Device Related Hospital Acquired Pressure Ulcers in Long Term Acute Care Hospitals

Purpose:

This poster will examine hospital –acquired pressure ulcers (HAPUs) in Long Term Acute Care Hospitals (LTACHs) related to medical devices.

Methodology:

Three LTACH facilities collaborated to gather data on device related hospital-acquired pressure ulcers from July 1, 2009 through June 30, 2010. Spaulding Hospital for Continuing Medical Care – North Shore in Salem, Massachusetts, Bethesda Hospital in St. Paul, Minnesota and Drake Center in Cincinnati, Ohio all care for complex chronically ill patients.  Some of the populations they serve are patients who have ventilator dependency, brain injury, spinal cord injury and dementia.   Many of these patients have chronic medical conditions related to pulmonary, cardiac, oncology or gastrointestinal conditions. Pressure ulcer prevalence and incidence, stage and location of hospital-acquired pressure ulcers, incidence of device-related pressure ulcers and type of devices are defined.

Results:

For the twelve month period 38% of the HAPUs at Spaulding Hospital for Continuing Medical Care – North Shore were device related; 47% of HAPUs at Bethesda Hospital were device related; and 50% of HAPUs at Drake Center were device related.

Conclusion:

With long term acute care patients, length of stay is increased.  Multiple devices, such as splints, boots, casts, trach faceplates and tubings (i.e. nasogastric, oxygen, etc.) are used longer, which increases the risk of device related pressure ulcers for the populations they serve.  Although device related pressure ulcers have been appreciated in the pediatric population (i.e. WOCN Research Abstract Presentation, St. Louis, 2009), limited data is available on the scope of the issue in the adult population.  This poster will provide information about the scope of the problem in this unique patient population.  Aggregating the data from these three facilities has allowed us to recognize the risk of device related pressure damage, an attribute that is not currently assessed when completing pressure ulcer risk.