Carolyn DelVecchio, R.N.
SUNY Empire
Hydrocolloids in pressure ulcer prevention
INTRODUCTION TO PROBLEM
Hospital Acquired ulcers (HAPU) are a common problem in healthcare facilities-They are a financial burden to healthcare facilities and can cause an adverse outcome to patients. An estimated 60,000 patients die each year from complications due to (HAPU) and can cost up to $362,000 to 28 billion a year (Duncan, 2007, p.605). Since 2008, the Centers for Medicare and Medicaid services will not reimburse hospitals for treatments associated with stage III and stage IV pressure ulcers. Prevention is the cornerstone of pressure ulcer treatment. Since the 1960’s studies have shown that a moist wound environment is associated with quicker, healing compared to an environment allowed to dry through exposure to air. Modern dressings such as hydrocolloids, foams and hydrogels have been designed to maintain a moist environment, and these were found to be cost effective in the treatment of pressure ulcers (Payne, et al.2009), Heyneman, Beele, Vanderwee, & Defloor, 2008). Technical approaches of prevention employed in hospitals include pressure reliving mattress, cushion and postures, and human approaches including turning and positioning patients (Schuurman et al., 2009) as well as applying a moisture barrier to patient’s skin. We must also ask the question is the patient incontinent. Is the patient being left, on soiled linens, and how are the patient’s nutritional status and albumin levels, which also contribute to healing (Sayer, Turgut, Dogan Ekici, Yurtsever, Demirkin &Taselen, 2009). This is standard nursing pressure ulcer prevention. 60.4 % of all hospital-acquired pressure ulcers (HPAUs) identified occurred on the bony prominences (Alderden, Whitney Taylor, & Zaratkiewicz, 2011). The frequent positioning of the patients decreases the friction and shear on the bony prominences. Treatment based on advance