Connecting the Dots: Pressure Ulcer Prevention and Safe Patient Handling

Background:  Turning and positioning immobilized patients is a necessary intervention in a pressure ulcer prevention program.  This intervention promotes patient safety when effectively applied.  However, turning and positioning may impose repetitive injury to caregivers.  OSHA published guidelines on preventing hospital worker injuries suggests the average worker’s compensation claim for hospital worker injury is $15,860.  Safe patient handling is a factor that must be included in a pressure ulcer prevention program.  Every caregiver should be offered a method of turning and positioning patients, which maximizes ergonomic efficiency and promotes proper body mechanics.    

Purpose: A 300+ bed acute care hospital identified staff injuries as a result of lifting patients as a problem.  In 2012, there were 85 incidents related to patient handling, 31 involving claims. Turning and positioning patients was a cornerstone of the hospital’s successful pressure ulcer prevention program, a search for an innovative solution ensued.  In January 2013, a single patient use overlay turning, positioning and offloading system was successfully piloted, then implemented across inpatient units.  To ensure maximized resource utilization, a process was developed to ensure patients met clinical justification.  Clinical justification criteria: patient’s weight, Braden Sub-score Mobility and Sensory Perception. In 2013, there were 265 devices placed which cost approximately $42,508.  

Outcomes:  The pressure ulcer prevalence rates were maintained at the same level as 2012 at approximately 1.0%.  The 2013 incidents and claims related to patient handling were reduced by 55% compared with 2012 claims, resulting in approximately $222K cost avoidance.  The 2013 bed rental usage was decreased by 66% compared with 2012, resulting in $58K cost savings. This $42K investment in an innovative strategy successfully reduced patient handling injuries.  A system and process was effectively implemented by considering resource utilization, maintenance of quality performance, which positively impacted the delivery of pressure ulcer preventive care.