An Ounce of Prevention: The Use of a Soft Silicone Five-Layer Bordered Foam Heel Dressing to Decrease the Incidence of Hospital-Acquired Heel Pressure Ulcers in an Acute Care Setting

In 2013, eighty-one hospital acquired (HA) pressure ulcers occurred at this 533- bed teaching hospital located in the southeastern United States. Thirty-three (41%) were heel pressure ulcers. Heels are the second most common location for pressure ulcers.¹ During the first quarter of 2014, the Wound Care Team observed a spike in the incidence of HA pressure ulcers in the coronary care/cardiovascular intensive care unit (CCU/CVICU). All of the hospital-acquired pressure ulcers during this three month period were located on the heel.  The Wound Care Team began to evaluate interventions to decrease the number of HA heel pressure ulcers.

A literature review was conducted to determine evidence based practices for the prevention of heel pressure ulcers. Previous studies ( Brindle, Brindle & Wegelin, Santamaria) suggested that the use of a soft silicone five layer foam dressing aids in the prevention of pressure ulcer development through the management of the skin’s microclimate and reduction of friction and shearing. Previously, the facility had experienced success in the implementation of this foam dressing to reduce the occurrence of HA sacral pressure ulcers. Based on this, the Wound Care Team chose to conduct a pilot project with the foam heel dressing in CCU/CVICU. This project was conducted August 1 through October 31, 2014. The dressings were placed on patients that met the project criteria of being high risk for heel pressure ulcer development. Thirty-one patients were assessed to be at high risk during this period and had the foam heel dressings applied. No heel pressure ulcers developed on these patients.

Due to the success of this project, the facility will incorporate the use of the foam heel dressing into its Skin Care/Wound Care Protocol. The heel dressing will now be used throughout the facility for patients deemed high risk for heel pressure ulcer development.