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Pressure Ulceration In Older Adults: Lessons From A Four Year Service Review

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Ms Maree Barry Clinical Nurse Specialist Tissue Viability

Published in: Health & Medicine
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Pressure Ulceration In Older Adults: Lessons From A Four Year Service Review

  1. 1. Pressure Ulceration in St. Mary’s Hospital: A Four Year Health Service Evaluation M Barry CNSp Tissue Viability, St. Marys Hospital C Murphy School of Nursing and Human Sciences, DCU
  2. 2. Introduction • Pressure ulcers cause great pain and suffering
  3. 3. Introduction • Major financial burden for healthcare providers
  4. 4. Introduction • €48/day for a stage1 pressure ulcer to €418/day for a stage 4 pressure ulcer (Dealey et al 2012)
  5. 5. Aims 1. Examine differences in the site and severity of pressure ulceration in persons admitted to St. Mary’s compared to pressure ulceration acquired as an inpatient over a four year period 2. Describe trends in total person time exposed to pressure ulceration
  6. 6. Methods • Incidence, prevalence and healing data collected
  7. 7. Overview of pressure ulcer data 2013 2014 2015 2016 Total N N N N Patient with PU on admission 15 17 10 9 51 (48.5%) Patient with PU acquired in St. Marys 16 11 13 14 54 (51.4%) Total number of new patients 31 28 23 23 105 Multiple PU Single PU 24 21 21 18 84 (80%) Two PU 6 3 2 3 14 (13%) Three PU 1 4 0 2 7 (7%) Total number of new PUs 39 39 25 30 133
  8. 8. Figure 1: Differences in pressure ulceration site in persons resident in St. Mary’s compared to those with pressure ulceration on admission
  9. 9. Figure 2: Differences in severity of pressure ulceration in persons resident in St. Mary’s compared to those with pressure ulceration present on admission 0 10 20 30 40 50 60 70 Grade 2 Grade 3 Grade 4 Acquired in St Marys Present on admission % Pressure ulcer grade
  10. 10. Table 1: Total person time spent with a pressure ulcer in St. Mary’s from 2014-2016 and estimated associated costs
  11. 11. Discussion • Inpatients had lower severity of Pressure Ulcers • Shift from traditional sites compared to ulceration present on admission. • A decrease in the number of days exposed to PU over the period suggesting an associated reduction in health care costs
  12. 12. Discussion • On-going staff education • Heighten awareness of vulnerability of foot and heel • Multi-disciplinary involvement • Off Loading devices • Carer/patient/resident education
  13. 13. Conclusion • The need for on-going education for all staff and evaluation of practice is essential to ensure there is continued awareness of the importance of pressure ulcer prevention. • The increasing prevalence of pressure ulceration at “non-traditional” sites in residents has implications for education and equipment provision at the facility whilst the prevalence of pressure ulceration at “traditional” sites found on admission could be incorporated into a wider educational programme for community based carers.
  14. 14. Thankyou

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