CS14-064 An economical Way to Prevent HEEL Ulcers in Surgical Patients

Nancy Chaiken, CWOCN, ANP-C, Swedish Covenant Hospital, Adult Nurse Practitioner, Certified Wound, Ostomy Continence Nurse, Chicago, IL
An economical way to prevent heel ulcers in orthopedic hip surgical patients


The development of heel pressure ulcers is a major concern in the orthopedic hip population. It is essential for organizations to provide high quality care but also be mindful of the economic impact. A prospective 17 month study was conducted in a Chicago Hospital to determine if the incidence of surgical heel  pressure ulcers could be reduced by using a heel pillow. Heel pillows allow the heel to off-load, but are considerably less expensive than a heel lift suspension boot. Fifty-four hip orthopedic surgical patients were examined to determine first our incidence of heel wounds. Standard prevention practices were employed. A second group of 27 patients were then examined to determine if the use of the heel pillows were effective in reducing heel pressure ulcers.  

Direct heel assessments were preformed prior to hip surgery and again on post op day three by a WOCN or a WCC. Those patients with pre-existing heel wounds were omitted from the study.

Practice innovations consisted of the standard use of heel pillows (posey) which was implemented on each post surgical hip patient post-op.  Pillows were applied once the patient returned to the surgical unit. Prior to the practice innovation prevention practices consisted of a foam heel boot or a bunny boot.

RESULTS: Prior to our use of the heel pillows our heel incidence rate in orthopedic heel surgical patients was 14.6%. 54 patients were examined. Of those 54 patients 8 heel wounds developed.

Post implementation of the heel pillows, 27 patients were examined with one heel wound occurrence. Our rate dropped to 4%.  Our cost of the product was considerably less than the prior foam product.