Static overlays for pressure ulcer prevention: a hospital-based health technology assessment.

INTRODUCTION: At Odense University Hospital (OUH) alternating-air mattresses (AAM) are used in the prevention of pressure ulcers (PU); however, static overlays might be more effective and have lower costs. To investigate the properties and consequences of using static overlays for prevention of PU at OUH, a hospital-based health technology assessment (HTA) was conducted. METHODS: Two types of static overlays were tested in an observational study and compared with AAM for patients with a medium-high risk of PU in geriatric and orthopaedic wards at OUH. Incidence of PU was investigated 7 months before (n=720) and 6 months after implementation (n=837). Staff attitudes were examined in a questionnaire survey (n=55) and focus group interviews (n=13). Patients who had tried one of the overlays and the AAM were interviewed (n=12). RESULTS: No statistical difference in PU incidence was found before and after the implementation of overlays (2.5% before, 2.7% after, P=0.874, n=1557) and no patients lying on overlays developed PU (n=123). Staff had mixed attitudes, but the majority preferred having overlays as an option for their patients. Interviewed patients preferred overlays due to less noise and improved mobility. CONCLUSION: Both types of overlay are effective in PU prevention. However, overlays introduce challenges for staff and clear guidelines for the selection of support surfaces are needed. Overall, it is recommended that static overlays are considered as an alternative to AAM for PU prevention.

Pressure ulcer prevention in hospitals: a successful nurse-led clinical quality improvement intervention.

A pressure ulcer prevalence of 17.3% at Odense University Hospital in Denmark in 2010 prompted action and a quality improvement project was planned. This had two aims: to reduce pressure ulcers at the hospital by 50% and to have no pressure ulcers at or above category 3. An project was established with a steering committee, a pressure ulcer specialist nurse, local dedicated nurses and nurse assistants to implement a pressure ulcer bundle in clinical practice at all departments at the hospital. Six years later the pressure ulcer prevalence was down to approximately 2% and in 2018 only one stage 3 pressure ulcer occurred in the hospital. Pressure ulcer prevention is now incorporated into clinical practice in all departments at the hospital.

[Occurrence of pressure ulcers in a hospital. Registration of pressure relief and documentation in medical records]. / Forekomst af decubitus på hospital. Registrering af aflastningstiltag samt dokumentation i journalerne

INTRODUCTION: University Centre of Woundhealing, Odense University Hospital (OUH) has conducted a prevalence study of pressure ulcers. The purpose of this article is to present the results of the study. MATERIAL AND METHODS: All patients above the age of 15 years who were in hospital in week 5-6 2008 were included in the study. Six wound nurses and two doctors from the University Centre of Woundhealing undertook the examination. The following were recorded: length of stay, gender, age, number and grade of pressure ulcer(s). The pressure ulcer relief of the patients and documentation in the hospital journals were also recorded. RESULTS: A total of 591 inpatients were included. In all, 164 patients were excluded and 427 patients from the project group were examined. 192 patients were found with pressure ulcers of grade 0-IV, corresponding to a prevalence of 32.5%. If grade 0 pressure ulcers were not included, the prevalence was 17.3%. CONCLUSION: The study showed a high prevalence. There was an overall insufficient pressure ulcer relief of patients and missing documentation in hospital journals.