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FREE PAPER SESSION: PRESSURE ULCERS AND HEALTH ECONOMICS
Free Paper Session: Pressure Ulcers and Health Economics
150
SERVICE EVALUATION OF A RAPID RISK IDENTIFICATION TOOL FOR PRESSURE
ULCER PREVENTION – A PILOT STUDY
Mike Ellis 1
1 Royal Devon and Exeter NHS Foundation Trust (Exeter, United Kingdom).
Aim: To explore the feasibility of utilising a rapid risk identification tool as an alternative
to traditional risk assessment methods for pressure ulcer prevention.
Methods: A draft rapid risk identification tool was introduced to an Emergency
Department (ED) for a period of 4 weeks.
Inclusion Criteria:
• 18 years or older
• Identified for admission to the main hospital area between study dates
Exclusion Criteria:
• Admitted to maternity services
• Died prior to leaving ED
All eligible patients should be assessed while they were in the ED using the new tool. All
patients would then be assessed within 24 hours of admission using the Waterlow risk
assessment scale. Comparison of identified risk levels were then undertaken at the end
of this 4-week period.
Results: 621 out of 987 patients were assessed using both tools. 73.9% compliance
with new tool, 86.1% compliance with Waterlow. 45% of patients were high or very high
risk using Waterlow compared to 40.7% at significant risk using the new tool.
Conclusions: The concept of a rapid risk identification tool may be a feasible alternative
to traditional assessment tools for pressure ulcer risk. There was a strong correlation
between those identified at risk using the new tool and very high risk using Waterlow. A
discrepancy between general nurses’ assessment and specialist assessment supports
the need for a further study to explore nurses’ use of risk assessment in pressure ulcer
prevention and further development of this tool.
151
Free Paper Session: Pressure Ulcers and Health Economics
Lobbying Government to support clients suffering from venous
leg ulceration: Strategies and outcomes achieved by the
Australian Wound Management Association (AWMA) campaign.
William McGuiness 1
1 La Trobe University (Melbourne, Australia).
Associations between compression therapy (CT) and the healing of venous leg
ulceration (VLU) have been supported by research for several decades. However,
demonstrated efficacy is only part of the solution for the successful implementation of
VLU management.
Aim: A critical element is to ensure the support of government for clients suffering from
VLU. Within Australia there are multiple treatment options for VLU. Each option has
different funding and reimbursement options, often leaving the patient with considerable
out of pocket expenses. In 2010 AWMA has commenced a campaign to have
government subsidise CT for this client cohort.
Method: Strategies used included the development of an evidence base, increasing
awareness amongst the general population; a formal cost benefit analysis, using existing
government structures, members as individual lobbyists, and the use of patient stories in
the popular press.
Results: Clinical practice guidelines were developed in 2011 which have been endorsed
by the National health and medical research council of Australia, the cost-benefit report
identified that not subsidising CT was more expensive than the subsidy, the Senate
Committee for Community Affairs has agreed to pursue the subsidy of CT, and a number
of stories and interviews have been conducted with the popular press.
Conclusion: The concerted campaign has achieved formal recognition of the problem
by government and increased general public awareness of the situation for this client
cohort. It is hoped that the 2013/14 Australian budget will provide subsidy for CT. Similar
strategies could be used by any association wishing to improve wound management
outcomes.
EWMA 2013
COPENHAGEN
15-17 May · 2013
Danish Wound
Healing Society
95