Impact of a Swiss pressure ulcer prevention breakthrough collaborative

Area of Science:

• Healthcare Improvement Science
• Patient Safety Research
• Clinical Quality Management

Background:

• Hospital-acquired pressure ulcers significantly impair patient quality of life.
• In Switzerland, 4% of patients develop hospital-acquired pressure ulcers.
• A Breakthrough Collaborative aimed to reduce these ulcers by 50%.

Purpose of the Study:

• To assess the effectiveness of a multimodal intervention in reducing hospital-acquired pressure ulcers.
• To evaluate the impact of a collaborative improvement approach on patient safety.

Main Methods:

• A multimodal intervention including risk assessment, prevention bundles, e-learning, and patient engagement was implemented over 18 months.
• Six Swiss hospitals participated, monitoring compliance and using a safety calendar for data tracking.
• Interventions were deployed across all wards except obstetrics and gynaecology.

Main Results:

• Compliance with Braden risk assessments increased from 39% to 61% (P < .001).
• Prevention bundle compliance rose from 2% to 30% (P < .001).
• Hospital-acquired pressure ulcers decreased by 49% (P < .001), preventing 1124 new cases.

Conclusions:

• A multimodal improvement approach, coupled with measurement and feedback, significantly reduced hospital-acquired pressure ulcers.
• The collaborative achieved a statistically and clinically significant reduction, nearing the 50% goal.
• Improved compliance to best practices was a key factor in the observed reduction.