Promoting pressure ulcer prevention and cost-savings in a cardiovascular hospital

The purpose of this project was to demonstrate a WOC nurse's role in cost savings and benefits by challenging the pressure ulcer prevention program's bed rental vendor to a new vendor with low air loss therapy mattress providing the equivalent of 1740 liters of air per minute for all patients with a Braden score of 18 or less towards reducing pressure ulcer incidence and promote cost savings in cardiac patients. The rental product needed to withstand 600 pounds and be durably constructed to promote safe patient handling.

Cardiac patients have many if not all of the “risk factors” for pressure ulcer development: impaired activity or mobility, impaired nutrition, poor perfusion and oxygenation, increased skin moisture, advanced age, increased shear, poor sensory perception and poor general health status.

Hospitals are cognizant of the pressure ulcer prevention measures that are necessary. However, the monies required for purchasing pressure redistribution mattresses is financially prohibiting and renting is the only choice for prevention surfaces.

The objectives of this project were to (1) create algorithms for proper support surface and bed selection for the ICU and the PCU cardiac patient population (2) monitor hospital acquired pressure ulcers (3) record the costs associated with support surface rentals (4) record the cost savings  based on the reduction of hospital acquired pressure ulcers in the facility.

The project was conducted in a small 60 bed cardiovascular hospital in Tucson, AZ.  Historical rates of incidence including suspected deep tissue injury (DTI) were 6%. Education was delivered to staff on pressure ulcer prevention and the newly developed algorithms. vendor was trialed and approved for rental use. Cost-savings were compared between the old and new vendor with a $6000/month savings using the new vendor. The efficacy of the product was determined in the next prevalence and incidence study and a rate of zero hospital-acquired pressure ulcers was found.