Effectiveness of Protocol for Pressure Sore Prevention

Abstract

Background: Pressure sores are a major healthcare problem which diminishes quality of life in all aspects and causes dissatisfaction towards health care process. Since pressure sores are prevent able, it is considered as an indicator of healthcare quality. Prevention requires systematic approach from patient admission to discharge and involves the health care team, patients, caregivers and relatives.
Objectives: To develop and determine effectiveness of pressure sore prevention protocol.
Material and Methods: During March 1st to July 31st, 2013, 4 steps were done: 1) Gathering information, 2) protocol development, 3) pilot protocol implementation, 4) protocol evaluation and improvement. Male patients 15 years of age and over admitted to male Orthopedic ward, Surin hospital with Braden Scale less than 16 for patients less than 70 years of age and less than 18 for patients over were included. Forteen nurses also participated. Instruments include the draft protocol, pressure sore surveillance form, repositioning and skin lesions record, pressure sore reporting form, evaluation form of the prevention protocol, and satisfaction questionnaire.
Results: The protocol was implemented at admission, during admission, and at discharge. Eighty-seven patients were enrolled, 8 developed pressure sores (9.2%) equating to 13.7:1,000 admission days. Implementation of the protocol reduced rate of pressure sores (p <0.05). Satisfaction was high for both nurses (3.7±0.3), patients and relatives (4.2±0.3).
Conclusion: Development resulted in a pressure sore prevention protocol implemented throughout all stages of hospital admission. The protocol was practical and satisfaction was high.