Authors (including presenting author) :
Angela Kwok(1)(2)(3),Patricia Lee (1), Savina Sze(1),Phoebe Yeung(1), Chau LS (1), Tracy Chui(1), Mabel Poon (1), Eliza Shum (2),Chu WT (3), Yuk KL (1), Vanessa Au (1) (2), Carol Li (1), Jonathan Leung (1)
Affiliation :
(1) Shatin Hospital (2) Bradbury Hospice (3) Cheshire Home, Shatin
Introduction :
According to the HAHO’s report of Prevalence Survey on Pressure Ulcers 2016, hospital acquired and community acquired pressure injuries accounted for 9.4% and 55.56% respectively in the specialty of Medicine. (Nursing Quality & Safety Annual Report 2016‐2017)
Despite of high volume of wounds in medical wards, majority of pressure injury can be prevented through appropriate care, particularly through the use of pressure redistributing and repositioning equipment.
Objectives :
1) There is no hospital acquired pressure injury development for those high risk patients, such as Norton Score <14/20 or those who had multiple pressure injuries on admission. 2) The pressure injuries have improvement showed after redistributing the pressures.
Methodology :
With the support of QOCP fund, 2 pilot programs were implemented in SH 1) Use of head ring to reduce the pressure on the bony prominent over the head and ears in bedridden patients.
(The pilot was started in Sept 2017) 2) Use of the static & dynamic pressure relieving mattress to reduce pressure on bony prominent for those frail patients and promote wound healing of multiple pressure injuries. (Due to the delaying of delivery schedule, the full pilot was rolled out in Jan 2018 till Feb 2018.) Evaluation plan:
Staff satisfaction survey, Hospital acquired pressure injury rate in 2018, Case sharing of using the dynamic & static pressure relieving mattress were used for evaluating the programs.
Result & Outcome :
Head-Ring:
Total 10 pieces of head rings were used in 15 cases during the pilot period; all of them had no pressure injury acquired over the head and ear during the period. 100% of supporting staff and 90 % of nurses agreed the head ring was effective in preventing pressure injury over the head and ear. The effectiveness of the device can also be shown by no hospital acquired pressure injury over the head and ears in 2018. 2. Dynamic and Static mattress:
6 sets of Dynamic and Static mattresses were distributed to wards.
Point prevalence showed that 75% cases under the category of local infirmary (Med C) in M&G wards have complicated wounds requiring prolonged stay in hospital. When comparing the data of Mar-July in 2017 & 2018, the number of Med C patients increased from 26 cases to 38 cases, however, their average length of stay dropped from 70 to 64 days. One of the possible factors may relate to the use of this mattress for pressure redistribution and facilitation of wound care management. 8 cases were recruited during the pilot period. All of their wounds showed improvement in different aspects, in terms of wound size or wound bed colour or pain relieve during the evaluation. Moreover, there was no hospital acquired pressure injury development in M&G in 2018. Staff’s feedback on the device was also encouraging. Conclusion
The use of head ring and static mattress are effective in prevention of pressure injury and promotion of wound healing. Nonetheless, joint efforts of multidisciplinary team are of paramount importance to enhance the quality care in wound prevention and management programs.
Co-location with:
