The NDF has been contacted by a representative of the NY State Legislature to inform us that a bill modeled after the New Jersey Law is making its way through the State Senate. The New York bill covers hospitals as well as nursing homes, whereas the New Jersey law includes nursing homes only. Hospitals would be required to have on hand sufficient pressure-relieving mattresses to be provided to every pressure ulcer at-risk patient upon admission to the hospital.
It was explained that this is something some members of the legislature have wanted to do for some time, but the results of the last election had only now made possible. We were also told that when New York passes such a law, other states are likely to follow. The law will be known as "Nellie's Law". This is an extremely hopeful development as we continue to strive for eradication of hospital-caused bedsores.
Monday, March 18, 2013
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.
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.
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.
Friday, November 16, 2012
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."
" 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."
Thursday, October 18, 2012
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.
Please join in the fight to make hospitals accountable by contributing now. Thank you.
Friday, October 12, 2012
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.
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.
Monday, September 10, 2012
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.
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.
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