Other Nursing Sensitive Measures



Pressure Ulcer Prevalence on Medical Units

What are we measuring and why?

Pressure ulcers – also known as bedsores or decubitus ulcers – are skin breakdowns that occur when patients stay in one position for too long without shifting weight. This injury is most common in patients who are underweight, recently lost weight (i.e., 10+ pounds in one year), use a wheelchair, or are bedridden, even if only for a short period. Many pressure ulcers can either be prevented or identified and treated early enough to minimize complications. However, some are unavoidable, such as those that develop among patients with poor blood flow, nutritional deficiencies, or an infection. MGH tracks the percentage of patients over 17 years of age who acquire pressure ulcers in the hospital. The highest percentage occur in intensive care areas where patients have complex conditions that compromise the body's ability to keep the skin healthy.   

How are we doing and how do we compare to best practice?

The results shown are based on quarterly pressure ulcer prevalence surveys that were conducted from June 2016 to March 2017. Our rates in the four areas surveyed were not statistically significant compared to state averages for hospitals with over 500 beds (www.patientcarelink.org).

  • Current Scores
  • Lower values are better
1.75 0.81 5.92 1.42 1.56 0.68 4.55 0.42

MGH Source: MGH Quarterly Pressure Ulcer Prevalence Study.
Comparison Group Source: PatientCareLink

Jun 16, Sep 16, Dec 16, and Mar 17.

5.92 5.39 4.55 4.12 1.42 1.07 0.42 0.4 1.75 1.68 1.56 1.6 0.81 1.01 0.68 0.87

MGH Source: MGH Quarterly Pressure Ulcer Prevalence Study.
Comparison Group Source: PatientCareLink



What are we doing to improve?

Overall, the rate of pressure ulcers at MGH is low, which reflects our keen focus on prevention. When patients are admitted to the hospital, a nurse assesses the condition of the patient's skin and incorporates appropriate interventions into their care plan (e.g., frequent turning, a nutrition consult). All nurses attend a Wound Care Education Program shortly after hire to ensure that they have the necessary knowledge for skin assessments and interventions, and receive ongoing support from their unit's Clinical Nurse Specialist. In addition, MGH recently purchased beds with surfaces that assist in maintaining skin health.

What can you do?

If you or a family member will be bedridden or immobile for any reason, someone should check for pressure sores every day. This is particularly important for those with diabetes, circulation problems, incontinence, or mental disabilities. Look for reddened areas that do not turn white when pressed, as well as blisters, sores, or craters.

You can help prevent pressure ulcers by doing the following:

  • Change position at least once every two hours to relieve pressure.
  • Use items that can help reduce pressure, such as pillows, sheepskin, foam padding, or powders from medical supply stores.
  • Eat healthy, well-balanced meals.
  • Exercise daily; this includes range-of-motion exercises for immobile patients.
  • Keep skin clean and dry. If incontinence is a problem, take extra steps to minimize moisture.

 

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