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Successful Heel Pressure Ulcer Prevention Program in a Long-term Care Setting

Lyman, Vicky

Journal of Wound, Ostomy and Continence Nursing: November-December 2009 - Volume 36 - Issue 6 - p 616–621
doi: 10.1097/WON.0b013e3181bd813e
WOUND CARE

Heel pressure ulcers (PUs) are common in long-term healthcare settings. Early identification of risk and the use of preventive measures are central to reducing the morbidity, mortality, and high medical costs associated with heel PUs. A Quality Improvement Process was initated based on a tailored protocol, in-service education program, and a heel protective device was approved by the US Food and Drug Administration. The Braden Scale was used to evaluate PU risk in 550 patients in a long-term healthcare facility. Patients with a Braden Scale score of 18 or less and with 1 of 7 high-risk comorbidities were considered at high risk for PUs, and this prompted a more aggressive prevention program that included a protocol for reducing the risk of heel ulceration. The number of hospital-acquired heel PUs during the 6-month preintervention period was 39. Following the intervention, there were 2 occurrences, representing a 95% reduction in heel ulcers between the 2 periods. After the cost of 2 heel protectors for 550 at-risk patients was subtracted from the estimated cost of treating the 37 heel ulcers prevented, the estimated cost savings was calculated to be between $12,400 and $1,048,400.

Vicky Lyman, RN, ICP, WOCN, Loretto Health and Rehabilitation Center, Syracuse, New York.

Corresponding author: Vicky Lyman, RN, ICP, WOCN, 1 Regina Dr, Cortland, NY 13045 (vburda@lorettosystem.org).

Copyright © 2009 by the Wound, Ostomy and Continence Nurses Society