Becker's Clinical Quality & Infection Control

CLIC_July_August_2023_Final

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11 Executive Briefing 3 EXECUTIVE BRIEFING An example of a prophylactic dressing that is both clinically effective and cost efficient is the ALLEVYN ◊ LIFE Foam Dressing. This dressing has a unique, 5-layer construction that absorbs fluids and redistributes pressure over a larger contact area than traditional dressings. 14 With multiple shapes and sizes available, nurses are able to deploy dressings that are designed to fit specific body contours like the heel or sacrum. In addition to its absorbent and protective layers, ALLEVYN dressings also have an innovative EXUMASK ◊ Change Indicator that helps visualize when it is time to change to a fresh dressing. 10, 17, 18 In practice, ALLEVYN◊ LIFE foam dressings can be worn up to 7 days 19 , which is twice as long as the wear time of traditional dressings. 20 In one study, the time saved in reducing the number of dressing changes was shown to release 397 hours for nursing staff per week, 21 leading to per-patient cost savings of up to 69%. 22-23 On the clinical side, the use of ALLEVYN LIFE dressings resulted in a 71% reduction in the incidence of sacral pressure injuries, 22 and the similar ALLEVYN Gentle Border dressings resulted in a 90% relative reduction in pressure injuries compared to standard preventative care alone. 24 Pressure inventory prevention Every hospital needs to assess which protocols are most appropriate for their facilities and their patients. The effectiveness of even the best practices, protocols and products can be limited by a variety of constraints that are not always within a facility's control. But having an awareness of the latest clinical guidelines for the prevention of pressure injuries is an essential part of any strategy. Armed with this knowledge, decisionmakers can identify the most cost-effective solutions for preventing HAPIs. For some hospitals that might mean prioritizing patient repositioning with the LEAF ◊ Patient Monitoring System to improve turning compliance. For others it might mean integrating Smith+Nephew's prophylactic ALLEVYN LIFE Foam Dressings to redistribute pressure and maximize wear time. Others still may find that adding both interventions to their inventory works best. By combining proper practices and protocols with innovative products, hospital staff have the best chance of making a positive impact on both their facilities and their patients. References 1 Padula WV, Delarmente BA. The national cost of hospital-acquired pressure injuries in the United States. Int Wound J. 2019;16(3):634-40. 2 National Scorecard on Hospital-Acquired Conditions, Agency for Healthcare Research and Quality (AHRQ). June 2019. Accessed November, 2019 at AHRQ National Scorecard on Hospital-Acquired Conditions Updated Baseline Rates and Preliminary Results 2014-2017. 3 Lyder CH, Ayello EA. Pressure Ulcers: A Patient Safety Issue. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Advances in Patient Safety. Rockville (MD)2008. 4 Agency for Healthcare Research and Quality website. Preventing pressure ulcers in hospitals: a toolkit for improving quality of care. https://www.ahrq.gov/professionals/ systems/hospital/pressureulcertoolkit/putool1.html.Updated October 2014. Accessed June 20, 2017. 5 Wassel C et al. Poster presented at SAWC Fall 2019 Conference; Las Vegas, NV, USA. Oct 12-15, 2019. 2. Dreyfus J et al. Am J Med Qual. 2018;33(4):348-358. 6 Balzer K, Kottner J.Int. J of Nursing Studies. 2015; 52 (11) 2618:1655-1658. 2. Wassel C et al. Poster presented at SAWC Fall 2019 Conference; Las Vegas, NV, USA. Oct 12-15, 2019. 3. Dreyfus et al. Am J Med Qual. 2018;33(4):348-358. 7 European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel and Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline. Emily Haesler (Ed.). EPUAP/NPIAP/PPPIA: 2019. 8 Padula WV, Pronovost PJ, Makic MBF, Wald HL, Moran D, Mishra MK, et al. Value of hospital resources for effective pressure injury prevention: a cost-effectiveness analysis. BMJ Qual Saf. 2019;28(2):132-41. 9 Lin F, Wu Z, Song B, Coyer F, Chaboyer W. The effectiveness of multicomponent pressure injury prevention programs in adult intensive care patients: A systematic review. Int J Nurs Stud. 2020;102:103483. 10 Schutt SC, Tarver C, Pezzani M. Pilot study: Assessing the effect of continual position monitoring technology on compliance with patient turning protocols. Nurs Open. 2018;5(1):21-8. 11 Turmell M, Cooley A, Yap TL, Alderden J, Sabol VK, Lin JA, et al. Improving Pressure Injury Prevention by Using Wearable Sensors to Cue Critical Care Patient Repositioning. Am J Crit Care. 2022;31(4):295-305. 12 Maguire J, Hastings D, Adams M, Phillips D, McKenna J, Lin JR, et al. Development and Implementation of an Individualized Turning Program for Pressure Injury Prevention Using Sensor Technology in Nursing Homes: A Quality Improvement Program. Wound Manag Prev. 2021;67(11):12-25. 13 Pickham et al. Pressure injury prevention practices in the Intensive Care Unit: Real-world data captured by a wearable patient sensor. WOUNDS, August 2018. 14 Pickham D et al. Effect of a wearable patient sensor on care delivery for preventing pressure injuries in acutely ill adults: A pragmatic randomized clinical trial (LS-HAPI study). Int J Nurs Stud. 2018 Apr;80:12-19. doi: 10.1016/j.ijnurstu.2017.12.012. Epub 2017 Dec 30. 15 Gefen A. How do microclimate factors affect the risk for superficial pressure ulcers: a mathematical modeling study. J Tissue Viability. 2011;20(3):81-8. 16 Cornish L. The use of prophylactic dressings in the prevention of pressure ulcers: a literature review. Br J Community Nurs. 2017;22(Sup6):S26-S32. 17 Data on File Report DS/15/025/R – May 2016, L. Daubney. Physical Testing ALLEVYN LIFE Gen2. 18 SECURA Protective Ointment [Instructions for Use]. 19 Rogers M. Reducing Hospital-Acquired Pressure Injuries (HAPI) in Long-term Acute Care with Turn Cueing Technology. Poster presented at AONL 2020. 20 Joy H et al. A collaborative project to enhance efficiency through dressing change practice. Journal of Wound Care. Vol 24. No 7. July 2015 P3-4. 21 Data on File Report DS/15/217/R – October 2015, L. Daubney. Pressure Transmission Testing. 22 Forni C, Searle R. Economic evaluation of the use of a multi-layer polyurethane foam dressing for the prevention of pressure ulcers in elderly patients with hip fractures. Poster presented at EPUAP annual meeting, September 2018. 23 Forni C, D'Alessandro F, Gallerani P, et al. Effectiveness of using a new polyurethane foam multi-layer dressing in the sacral area to prevent the onset of pressure ulcer in the elderly with hip fractures: A pragmatic randomised controlled trial. Int Wound J. 2018; 15(3):383-390. 24 Lee YJ, Kim JY, Shin WY, Yeon YH. Use of prophylactic silicone adhesive dressings for maintaining skin integrity in intensive care unit patients: A randomised controlled trial. Int Wound J. 2019;16(Suppl. 1): 36–42. https://doi.org/10. 1111/iwj.13028. Smith+Nephew is a portfolio medical technology company focused on the repair, regeneration and replacement of soft and hard tissue. We exist to restore people's bodies and their self-belief by using technology to take the limits off living. Alongside our customers we will not settle until we have solved the challenges of preventing and healing wounds, because they hold back too many lives.

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