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.

Today is "Stop Pressure Ulcer Day'

'Stop Pressure Ulcer Day' was created by the "Declaration of Rio de Janeiro" in 2011.  This effort has been recognized by the European Pressure Ulcer Advisory Panel, who issued the following statement:

" In recent years we have seen 'Stop Pressure Ulcer Days' occurring in Spanish-speaking countries, and last year these organisations created a Declaration in Rio speaking out against people developing pressure ulcers. In 2012 there will again be a Stop Pressure Ulcer Day to be held on November 16th 2012. The European Pressure Ulcer Advisory Panel applauds the efforts of such events to bring pressure ulcers to the public, the professionals and our politicians. EPUAP has decided to join the Stop Pressure Ulcer Day to help publicise pressure ulcers...."

This is a wonderful development that should be brought to the attention of local newspapers, hospitals, and local and national politicians.  The NPUAP expressed their support just yesterday, stating "Over 2.5 million US residents develop pressure ulcers every year.  There are more patients who develop pressure ulcers than who develop cancer every year."

Your Contributions are Important

The National Decubitus Foundation is presently concentrating its efforts on urging states to require full disclosure of medical errors by hospitals, including Stage III and IV pressure ulcers.  This is an expensive and time-consuming process, but we believe it to be the most effective way of exposing those hospitals that continue to cause bedsores, and getting them to adopt the NDF Prevention Protocol. 

Please join in the fight to make hospitals accountable by contributing now.  Thank you.

UCLA Findings Confirm NDF Recommendations

The UCLA School of Nursing has published a study showing that those hospital patients allowed to develop a bedsore have a significanly increased chance of death.  This study, in the September issue of the Journal of the American Geriatrics Society, only confirms the NDF study of July 2008 in Advances in Skin and Wound Care.  The NDF study stated "Pressure ulcers are a significant cause of death in hospitals, although the recorded cause of death often disguises this fact."

The UCLA study states "This is a serious issue, and now we have data that can help the healthcare system address this ongoing problem.  Individuals entering the hospital with the risk conditions that we've identified should send up a immediate warning signal that appropriate steps should be taken to minimize the chance of pressure ulcers occuring."  This is exactly the procedure identified by the NDF Prevention Protocol, where risk conditions are identified by use of the Braden Scale, and the steps to be tken involve immediate use of the appropriate supporrt surface.

The UCLA study also found that of 3000 patients identified as entering the hospital with an existing bedsore, 16.7 percent developed at least one additional bedsore on a different part of their body.  This is strong support for the NDF position that all hospitals must be required to invest in sufficient pressure relieving support surfaces to accomodate all at-risk patients at admission.

US Health Care System Wastes $750B a Year

The Institute of Medicine, an arm of the National Academy of Sciences, just released a report more than 18 months in the making.  They conclude that over $750 Billion is wasted every year "through unneeded care, byzantine paperwork, fraud and other waste."

They assign $55B of the $750B to "Prevention Failures".  Failure to prevent pressure ulcers must be a very large part of this.  In fact, the NDF completed a study several years ago that found the failure to prevent pressure ulcers alone was costing $50 Billion annually.  And we now know that prevention is, for the most part, straightforward by implementation of the NDF Prevention Protocol.  Assess the risk for every admitted patient usong the Braden Scale, and assign each high risk patient to a proven pressure-relieving support surface. With potential savings so great, we don't understand why every hospital does not make the required investment.

Consumer Reports - August 2012

The current issue of Consumer Reports contains a major article on hospital safety.  They list "8 things that should never happen in a hospital"  and number one on the list is Bedsores.  They state that their attempts to rate hospitals are hampered by a lack of disclosure:

"Still, our Ratings include only 18 percent of U.S. hospitals because data on patient harm still isn’t reported fully or consistently nationwide. “Hospitals that volunteer safety information, regardless of their score, deserve credit, since the first step in safety is accountability,” says John Santa, M.D., director of the Consumer Reports Health Ratings Center. “But the fact that consumers can’t get a full picture of most hospitals in the U.S. underscores the need for more public reporting."

This is confirmation the NDF decision to emphasize state by state requiring of the reporting of hospital errors is on the right track.

Focus on Disclosure

For the forseeable future, the focus of NDF efforts to eradicate hospital-caused pressure ulcers will be on disclosure.  Many states now require that hospitals disclose medical errors, including Stage III and IV pressure ulcers.  The NDF will urge all states to enact strong disclosure requirements, and will work to ensure that these requirements have real "teeth" in the form of serious fines for failure to report or for incomplete reports.

The NDF website features one state each month to highlight disclosure status and hospital performance (if available).  Visitors are asked to contact the poorest performing hospitals to insist that they adopt the NDF Prevention Protocol.