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Preventing pressure injuries at Waikato DHB

Pressure injuries prevention

Today (Thursday 17 October) is Pressure Injury Awareness Day and appropriately a nationally agreed approach to measure pressure injury prevalence, developed by a national expert group and led by the Health Quality and Safety Commission, was signed off recently. Read about the national project and report here

A pressure injury is a redness or break in the skin caused by too much pressure on the skin for too long. The pressure prevents blood getting to the skin, and eventually the skin dies. Back in the day, they were often referred to as “bed sores” because people who spent a lot of time immobilised are particularly vulnerable. However pressure injuries are not limited to old or immobile people. Common places for pressure injuries are bottoms, heels, elbows and inner side of the knees. Read more about pressure injuries here

At Waikato District Health Board pressure injuries have been the focus of an improvement project since early 2014, initially with orthopaedics, cardiovascular and stroke patients but now applied across all services.

The project includes a revised risk assessment tool (Braden assessment), packages of care for different risk levels, education on prevention and management of pressure injuries, ward education sessions, and monthly prevalence audits.

The hospital beds were also replaced with reactive pressure mattresses several years ago, which means patients are all on appropriate surfaces from the time they are admitted, and this helps prevent pressure injuries from occurring.

It is through the audits that Waikato DHB has tracked a steady improvement over the past few years, bring the prevalence rate of pressure injuries acquired in hospital to below 5 percent.

Preventing pressure injuries at Waikato DHB

On second Tuesday of each month an audit is undertaken on randomly selected patients to identify whether they have sustained a pressure injury either prior to admission or during their admission. This initially started on the three pilot wards and is now being undertaken on 30 wards across the DHB. One of the aims of the project was to have a monthly prevalence of 6% or less and currently the average is 5.1% of all patients audited have developed a pressure injury while in hospital.

“Our statistics were not significantly high before the project started, but we did have three advanced hospital-acquired pressure injuries in 2013 and that was the impetus to make improvements,” says Julie Betts, nurse practitioner: Wound Care.

“Now we are at a point where knowing what our pressure injury rate is we can measure ourselves against other hospitals nationally and internationally to make sure we are providing care at a level that would be expected and measure ongoing improvements in reducing pressure injuries further. Our current prevalence rate is below international standards, which is a great achievement and something our front line staff can be congratulated for. Our next target will be to reduce hospital prevalence rate to 2 percent.”

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