Pressure ulcer prevention in hospitals: a successful nurse-led clinical quality improvement intervention
A pressure ulcer prevalence of 17.3% at Odense University Hospital in Denmark in 2010 prompted action and a quality improvement project was planned. This had two aims: to reduce pressure ulcers at the hospital by 50% and to have no pressure ulcers at or above category 3. An project was established with a steering committee, a pressure ulcer specialist nurse, local dedicated nurses and nurse assistants to implement a pressure ulcer bundle in clinical practice at all departments at the hospital. Six years later the pressure ulcer prevalence was down to approximately 2% and in 2018 only one stage 3 pressure ulcer occurred in the hospital. Pressure ulcer prevention is now incorporated into clinical practice in all departments at the hospital.
Susceptibility to wounds, including pressure damage, becomes more common after the age of 65, owing to thinning of the epidermis and diminishing immunity. As the UK has an ageing population, wound care is a public health concern. Posnett and Franks (2008) reported that one in five hospital inpatients in the UK has a pressure ulcer. Pressure ulcers are an area of concern in Denmark, which also has an ageing population.
Odense University Hospital (OUH) is one of the four university hospitals in Denmark. All medical specialties are represented. OUH is one of the largest education and training centres in the Region of Southern Denmark, and has a close collaboration with the University of Southern Denmark. The hospital has two units: one in the city of Odense and one in Svendborg.
In 2010, OUH conducted a prevalence study on pressure ulcers, which showed it to be 32.3% among inpatients. If category 0 pressure ulcers were excluded, the prevalence was 17.3% (Dorsche and Fremmelevholm, 2010).
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