References
Pressure ulcer prevalence and prevention rates in Abu Dhabi: an update
Abstract
Objective:
This article compares the results from a recent pressure ulcer (PU) prevalence audit at the Sheikh Khalifa Medical City (SKMC) hospital in Abu Dhabi to identify the impact of new prevention initiatives introduced around 2013 and establish the effectiveness of PU prevention strategies, judged quality of nursing care, and costs associated with patients developing a hospital-acquired pressure ulcer (HAPU).
Method:
The methods used were based on a previous point prevalence study involving 441 acute care patients, who were assessed using the International Pressure Ulcer Prevalence (IPUP) Survey. Following pre-selection of a 24-hour period for data capture, hospital staff collected PU data. Hill-Rom provided SKMC with an electronic report comprising various epidemiological and financial outputs.
Results:
PU prevalence was 10.4% in 2018 versus 6.4% in 2013. The 2018 HAPU prevalence was 1.8% versus 2% in 2013. The 2018 findings were in line with IPUP's international benchmarks. In 2018, 99% of patients had their skin assessed and PU risk documented within 24 hours of admission, leading to rapid implementation of a prevention care plan. Most patients who developed a HAPU (n=8) were female (62%) and aged 20–29 years old (25%) or 70–79 years old (25%). All HAPU patients lay on three layers of linen, most on their side (88%) and 75% were hospitalised for >30 days. Costs were estimated for the eight HAPU patients; weighted average cost (per case) was around US$8035.32, giving a total estimated cost of US$64,282.54. Total annual cost (average length of stay basis) for the eight patients was estimated at US$1,830,082.32.
Conclusion:
The PU prevention plan at SKMC proved to be effective, reflected by a low HAPU prevalence rate, suggesting an excellent quality of patient care.
Pressure ulcers (PU) are a serious problem for clinicians, causing excess morbidity and mortality among patients, and representing a significant financial burden.1,2 In addition, PU erode patients' quality of life (QoL) and may cause them considerable pain, particularly when dressings are changed and/or removed.2 PU prevention, therefore, is key to improve patient outcomes and reduce health-care costs.
A number of risk factors for PU have been identified, leading to a variety of preventive initiatives, including different body positions,3 alternating pressure air mattresses (APAM)4 and Braden risk score analysis,5 among others.6 The presence of non-blanchable erythema in hospitalised patients is a risk factor for PU,7 but PU preventive measures can be delayed until non-blanchable erythema is present without increasing the risk of PU development.7 Globally, PU prevalence rates vary considerably from 1.26% in China8 to around 54% in acute European settings,9 although an average of 18.5% is more likely.9,10
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