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Pressure is On to Reduce Pressure Ulcers

Cheryl Clark, for HealthLeaders Media, November 21, 2013

With a new Epic electronic health record system to be installed at WellStar Cobb soon, there will be an embedded alert mechanism for nurses and doctors to signal the beginnings of skin breakdown, Delk says. The alert prompts review and documentation, as well as two-way communication.

Until then, the hospital uses a "pink sheet," with a diagram of the patient showing the areas of concern.

"That allows the physician to go right to that area with the nursing team and make sure they're dealing with the correct area of the body," Delk says.

Other strategies include spending $5 million across the five-hospital WellStar system to purchase special beds, including about 30 beds that use alternating air pulsations to reduce pressure on certain areas and shift the patient's weight around on a schedule that nursing staff can customize.

But one effort the hospital is excited about, Delk says, is a still somewhat experimental Early Mobility Program for all patients in the intensive care unit, including those on ventilators. Launched by Johns Hopkins researchers, the program requires staff to devote time with ICU patients to get them up and moving, actually walking, even while on ventilators, she says.

So far, the program has not only reduced pressure ulcer formations in the ICU, but also seems to have increased muscle strength, reduced pulmonary complications in this high-risk population, and increased their alertness because sedation is decreased during the process.

"Patients who can get up and participate seem to enjoy it. Even though they don't enjoy being sick, it gives them a very positive attitude that they are making progress," Delk says.

Delk adds that there have been no pressure ulcers, according Johns Hopkins' most recent report covering 2010 to 2012.

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5 comments on "Pressure is On to Reduce Pressure Ulcers"


David Sutterfield (12/6/2013 at 8:06 AM)
All the Mount Sinai Hospital study seems to state is that the risk of developing a PU increases as the number of co-morbidities increases. That has been known for years. The UTH study noted in this issue makes a case that it is still about relieving pressure and other preventive care, noting they achieved a high rate of success with use of high density foam mattresses. If the MSH study had any validity, then one would not see the wide ranges of outcomes between facilities with bad facilities having consistently bad outcomes and good facilities having consistently good outcomes.

Karen Bry (12/4/2013 at 11:32 AM)
The Wound Care Team at Mount Sinai Hospital in Chicago conducted research investigating the link between hospital acquired pressure ulcer (HAPU) development and co-morbidity. We found that persons who developed HAPU (despite having all recommended prevention)had an average of 9.25 major co-morbid conditions Skin Failure literature discusses the physiology of skin death. Skin Fails too....we need to optimize prevention, invest in the best bed surfaces and prevention devices and ......stop blaming the nurses!

Bonnie Altman (12/4/2013 at 9:51 AM)
PS Hospital Admin. is partially at fault. Hire more nurses and higher quality nurses and nursing staff. Offer better in house edu. ongoing. Put your money and your investment in your nurses and reduce the "need" for unnecessary, prolonged analysis.