pressure ulceration in older adults: lessons from a four year service review
TRANSCRIPT
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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
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Introduction
• Pressure ulcers cause great pain and suffering
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Introduction
• Major financial burden for healthcare providers
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Introduction
• €48/day for a stage1 pressure ulcer to €418/day for a stage 4 pressure ulcer
(Dealey et al 2012)
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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
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Methods
• Incidence, prevalence and healing data collected
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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
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Figure 1: Differences in pressure ulceration site in persons resident in St. Mary’s compared to those with pressure
ulceration on admission
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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
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Table 1: Total person time spent with a pressure ulcer in St. Mary’s from 2014-2016 and estimated associated costs
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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
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Discussion
• On-going staff education
• Heighten awareness of vulnerability of foot and heel
• Multi-disciplinary involvement
• Off Loading devices
• Carer/patient/resident education
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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.
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Thankyou