confirm that older adults, those with multiple comorbidities and individuals living in aged care facilities are more likely to come to hospital with a pre‐existing pressure injury or develop one soon after admission. Relevance to clinical practice Many older patients come to hospital with a community‐acquired pressure injury or develop a pressure injury soon after admission. This highlights the importance of the early detection of pressure injuries among older persons so that timely management strategies can be implemented along with the potential to reduce unnecessary financial penalties.

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Section: Discussionmentioning

confidence: 99%

Pressure injury prevalence and predictors among older adults in the first 36 hours of hospitalisation

Latimer

Chaboyer

Thalib

et al. 2019

Journal of Clinical Nursing

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“…The observation audit items included assessment of the PI stage, the PI treatment activities that were conducted, the number and level of staff utilised for PI treatment, and the time taken to complete PI treatment activities. The latter was measured with an iPhone in stopwatch mode, an approach that offers accuracy when measuring time spent on treatment activities …”

Section: Methodsmentioning

confidence: 99%

“…PIs are an international concern, and although it is widely accepted that PIs are costly, report of the actual cost of treating pressure injuries is scant. Research conducted by Dealey et al 2004 and updated in 2012 . suggests that the cost of PI treatment is higher when the severity of the PI is greater.…”

Section: Introductionmentioning

confidence: 99%

“…The incidence and cost of PIs are compelling reasons to invest in PI research; however, with regard to cost, research to date has tended to estimate or extrapolate, resulting in considerable uncertainty about the actual cost of PIs. This issue has been identified in a recent systematic review which highlighted the need for research that more accurately calculates the direct cost of PI treatment …”

Section: Introductionmentioning

confidence: 99%

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The direct cost of pressure injuries in an Australian residential aged care setting

Wilson

Kapp

Santamaria

2018

International Wound Journal

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Pressure injuries have a negative effect on well‐being and the cost of treatment places a significant burden on the health care system. Research has, however, tended to extrapolate or estimate the cost of pressure injuries resulting in uncertainty regarding the true cost of this condition. The aim of this prospective observational study was to quantify the cost of pressure injury treatment in the Australian residential aged care setting. An electronic health care record audit and observation of usual pressure injury treatment was undertaken with a sample of 20 participants who had 23 pressure injuries. The actual treatment cost, an evidence‐based practice model cost, and a projected treatment cost were calculated. The overall cost of pressure injury treatment was AU$98,489.22. The average daily cost by pressure injury stage was AU$26.42 for a Stage 1 pressure injury, AU$37.17 for a Stage 2 pressure injury, AU$30.01 for a Stage 3 pressure injury, and AU$10.22 for an Unstageable pressure injury. The projected cost of treatment was AU$104,510.41. At 42 days this cost extended to AU$116,552.79. This study has quantified the cost of pressure injury treatment in a residential aged care setting. The study may inform future efforts to accurately calculate the cost of PIs and the effectiveness of strategies to reduce the economic burden of this condition.

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“…Pressure ulcers have been associated with a substantial burden for patients, health care providers, and the society, arising as a consequence of wound‐related pain, a decreased quality of life, an increased length of hospital stay, and an increased mortality rate . In addition, the costs associated with the time and resources required to treat pressure ulcers cause an important financial burden …”

Section: Introductionmentioning

confidence: 99%

Physiological processes of inflammation and edema initiated by sustained mechanical loading in subcutaneous tissues: A scoping review

Damme

Hecke

Remue

et al. 2019

Wound Repair Regeneration

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Deep tissue injuries are pressure ulcers which initiate in the subcutaneous tissues and extend through a bottom‐up pathway. Once deep tissue injuries are visual at skin level, serious irreversible tissue damage has already occurred. In pressure ulcer development, inflammation and edema are coupled physiological processes associated with tissue damage arising due to sustained mechanical loading. This study aimed to provide an in‐depth overview of the physiological processes of inflammation and edema initiated by sustained mechanical loading in subcutaneous tissues, in the context of pressure ulceration. A scoping review was performed according to the framework by Arksey and O'Malley. The databases MEDLINE, EMBASE, Web of Science, and Scopus, and the reference lists of included studies were searched for in vivo (animal, human), and in vitro studies matching the study objectives (from inception to 28 May 2018). No restrictions for inclusion were applied for study design, setting, participants, and year of publication. A total of 12 studies were included, varying in study design, sample characteristics, amount and duration of mechanical loads that were applied, follow‐up time, and assessment methods. Neutrophil infiltration and edema occur in the subcutaneous tissues nearly immediately after the application of load on soft tissues. The amount of neutrophils and edema increase in the first days after the mechanical insult and decrease once healing has been initiated and no supplementary mechanical load was applied. One study indicated that edema may extend up to the level of the dermo‐epidermal junction. Further research should focus on how deep tissue inflammation and edema are reflected into unique tissue changes at skin level, and how abnormal inflammatory responses manifest (e.g. when the nervous system is not functioning normally).

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The cost of pressure ulcer prevention and treatment in hospitals and nursing homes in Flanders: A cost-of-illness study

Cited by 66 publications

References 24 publications

Pressure injury prevalence and predictors among older adults in the first 36 hours of hospitalisation

Pressure injury prevalence and predictors among older adults in the first 36 hours of hospitalisation

The direct cost of pressure injuries in an Australian residential aged care setting

Physiological processes of inflammation and edema initiated by sustained mechanical loading in subcutaneous tissues: A scoping review

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