Incorporating the Use of an Adhesive Sacral Foam Dressing with a Sodium Carboxymethylcellulose Contact Layer in a Hospitals Pressure Ulcer Prevention Program

The prevention of pressure ulcers has become a national focus since they are both high-cost and high volume adverse events. CMS has named this as a preventable hospital acquired condition and no longer reimburses acute care facilities for this event.  This can be financially devastating to the hospital. Pressure ulcer incidence is also included as a national indicator of excellence in nursing. Patient satisfaction scores will affect the reputation of the facility. Hospital-generated benchmarks are an emerging arena. Therefore, pressure ulcer prevention is a high priority. Traditionally, we have been limited to prevention guidelines that include support surfaces, mobilization, positioning devices, incontinence management, skin care, and nutritional support.  Recently, studies have been done to show prevention of pressure ulcers to the sacrum with prophylactic use of a product applied to the sacrum to prevent pressure related injury. It is hypothesized that this occurs because it is reducing friction, shear and moisture to the sacral area as well as redistributing pressure. A 6 patient case study evaluation was initiated to evaluate the performance of a foam dressing including a Sodium Carboxymethylcellulose Wound (Na-CMC) contact layer with an adhesive border. The patient selection included those at risk for sacral ulcer development and patients with altered skin integrity to the sacral area with concerns for deterioration. The outcomes were positive in several areas. The dressing performed well in conforming to the sacrum and being resistant to minor fecal and urinary incontinence.  Patients with existing alteration in skin integrity to sacral area showed improvement. The nurse response was positive for dressing application and removal. The patient responses were positive for decrease pain with application and removal as well as expressing comfort during wear time.  Therefore, our facility will move forward with incorporating this practice as part of our Pressure Ulcer Prevention program.