Indianapolis nurses create program to cut back on rate of hospital-acquired pressure ulcers

A team of nurses at an Indianapolis hospital reduced the rate of hospital-acquired pressure ulcers by more than half, cutting related costs by about $700,000 a year.

The team from Eskenazi Health Center introduced new products and interventions to the critical care unit, and also worked to convince other clinicians that ulcers were an often costly side-effect of care. The rate was 69 percent lower 2013 than in 2011, according to study results published in the American Journal of Critical Care, despite a 22 percent increase in patient load.  "Before we started this, nurses knew it was an issue, but had the mindset that pressure ulcers were expected with a critical care patient; it was fine as long as the patient survived," study author Christina Dunn, R.N., told Medscape Medical News.

Initiatives included revising skin care protocols, using fluidized repositioners to move patients, applying silicone bandages and face-to-face teaching, according to the study. The team also began weekly skin audits to evaluate compliance and offer feedback to the critical care nurses, according to the study.

Planning began in 2012 and changes were implemented the following year, according to the study, before being evaluated over the course of three years. "It's been almost a 3-year process. Today, for most of the nurses in our hospital, attention to hospital-acquired pressure ulcers has become part of daily care," Dunn told Medscape. "But we do annual education to keep nurses thinking about it."

Medicare has penalized hospitals for hospital-acquired conditions like ulcers, FierceHealthcare previously reported. Dunn told Medscape that some ulcers may be unavoidable, but providers should be trying to reduce those that are unncessary.

To learn more:
- read the study
- here's the Medscape article

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