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Pressure Ulcers

What Are We Measuring?

Pressure injury (pressure ulcers or bedsores) is localized damage to the skin and/or underlying tissue, because of pressure or pressure in combination with shear. Pressure injuries usually occur over a bony prominence but may also be related to a medical device or other object. There are many contributing factors associated with the development of a pressure injury, most common is the inability to move or reposition.

Patient skin is assessed daily and evaluated using a risk assessment tool to identify patients who are at risk for pressure injury development. Pressure injury prevention includes identification of skin breakdown, ensuring appropriate offloading, utilization of offloading devices, prevention dressings, and application of skin barriers. Populations who are at higher risk for pressure injury development include: acutely ill and/or in critical care, sustained a hip fracture, spinal cord injuries, diabetes mellitus, elderly, and have experienced trauma and/or prolonged surgery. Nurses compare pressure injury results to other hospitals of like size and Magnet hospitals to identify opportunities for improvement across the organization.

How Are We Performing?

National reporting databases report pressure ulcers that develop during the patient’s stay at Hendricks Regional Health (HRH) and are staged as a III, IV, unstageable or deep tissue injury (DTI). Once a pressure ulcer develops, the stage is confirmed by a team member in the Wound Healing Center and a treatment plan is created. The lower the pressure ulcer rate the better. The graph below reflects data publicly released in January 2022 for a selected period of time. Learn more by visiting Medicare.gov Care Compare.


What Are We Doing to Improve?

HRH has robust and accurate processes for the assessment, prevention, and treatment of pressure injuries which is tailored to each patient we serve. An interprofessional Skin Committee exists and meets monthly to examine and improve processes across the organization. When entering the organization for an emergency, surgery, and/or a hospital admission, nurses use the four-eyes skin assessment approach. This approach is where two nurses come together to assess the entire patient at the same time to evaluate for any existing pressure injuries. This assessment technique continues throughout a patient’s stay. Any identified pressure injuries are tracked and treated to heal as soon as possible.

Many steps are taken to avoid pressure injury development while in the hospital, including turning patients from side-to-side a minimum of every two hours, using special products/devices/beds, providing the highest levels of nutrition, and access to trained experts in skin care.

In the uncommon situation a pressure injury would develop in the hospital, specific pressure injury treatments occur quickly to get that area on a track to healing. In collaboration with the HRH Wound Healing Center, a wound care certified clinical nurse specialist rounds on all hospitalized patients with a pressure injury to assure optimal treatments are in place.

Learn More

We encourage patients and family members to use many of the different resources available to compare and choose a hospital or healthcare provider. Examples include Medicare.gov Care Compare and Leapfrog Ratings as well as talking with your doctor.