El Hospital: Hospital-acquired pressure ulcers at University of Minnesota Medical Center, Fairview and University of Minnesota Amplatz Children’s Hospital

Dermatology
Hospital-acquired pressure ulcers at University of Minnesota Medical Center, Fairview and University of Minnesota Amplatz Children’s Hospital

MEGAN DAMAN, MA, RN, ACNS-BC, OCN; MICHAEL FLYNN, MPH, RN; MARGORIE PAGE, DNP, RN, Y CHRISTY SWARTHOUT, MBA

Hospital acquired pressure ulcers continue to occur in patients despite implementation of evidence-based skin safety interventions. In the United States the prevalence of hospitalized patients who experience pressure ulcers has increased dramatically. Pressure ulcers were a primary or secondary diagnosis among 281,400 hospital admissions in 1993, while in 2006 this number rose to 503,300, an 80% increase even as overall hospital admissions raised by only 15%.

The pain and suffering caused by pressure ulcers is worsened by the financial implications. The cost of treating a pressure ulcer is estimated to range from $10,000 to $86,000 with a median cost of $27,000. In 2006, 11 billion dollars were spent on pressure ulcer related costs in the United States.

Pressure ulcers are a nursing sensitive outcome as defined by the National Database for Nursing Quality Indicators (NDNQI). Since pressure ulcers are determined to be preventable with diligent nursing care, the Centers for Medicare and Medicaid Services (CMS) ruled that, effective October 2008, hospital-acquired stage III or IV pressure ulcers would not be reimbursable with CMS funds. In addition, the state of Minnesota became a national leader by following CMS’s decision to not pass on costs associated with hospital-acquired stage III or IV pressure ulcer care to private payers.

University of Minnesota Medical Center (UMMC), Fairview and University of Minnesota Amplatz Children’s Hospital (UMACH), a large tertiary and quaternary facility with over 600 beds provides care to complex specialized pediatric and adult populations, including solid organ and bone marrow transplant patients. UMMC and UMACH are hospitals within a comprehensive health system, Fairview Health Services, which provides all levels of healthcare including clinics, transitional care, and homecare. Due to the complexity of patients cared for at UMMC and UMACH, combined with external financial and regulatory pressures, there was a great need to develop a comprehensive pressure ulcer prevention plan.

Minnesota’s Adverse Health Care Event Reporting Law went into effect in 2003 requiring stage III or IV hospital acquired pressure ulcers to be reported to Minnesota Hospital Association’s Patient Safety Registry. In April 2004, an active pressure ulcer prevention nursing workgroup was established at UMMC. The following year, the Minnesota Alliance for Patient Safety held a one-day Pressure Ulcer Prevention Summit underscoring UMMC leaderships’ recognition and commitment to further reduce reportable pressure ulcers. In December 2006, Fairview’s system-wide pressure ulcer prevention policy went into effect helping to support this effort.

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http://www.elhospital.com/eb/10/pdf/pdfArtdermatologia.pdf


spanish version:
El Hospital: Información para el desarrollo de los servicios de salud en América Latina