662 / Decubitus ulcers: Prevention and Treatment

ITALY
Classification of the PSP
Type of Patient Safety Practice Safe
 
Clinical Practice (CP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Decubitus ulcers
Diabetes care There is no specified text here
Topic of the reported practice
Clinical guidelines or pathways
Aim and the benefit of the Patient Safety Practice
 
The practice aims at preventing decubit ulcer and suggesting the proper treatments.
The decubit ulcer is a localized area of damage of the skin and subcutaneous tissues caused by forces of pressure, tension, friction, or by a combination of these factors in fragile subjects.
The ulcer is formed normally at bony prominences and its seriousness is classified on a scale. The decubit ulcer produces physical and psychological suffering for patients, costs for health care services in terms of days of hospitalization, drug consumption, anti-bedsore mattresses.
Prevention is the first goal to reach and has to be carried out by ensuring a proper risk assessment together with specific planning of preventive actions. While planning the treatment of a person with decubitus ulcers, it is worth taking into consideration his/her clinical condition and the status of ulcers.
Description of the Patient Safety Practice
 
Reducing incidence of decubitus ulcers has been identified by many countries as a priority action to improve the quality of health services.
In order to assess the risk of decubitus ulcers, medical records of patients with ambulation difficulties include
a) evaluation index of the functional state through a validated scale (eg, Barthel);
b) evaluation index of the risk of pressure ulcers through a validated scale (eg, Braden);
c) evaluation index of malnutrition risk through a validated scale (eg, index MUST) and weight;
d) factors predisposing the development of Pressure ulcers;
e) pain assessment by a validated scale (eg VAS);
f) re-evaluation of risk at regular intervals and at every change in the terms and conditions of the assisted;
g) preventive actions, with reporting:
• date and time;
• type of intervention;
• who performed the intervention
For non-self-sufficient patients (or patient at risk of decubitus ulcers):
- the care pathway "prevention of decubitus ulcers" is arranged
- at the moment of the discharge, a report regarding the patient conditions is sent to the GP
Furthermore, informative leaflets are given to patients, families and caregivers in order to increase awareness on the problem.
Attachment of relevant written information and/or photos, as appropriate
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Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
Yes, fully
Level of implementation of reported practice
Institution level
Specific and measurable outcome for the reported practice were defined
Yes
A baseline measurement before implementation of the reported practice was obtained
Yes
A measurement after full implementation of the reported practice was obtained
Yes
Evaluation of a "positive" effect of the reported practice on Patient Safety
The evaluation showed improvements in Patient Safety outcomes
Type of before-and after evaluation
Qualitative
Enclosure of a reference or attachment in case of published evaluation's results
There is no specified text here
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Health care context where the Patient Safety Practices was implemented
 
Hospital
Transferability
 
Successful implementation of this Patient Safety Practice in other health care settings than above stated
No
Specification of implementation in another health care setting(s)
There is no specified text here
Successful implementation's level  of this Patient Safety Practice across settings
There is no specified text here
Involved health care staff
 
Physicians
Nurses
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
No
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
There is no specified text here
Point of time in which service user or their reprasentatives' involvement takes place
There is no specified text here
Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
There is no specified text here
Short description of the service users' level of involvement
There is no specified text here
Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
Yes
List of sources where public information is accessible
http://buonepratiche.agenas.it/practicesdetail.aspx
Implementation of the Patient Safety Practice
 
Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice
No
Problems encountering in the implememntation course of this Patient Safety Practice like lack of motivation, no management support, etc.
Not known or not relevant
List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice
There is no specified text here
List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
There is no specified text here
Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice
Not relevant
Description of used incentives, if any.
There is no specified text here
Existence of support or approval by the clinical or hospital management or any other hihg level authority in the implementation process of this Patient Safety Practice
Not relevant
Costs of the Patient Safety Practices
 
Completion of cost calculation related to this Patient Safety Practice
Not relevant
Total number of person days required to implement this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total number of person days required for training as preparation for implementation of this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total cost in Euro of specific equipment (machines, software, communications supplies, etc.) needed to support implementation of this Patient Safety Practice
There is no specified text here
Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
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Contact information
 
Name: Sara Albolino
Country: ITALY
Organisation: Centro Gestione Rischio Clinico e Sicurezza del Paziente
E-mail: albolinos@aou-careggi.toscana.it
Phone: 0557946334
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