nursing home aderma dermal pad - smith & nephew
TRANSCRIPT
References1. Bennett G, Dealey C, Posnett J, The cost of pressure ulcers in the UK, Age and Ageing, Issue 33, p230-235, 2004.2. Royal College of Nursing, The management of pressure ulcers in primary and secondary care – A Clinical Practice Guideline, September 2005.3. Posnett J et al., The resource impact of wounds on health-care providers in Europe, Journal of Wound Care, Vol 18, No 4, April 2009.4. Graves N, Birrell F, Whitby M, Effect of Pressure Ulcers on length of Hospital Stay, The University of Chicago Press, on behalf of SHEA, Vol 26, No 3, pp 293-297, 2005. 5. Leonard S, Ormond K, An evaluation of a shaped dermal pad and their influences on pressure ulcers in an acute foundation trust, 2008, poster presentation, Wounds UK conference Harrogate.6. Hampton S, Tadejand M, Young S, An evaluation of Aderma Heel Pad, Wound healing centre, Eastbourne, 2011.
The following support materials are available for you to order:
• A3applicationposter• EvaluationForm• Skinguide• A5rangeguide
ADERMA Dermal PadDesigned to help prevent pressure ulcers
Hospital Community
ADERMA™ singles per carton S&N code NHS code S&N code PIP-code
Sheet 10x10x0.3cm 5 10-660 ELY373 FP0065 328-3918
Sheet 10x10x1.2cm 5 10-561 ELY065 FP0066 328-3934
Sheet 20x20x0.3cm 2 10-680 ELY371 FP0067 328-3900
Sheet 20x20x1.2cm 2 10-630 ELY367 NA NA
Strip 30x5.0x0.3cm 5 10-650 ELY372 FP0064 328-3926
Strip 50x2.5x0.3cm 5 10-670 FES9551 FP0063 365-5024
Heel standard 2 10-600 FES7524 FP0061 365-5032
Heel standard 30 10-600-BLK FES9552 NA NA
Heel extra large 2 10-640 ELY366 FP0062 365-5040
Sacrum/Anklewrap 1 10-610 FES7525 FP0060 365-5057
Ordering Codes
www.aderma.info
© Smith & Nephew April 2012 ™TrademarkofSmith&Nephew35050
Wound Management Smith & Nephew Healthcare Ltd Healthcare House 101 Hessle Road Hull HU3 2BN
T 01482 222200F 01482 222211
DesignADERMA was used on 28 residents across 3 nursing homes, all with a Waterlow score over 15 (highrisk)andexistinggrade1pressuredamagetothe heel. A visual and ultrasound inspection was carried out at the start of the study and after 1, 4, and8weeks.
DesignADERMA was used for 3 months in an acute NHS foundation trust as part of a Care Plan across 2 elderly wards, 1 orthopaedics ward and 1 general surgery ward. ADERMA was added to the care plan that already includedrepositioningandregularskininspections.Figures for incidence, severity and number of pressure ulcers were compared to the 3 months before ADERMA was included.
Clinical Evidence
Pressure ulcer incidence
Overall incidence
Hospital acquired incidence
4.0% 4.5%
3.5% 3.0%
2.5%
2.0% 1.5% 1.0% 0.5%
0.0%Jan-Mar Apr-Jun
Severity of pressure damage
Jan-Mar
Apr-Jun
161412
10
8642
0grade 1 grade 2 grade 3 grade 4
Nursing home
Hospital
ResultsAll the treated heals improved and returned to a pre-injured statewithinweeksofcommencingtreatment.ThevisualinspectionoftheskinshowedareductioninErythema,whereastheultrasoundimagesshowedthattheskincondition improved below the surface as well. The heels without ADERMA receiving standard care did not improve.
ADERMA™ on grade 1 pressure ulcers6
ResultsThe addition of ADERMA to the care plan contributed to an 87% drop in incidence of hospital acquired pressure ulcers. The reduction in the overall number of pressure ulcers was 75% including an eradication of all grade 3 and 4 pressure ulcers.
www.aderma.info
ADERMA as part of a Care Plan5
Sacrum around the ankle
ADERMA dermal padsDesigned to help prevent pressure ulcers
For patients. For budgets. For today.™www.aderma.info
™Trademark of Smith & Nephew© Smith & Nephew March 2012 34825
Strip Sheet Sacrum Heel
Early signs of pressure damage
Deep tissue damage Recently healed pressure ulcers Areas at risk of pressure damage
Use on intact skin only
Can be cut with scissors
Can be held in place with secondary fixation tape
Can be washed and re-used on the same patient
Keep packaging for easy storage
Early signs of pressure damage
Deep tissue damage Recently healed pressure ulcers
Areas at risk of pressure damage
ADERMA can be used on:
Wound Management Smith & Nephew Healthcare Ltd Healthcare House 101 Hessle Road Hull HU3 2BN
T 01482 222200F 01482 222211
Trimmed strip under masks
Sacrum over the shoulder
Heel long way across the heel (immobile patients)
Trimmed strip behind the ear
Sheet on the back of the head
Strip down the spineSacrum on the sacral area
Strip down the spineSacrum on the sacral area
Sheet under the shoulder
Sheet for hand contractures
Strip between fingers or toes
Heel long way across the foot (mobile patients)
Sheet between knees
Sheet around the foot
Heel over the knee or elbow
1 2
3 4
There are 3 layers to the skin1. EpidermisAlso known as the outer layer of the skin. The epidermis acts as the body’s major barrier against an inhospitable environment.
2. DermisAlso known as the middle layer of the skin and is composed of two layers, the papillary and reticular dermis.
3. HypodermisAlso called the subcutaneous tissue is the lower layer of the skin. The hypodermis consist primarily of loose connective tissue and lobules of fat, it contains large blood vessels and nerves.
Early signs on the skin of theformation of a pressure ulcer include:-
Change in skin colour either redder or darker indicate skin damage. A category 1 pressure ulcer exhibits non-blanching erythema, and as you can see in the picture below symptoms include a reddened (erythema) area on the skin. If you were to apply a small amount of pressure to this area it will not turn white (non-blanching).
Heat or cold can indicate the formation of a pressure ulcer as hot skin points to a sudden rush of blood suggesting circulation was cut for an amount of time.Whereas cold skin indicates the skin is dead and there is no blood flow in this area.
Discomfort or pain can be a sign of pressure ulcer formation as the area of skin and underlying tissue has been damaged due to either pressure, shearing or friction.
Any sign of skin damage can indicate the formation of a pressure ulcer however analysing the circumstances i.e. If the patient is immobile or being moved and handled, will help identify the cause of the damage.
Pressure ulcer grades 1 - 4 Depending on the grade of the pressure ulcer all layers of the skin can be affected. However some pressure ulcers cannot be categorized including those with deep tissue injury.
• Areasatriskorshowingsignsofdevelopingskin damage1
• Grade1pressureulcerstopreventdeterioration and aid tissue recovery2
• Recentlyhealedpressureulcerstohelpprevent re-ulceration3
They can be washed very quickly and re-used by the same patient making them very cost and time effective as part of a daily skin inspection routine.
Pressure ulcers can form due to a combination of factors including pressure, friction, immobility, sensory loss, poor blood circulation and malnutrition.
Preventing skin damage therefore starts with early risk assessments and a care plan for at-risk patients that includes regular repositioning, daily skin inspection, good nutrition and equipment such as specialized beds, cushions or skin care products.
ADERMA™DermalPads are an excellent addition to any prevention care plan to protect at-risk areas from pressuredamage,inparticularbonyareas.Madefroma unique polymer gel, the Dermal Pads are indicated for use on intact skin and can be used on:
The skin and its layers Signs on the skin Preventing skin damage
Epidermis
Dermis
Hypodermis
The skin is the largest organ of the body, and its derivatives (hair, nails, sweat and oil glands) make up the integumentary system. One of the main functions of the skin is protection from external factors such as bacteria, chemicals, and temperature.
ADERMA is available on prescription and can be ordered through your local pharmacy
Patient admitted into care
Early risk assessment
Care Plan for at-risk patients
ADERMA is a dermal gel pad that redistributes pressure to protect critical areas. Itistypicallyusedonbonyareastohelppreventskindamagefrompressure.
ADERMA™ Dermal Pads ADERMA™ as part of a Care Plan ADERMA™ can be used on:
How it works
High pressure points can disrupt the flow of blood and the supply of oxygen which can cause damage totheskin.
ADERMAworksbyredistributingpressure over a larger area to reducethepeakpressureatanyone point (usually a bony area liketheheelorthesacrum).Instead, the force is spread over a larger area, reducing the average pressureontheskin.
The human and economic cost of pressure ulcersAround412,000peoplearelikelytodevelopapressureulcer annually1, including 4-10% of patients admitted to hospital2.Anestimated31%aregrade3or4(EPUAP)3, causing severe pain and discomfort to the patient.
The costs of treating pressure ulcers has been estimated between £1.4bn - £2.1bn per year – the average cost to treat one grade 4 is £10,551 per episode1. Pressure ulcers also increase length of stay with an average of 4 days4, significantly increasing the demand on nursing time and resource.
ADERMA contributed to a 75% reduction of pressure ulcers 5
A Care Plan with ADERMA ADERMA dermal pads are an excellent addition to any Care Plan by
protecting at-risk areas from pressure damage, in particular bony areas. They can be washed and re-used by the same patient as part of a regular skin inspection routine:
1. Remove ADERMA and inspect the skin2. Clean the skin and the ADERMA pad with the same solution,
for example soap and water3. Dry the skin and the ADERMA pad and reapply
ADERMA has been shown to contribute to a significant drop in the number of pressure ulcers. To help you achieve a reduction in pressure ulcers you could add ADERMA to your care plan checklist:
Check if ADERMA is in place on at-risk areas
Care PlanACarePlanforpressureulcerpreventioncantakemanydifferentformsbutusuallyincludeselementslike:
• Regularrepositioning• Regularskininspection• Keepingtheskincleananddry
Somecaresettingshaveputtheseelementsintoasimplechecklist,forexampleas part of Intentional Rounding or using the SKIN Bundle. Such plans are based onregularchecksforcommonriskfactorsandroutinecaresuchasrepositioningor toileting assistance. An effective care plan could help to reduce call rates, patient falls and pressure ulcers, and increase patient satisfaction.
• Specializedbeds• Goodnutrition• Cushions
Early signs ofpressure damage
Deep tissuedamage
Recently healedpressure ulcers Areas at risk of
pressure damage
Use on intact skin only Can be cut with scissors Can be held in place with stockinette, tubular bandage, medical tape or silicone tapeCan be washed and re-used
on the same patientKeep packaging for easy storage
ADERMA
StripSacrum
HeelSheet
Heel - The heel can be used with the long way across the foot for mobile patients or with the long way across the heel for immobile patients. It can also be used on elbowsandknees.
Sacrum - This shape can be held in place with incontinence pads or underwear. Common practice includes usingasanklewraporaroundtheshoulder,hiporbackofthehead
Sheet - Can be used under the foot orheadwhilstresting,betweenkneesorunder the chin. They can also be used for handcontractures,makingthemidealforstrokerehabilitation.Thelargesheetscanbe used under the shoulder whilst lying down.
Strips - The strips are ideal for more trickyareaslikebetweenfingersandtoes,behind the ear, or over the nose under face masks.Thewiderstripisalsocommonlyused down the spine.
EarlyRiskAssessmentToidentifywhichpatientsneedacareplan,anearlyriskassessmentisusuallycarried out in the first 4-6 hours after the patient is admitted into care. Popular scoringcardslikeBradenorWaterlowlookatcommonriskfactorssuchas:
• Pressure&Friction• Moisture• Immobility• Skincondition
• Sensoryloss• Poorbloodcirculation• Malnutrition• Age,gender,weight
ADERMA redistributes pressure
Grade 4 pressure ulcer