Successful heel pressure ulcer prevention program in a long-term care setting

Area of Science:

• Gerontology
• Healthcare Quality Improvement
• Wound Care

Background:

• Heel pressure ulcers (PUs) pose a significant challenge in long-term healthcare settings, contributing to morbidity, mortality, and increased medical costs.
• Effective prevention strategies are crucial for managing PUs and improving patient outcomes.

Purpose of the Study:

• To implement and evaluate a quality improvement process aimed at reducing hospital-acquired heel pressure ulcers.
• To assess the effectiveness of a tailored protocol, education, and protective devices in preventing heel PUs.

Main Methods:

• A quality improvement process was implemented, including a specific protocol, in-service education, and the use of an FDA-approved heel protective device.
• The Braden Scale was utilized to identify 550 patients at risk for PUs in a long-term healthcare facility.
• High-risk patients (Braden Scale ≤ 18 and ≥ 1 high-risk comorbidity) received an aggressive prevention program.

Main Results:

• The incidence of hospital-acquired heel PUs decreased from 39 in the 6-month preintervention period to 2 postintervention, a 95% reduction.
• The intervention demonstrated significant cost savings, estimated between $12,400 and $1,048,400, after accounting for the cost of heel protectors and prevented treatment costs.

Conclusions:

• The implemented quality improvement process, combining risk assessment, a tailored protocol, education, and protective devices, was highly effective in reducing heel pressure ulcers.
• This approach offers a cost-effective strategy for preventing heel PUs in long-term care settings, improving patient care and reducing healthcare expenditures.