Other Nursing Sensitive Measures



Pressure Ulcer Prevalence on Medical Units

What are we measuring and why?

MGH tracks the percentage of patients over 17 years of age who acquire pressure ulcers in the hospital.

A pressure ulcer – also known as a bedsore or decubitus ulcer – is an area of skin injury or  breakdown which occurs if a patient stays in one position for a long period of time without shifting weight. This problem is most common in patients who are underweight, have recently lost weight (i.e.10 pounds in one year), use a wheelchair or are bedridden, even for a short period of time. Many pressure ulcers can be prevented or identified and treated in their earliest stages to minimize complications.  Some pressure ulcers are unavoidable. They develop in patients who have low blood flow, poor nutrition or infection. 

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

The results shown are based on pressure ulcer prevalence surveys conducted at the following times -  Dec 14, Mar 15, Jun 15, and Sep 15. For this reporting period, MGH’s rate for hospital acquired pressure ulcers was not statistically different than other hospitals in the state with more than 500 beds (www.patientcarelink.org).

  • Current Scores
  • Lower values are better
1.42 0.5 5.93 1.16 1.83 0.77 5.88 0.42

MGH Source: MGH Bi-annual Pressure Ulcer Prevalence Study.
Comparison Group Source: PatientCareLink

Dec 14, Mar 15, Jun 15, and Sep 15.

5.93 6.68 5.88 7.77 1.16 1.36 0.42 2.13 1.42 1.55 1.83 1.55 0.5 0.84 0.77 0.84

MGH Source: MGH Bi-annual Pressure Ulcer Prevalence Study.
Comparison Group Source: PatientCareLink



What are we doing to improve?

Overall, the rate of patients who have pressure ulcers at MGH is low. We achieve this by focusing on prevention. When a patient is admitted to the hospital, a nurse assesses the condition of the patient's skin and incorporates appropriate interventions (e.g., frequent turning, a nutrition consult) into the patient's plan of care. To ensure that nurses have the necessary knowledge for skin assessment and intervention they attend a Phase I Wound Care Education Program shortly after they are hired. They are also supported in their work toward pressure ulcer prevention by their local Clinical Nurse Specialist. Bed surface is a key factor in preventing pressure ulcers. To that end, MGH has recently purchased beds with surfaces that will help to keep the skin of our patients intact. The highest percentage of pressure ulcers occur in our intensive care areas where our patients have complex conditions that compromise the body's ability to keep the skin healthy.

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 if the you have 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 every two hours to relieve pressure
  • Use items that can help reduce pressure -- pillows, sheepskin, foam padding, and powders from medical supply stores
  • Eat healthy, well-balanced meals
  • Exercise daily, including 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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