"PRESSURE SORES IN NON-HOSPITAL

SETTINGS - PRESENTATION

OF A COOPERATION MODEL BETWEEN

HOSPITAL AND EXTERNAL INSTITUTIONS"

A. Bugalska-Żak

B. Bladowska

B. Wieczorek-Wójcik

M. Dykas

Ceynowa Hospital in Wejherowo, Poland

The Nursing Team for the Prevention and Treatment of Pressure Sores and Stomy Care

Introduction:

Patients with pressure sores arising in non-hospital settings are a significant group of hospitalised

patients, especially in the departments of internal medicine and medical treatment wards.

This can be attibuted to inefficiencies of PATIENT’S CARERS, and also deficiencies in the primary

care and non-regulated system of private nursing homes.

The Hospital – Public sector

General Practitioner

- Non Public SECTOR

Nursing Homes

-Non Public SECTOR

LACK OF CO-OPERATION….

Aim:

To present data detailing 3 years of collaboration between Ceynowa Hospital and primary care

centres/nursing homes in the Wejherowo district regarding pressure sores prevention and care

after hospital discharge.

Poland

Method:

The introduction of organisational changes to improve the quality of nursing care, the

presentation of modified tasks of the Team for Prevention and Treatment of Pressure Sores and

Stomy Care, and a demonstration of the Co-ordinator’s role in the context of incidence and

morbidity of pressure sores in six key hospital departments:

• Department of General Surgery - 60 Beds

• Department of Neurology - 36 Beds

• Department of Cardiology -37 Beds

• Department of ICU -10 Beds

• Department of Orthopaedics – 37 Beds

• Department Pulmonary Diseases – 50 Beds

TO PROVIDE:

A constant records of patients admitted to hospital;

Continous monitoring of the pressure sore treatment and supervision of care;

Development of the standards/procedures of prevention and treatment of pressure sores;

Documentation control;

Opinions and guidance on the management of patients discharged from the hospital;

Co-operation with GP, Nursing homes and the patient’s families and carers;

An ONLINE record of bedsores in „Decubitus Project”

GOALS FOR THE NURSING TEAM FOR THE

PREVENTION AND TREATMENT

OF PRESSURE SORES AND STOMY CARE:

Chart of solving a problem… Ceynowa Hospital

Team

CO-ORDINATOR

General Practictioner

&

District Nurse

Hospital Units Nursing Homes

Consultant District Nurse

of Wound Treatment

(Nursing and Midwives District Chamber in Gdańsk)

regular training

„ Wound Care”

Results:

35 571 patients were admitted to hospital departments between November 2009 and

November 2012, 13 691 of which were considered to be at high and very high of pressure sore.

1151 patients had pressure sores arising outside hospital. During hospitalisation, pressure sores

occurred in 504 of patients.

PROFILE OF PATIENTS WITH BEDSORES…

• Age ~ 73 years old

• Waterlow scale ~ 28 points

• Hospital pressure sores Iº-IIº(Torence scale)

• Non hospital pressue sores IIIº-Vº (Torence scale)

30%

70%

Pressure sores in Ceynowa Hospital2009-2012

hospital pressure sore

non-hospital pressure sore 96,4%

3,6%

patients with the risk of pressore sores

hospital pressure sores

PATIENT ADMISSION PATIENTS WITH PRESSURE SORES

IN CEYNOWA HOSPITAL SINCE 2009

•Keepinig wound documents

•Report bedsores (in each Unit where patient is treating)

•Take a bedsore tissue to Department of Microbiology ( the surgeon)

•According to the standard and procedures of patient care

•Consultation

•Assessment by the Torence scale

•Surgical treatment of pressure sores

•Recommendation of care and treatment

•Registration to electronic records

•Changing dressing

•Photo of bedsores

•Contact with the Co-ordinator of the Nursing Team for the Prevention and Treatment of Pressure Sores and Stomy Care

•Establishment of patient discharge card of bedsores

•Print Photos of bedsores and attach to the patient documentation (addmition and discharge ones)

•Recommendations for families / carers

•Contact with GP/District Nurse/ Nursing Home

Patients discharge

Emergency Unit

WARD Team

Co-ordinator

Conclusions:

Pressure sores remain a big problem that require innovative solutions.

The knowledge about pressure sore prevention should be shared with the

medical personnel looking after patients in hospitals and primary care

centres, as well as the patients’ families and carers.

Only such cooperation between primary and secondary care personnel will

prevent unnecessary long-term hospitalisation.

CONTACT: abugalska@wp.pl

Ceynowa Hospital in Wejherowo, Poland