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What They Are

A pressure ulcer or bedsore is an injury to the skin or underlying tissue usually over a bony protruding area of the body. Pressure ulcers can range in severity from minor skin reddening to deep wounds. Factors that cause pressure ulcers are unrelieved pressure on the skin, or slight rubbing or friction on the skin.

Who's At Risk

Patient risk factors for the development of pressure ulcers include age, immobility, incontinence, poor nutrition, sensory problems, circulation problems, dehydration and poor nutrition. Both wet skin and dry skin may lead to the development of pressure ulcers. Pressure ulcers in elderly individuals have been associated with increased mortality rates.

What's At Stake

In fiscal year 2007, the Centers for Medicare & Medicaid Services (CMS) reported nearly 258,000 cases of preventable pressure ulcers as secondary diagnoses for a patient's admission to the hospital. The estimated cost to heal each ulcer is $43,000. The incidence of pressure ulcers in patients in acute care hospitals is around 7 percent, which greatly by clinical setting: hospitals, long-term care, and home care.

What Providers Are Doing to Prevent Pressure Ulcers

Healthcare providers have developed programs/initiatives in pressure ulcer prevention that focus on initial risk assessment, and then reassessments of patients, followed by a multi-pronged approach to preventing pressure ulcers in high risk patients. The program/initiatives include the involvement of wound and skin specialists to provide patient consultation and staff education.

Many pressure ulcers can be prevented through adherence to evidence-based best practices and protocols. Recommendations include:

  • Conduct a pressure ulcer admission risk assessment for all patients.
  • Reassess risk for all patients daily.
  • For all patients identified as being at risk for pressure ulcers:
    • Inspect skin daily.
    • Manage moisture: Keep the patient dry and moisturize dry skin.
    • Optimize nutrition and hydration.
    • Minimize pressure: Ensure that patients are turned every two hours and use pressure-relieving surfaces.
    • Use standard assessment tools, checklists, cues, alerts, and reminders across the institution.
    • Form a multidisciplinary team to focus on preventing pressure ulcers with designated patient care unit champions
    • Involve patients and families

Massachusetts Pressure Ulcer Collaborative.
Collaboration Across the Continuum of Care: Reducing Pressure Ulcers

Approximately 50 healthcare organizations have joined the collaborative since its kickoff in April 2010. Its mission is to support participating healthcare organizations working together to implement a statewide quality initiative to prevent pressure ulcers across the continuum of care. This will be accomplished through the promotion of best practice, education, and communication.

More Information>>  Pressure Ulcer Collaborative Fact Sheet