Issue link: https://beckershealthcare.uberflip.com/i/1504258
10 Executive Briefing 2 EXECUTIVE BRIEFING SPONSORED BY Interventions Make the Difference in Pressure Injury Prevention Hospital-acquired pressure injuries (HAPIs) affect more than 2.5 million Americans every year. 1 And while healthcare facilities have made improvements in reducing the incidence of many different types of hospital-acquired conditions, the opposite is true of HAPIs, which were shown in recent years to have increased by 6%. 2 Healthcare facilities across the country have made pressure injury prevention an essential part of their operations 3 — and yet the challenge remains. Human and economic costs For patients, HAPIs mean more pain, longer stays in healthcare facilities and greater recovery costs. But it would be a mistake to dismiss pressure injuries as a little extra discomfort. While the majority of patients recover from complications, approximately 60,000 people in the United States die each year 4 as a result of preventable pressure injuries. Hospitals bear costs of their own. The average financial burden of a HAPI is $21,784 and they increase both the number of bed days (by 9.5 days) and the rate of readmissions. 5 In 2019, the economic impact of HAPIs was $9 billion — more than surgical site infections, falls, CAUTIs, DVTs, VAP, CDIs, and CLASBIs combined. 2 Indirect costs of pressure injuries include reduced quality metrics; damaged reputations; fines, penalties and litigation; and the need to utilize additional resources. 6 With such a range of consequences both for patients and providers, it is important for healthcare facilities to continue exploring evidence-based approaches to solving the problem of pressure injuries. New practices and protocols The National Pressure Injury Advisory Panel recently developed and released guidelines to help facilities reinforce pressure injury prevention. 7 These guidelines can help strengthen practices and protocols that lead to better clinical outcomes. Education, nutrition, repositioning, mobilization and skin care are all recommended. Different combinations of these activities may be appropriate for patients with different levels of risk, 8 and they may also differ depending on the setting and hospital unit. No matter how these protocols are bundled, it is worth noting that there are also products on the market that can play a significant role in a facility's pressure injury prevention efforts. In particular, products that facilitate patient repositioning and redistribute pressure have been shown to significantly reduce the risk of patients developing HAPIs. Patient repositioning Failure to adhere to patient repositioning protocols exposes healthcare facilities to a host of risks. Unfortunately, a recent study found the average compliance with turning protocols ranges between only 40%–70%. 9-12 Variability in care is also apparent based on the time of day, as well as, gender and BMI lines. 13 It is clear that there are improvements to be made. Fortunately, products like the LEAF ◊ Patient Monitoring System (developed by Smith+Nephew) are available to help improve adherence to repositioning protocols. The LEAF Patient Monitoring System is a wireless, wearable sensor that allows care staff to coordinate individualized turn protocols for their patients. The first of its kind, this system optimizes patient repositioning with its proprietary Integrated Positioning Index TM . This enables the sensor to transmit information about turn frequency, turn angle, and recovery time to facility computers so that nurses can identify and prioritize who needs to be turned and when. Patient Monitoring Systems have a range of clinical benefits. In one study, the LEAF System increased average adherence from 48% to 92%. 10 The study also showed a significant reduction in turning compliance variability after intervention. With adherence rates such as these, the LEAF System is able to reduce the incidence of HAPIs by 73%. 14 It is clear that facilities that integrate these types of sensors into their protocols can make major strides in their pressure injury prevention efforts. Prophylactic dressings When it comes to HAPIs, the use of prophylactic dressings can also go a long way in preventing pressure injuries. If pressure injuries result from friction between a patient's skin and another surface, it makes sense that placing a soft layer between the two surfaces can help. But there are more factors to consider than what is apparent at a glance. Temperature, moisture, and the pH of surface skin must be carefully managed to ensure the most successful outcome. 15 There are also economic considerations. While prophylactic dressings are generally regarded as inexpensive, accessible and easy to use, 16 some dressings have relatively short wear times and must be changed frequently. This costs facilities both money and time.