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

Introduction

• Pressure ulcers cause great pain and suffering

Introduction

• Major financial burden for healthcare providers

Introduction

• €48/day for a stage1 pressure ulcer to €418/day for a stage 4 pressure ulcer

(Dealey et al 2012)

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

Methods

• Incidence, prevalence and healing data collected

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

Figure 1: Differences in pressure ulceration site in persons resident in St. Mary’s compared to those with pressure

ulceration on admission

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

Table 1: Total person time spent with a pressure ulcer in St. Mary’s from 2014-2016 and estimated associated costs

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

Discussion

• On-going staff education

• Heighten awareness of vulnerability of foot and heel

• Multi-disciplinary involvement

• Off Loading devices

• Carer/patient/resident education

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.

Thankyou