Preventing Hospital Acquired Heel Pressure Injuries from Taking Root

Elizabeth Culver, BSN, RN, CWON1, Patricia Pezzella, BSN, RN, CWON1, Laura Phearman, BSN, RN, CPNP2, Julia Langin, BSN, RN, CWON, CMSRN3 and Linda Abbott, DNP, RN, CWON, AOCN4, (1)Nursing, University of Iowa Hospitals and Clinics, Iowa City, IA, (2)University of Iowa Children's Hospital, Pediatric Skin / Wound Care Nurse, Iowa City, IA, (3)Nursing, University of Iowa Hospital and Clinics, Iowa City, IA, (4)Nursing, University Of Iowa Hospitals and Clinics, Iowa City, IA

The purpose of this project is to implement an evidence-based intervention to reduce hospital acquired heel pressure injuries using a 5 layer soft silicone foam border dressing.


Despite increased scrutiny of hospital acquired pressure injuries and the agreement that heel pressure injuries should be a “never” event, they continue to occur. Despite documented benefits of heel protection boots/devices, there are patients who cannot or will not wear them. A lower cost alternative that has been documented as effective for the prevention of heel pressure injuries is available. 

Strategy and Implementation

At a large Midwestern tertiary medical center, a five layer soft silicone foam border dressing designed to protect heels was piloted on units with higher rates of heel pressure injuries than the rest of the organization. A policy and procedure was developed and proposed to the unit councils. When there was agreement to pilot the dressing on the unit, training was conducted by the Product Sales Representative and an instructional flyer was posted on each unit participating in the trial. Dressings were made available on the units for use with patients at risk as identified in the policy. Dressings were changed every 3 days if the patient remained at risk for heel pressure injury development.


For the 6 months before the pilot, the number of heel pressure injuries reported was 19. For the 6 months during the pilot, the number of heel pressure injuries reported was only 10. The number of reported heel pressure injuries went from 7 to 3 in the intensive care settings.