Friday, January 18, 2013

Amazing Wonderful News

The most hopeful news we have seen has just been announced by the Collaborative Alliance for Nursing Outcomes.  The current issue (Jan 2013) of Advances in Skin & Wound Care contains a research paper, "Eliminating Hospital-Acquired Pressure Ulcers: Within Our Reach".  The  authors used records from 78 hospitals, mostly in California, over the period 2003-2010, and found that, on average, the rate of hospital-acquired pressure ulcers (HAPU) had decreased steadily from 11% to 2%. Pressure ulcers of Stage III and above had decreased from 2% to .4%.

All of the hospitals included in the study were non-profit or government facilities.  This is extremely promising data and we can only hope that for-profit facilities may be shown to have done as well.

How did these hospitals achieve these very promising results? The authors state:

"The most commonly reported interventions were protocol development, staff education, new use of a risk assessment tool, performance monitoring, development of a team approach, use of new beds/support surfaces, implementation of guidelines, providing feedback to staff, and linking staff with resources."

Clearly, the only substantive changes in this list are the use of a risk assessment tool and the purchase of new beds/support surfaces. All of the other items mentioned are just staff guidelines for implementation of the new protocol. That new protocol is the NDF Prevention Protocol as described in our  report, "Reducing Pressure Ulcer Incidence through Braden Scale Risk Assessment and Support Surface Use", submitted July 5, 2006 and published July 2008 in Advances in Skin & Wound Care.  We are extremely gratified to have this confirmation of the efficacy of the NDF Prevention Protocol, whether the hospitals involved realize they were using the NDF protocol or not.

Friday, January 11, 2013

Promising Developments in Early 2013

The State of Connecticut has strong requirements for hospital reporting of adverse events.  This year, hospitals reported a rate of serious pressure ulcer development at only half of that reported last year.  Dr. Mary Reich Cooper, vice president and chief quality officer for the Connecticut Hospital Association, said the state’s hospitals are making extensive efforts to identify patients at risk of ... pressure sores upon admission. 

The Greater New York Hospital Association, a trade association comprising hospitals in New York, New Jersey, Connecticut and Rhode Island, just announced their free organizational assessment of a pressure ulcer prevention and management program.  The program requires that "all consumers receive a comprehansive skin inspection and risk assessment by a registered nurse at time of initiation of services by your organization".  Interventions to be considered for all at-risk patients include "pressure reduction, off-loading, pressure redistribution, the need for special mattress....devices."

Little by little, we believe the essentials of the NDF Prevention Protocol (Advances in Skin & Wound Care, July 2008) are being acted upon by hospital officials.