Reducing Hospital Acquired Pressure Ulcers: A Collaborative Approach

Reducing Hospital Acquired Pressure Ulcers: A Collaborative Approach

Purpose:  To decrease the rate of facility acquired heel ulcers in our hospital through education on risk assessment, prevention protocols, and implementation of a protective boot keeping the heels elevated off the bed.

Design:  Tracking of retrospective documentation of monthly hospital acquired heel pressure ulcers rates and for 6 months after the implementation of the boot.

Setting:  A 238 bed rural tertiary Level II Trauma Center in Northeastern Pennsylvania.

Participants:  Patients with hospital acquired heel pressure ulcers from July 2010 through August 2011.

Interventions:  Hospital wide education on pressure ulcer prevention with the use of online education was completed.  A new protective boot was put into practice with education.

Outcomes:   Incidence of hospital acquired heel pressure ulcers decreased by 100% from March 2011 to August 31, 2011.  Previous incidents of pressure ulcer to the heels at our facility included three Stage I, four Stage II, three suspected deep tissue injury (sDTI), one Stage I to the left ankle, and one sDTI to the lateral foot.  On March 1, 2011 in-services began on the protective boots.  In March two sDTI developed on the heels.  The first patient had their legs elevate on pillows instead of using the protective boot.  The second patient was using podus boots.  Both were previously accepted interventions.  Also in March one patient developed a Stage I pressure ulcers to their heel postoperatively when the protective boots were not initiated.  Overall, no known pressure ulcers to heels developed when the protective boot was placed on high risk patients.

Conclusion:    Reduction in incidence of hospital acquired heel pressure ulcers was achieved through pressure ulcer prevention measures, education, and the implementation of a protective boot to keep the heels elevated off the bed in high risk patients.