title: Successful heel pressure ulcer prevention program in a long-term care setting.
abstract: Heel pressure ulcers (PUs) are common in long-term healthcare settings. Early identification of risk and the use of preventive measures are central to reducing the morbidity, mortality, and high medical costs associated with heel PUs. A Quality Improvement Process was initated based on a tailored protocol, in-service education program, and a heel protective device was approved by the US Food and Drug Administration. The Braden Scale was used to evaluate PU risk in 550 patients in a long-term healthcare facility. Patients with a Braden Scale score of 18 or less and with 1 of 7 high-risk comorbidities were considered at high risk for PUs, and this prompted a more aggressive prevention program that included a protocol for reducing the risk of heel ulceration. The number of hospital-acquired heel PUs during the 6-month preintervention period was 39. Following the intervention, there were 2 occurrences, representing a 95% reduction in heel ulcers between the 2 periods. After the cost of 2 heel protectors for 550 at-risk patients was subtracted from the estimated cost of treating the 37 heel ulcers prevented, the estimated cost savings was calculated to be between $12,400 and $1,048,400.
authors.affiliation: Loretto Health and Rehabilitation Center, Syracuse, New York, USA. vburda@lorettosystem.org
authors.forename: Vicky
authors.initials: V
authors.lastname: Lyman
mesh_terms: D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D006707:Homes for the Aged / Q000458:organization & administration; D006801:Humans; D008134:Long-Term Care / Q000458:organization & administration; D008297:Male; D009735:Nursing Homes / Q000458:organization & administration; D003668:Pressure Ulcer / Q000191:economics* / Q000451:nursing / Q000517:prevention & control*; D015995:Prevalence; D011322:Primary Prevention / Q000458:organization & administration*; D015397:Program Evaluation; D011482:Protective Devices / Q000191:economics / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012720:Severity of Illness Index; D017592:Skin Care / Q000379:methods; D016896:Treatment Outcome; D014481:United States; D014945:Wound Healing / Q000502:physiology