Authors (including presenting author) :
Lam WSJ(1), Ngan HL(1), Kwan WK(1), Ng KK(1)
Affiliation :
(1) Wound and Stoma Care Team, United Christian Hospital
Introduction :
Pressure injury is the most common type of wound that nurses will encounter in hospitals and is an internationally recognized patient safety problem and serve as a clinical indicator for the standard of care provided.
In our hospital, United Christian Hospital, around 5100 community and hospital pressure injuries reports each year, while around 450 patients develop new pressure injuries during hospitalization. The most commonly affected area was coccyx and sacrum, representing 38.2% of the total number. However, the pressure injuries at these areas are difficult to heal because the wounds are always contaminated by effluent and it is hard to keep dressings intact and conforming to the wound. Nowadays, there are some new designed foam dressings to tackle these problems, However, it is around 18% more expensive than the usual foam dressing. Therefore, our team had carried out a CQI project to evaluate the effectiveness of these bordered foam dressing and is it worth the extra expense to use these.
Objectives :
• To evaluate the effectiveness of bordered foam dressing on different pressure injuries stages
• To evaluate the effectiveness of bordered foam dressing on improvement of wound condition, reducing wound size, healing rate and improvement of wound condition
• To evaluate the effectiveness of bordered foam dressing on cost-saving
Methodology :
The project was done in UCH and HHH during 25/2/2021-25/5/2021 by UCH Wound and Stoma Care Team. Patients with pressure injury at the coccyx or sacrum with wound size from 0.5x0.5cm to 10x10cm; stage 2-3 & Deep Tissue Pressure Injury (DTPI) were recruited.
Each case was assessed on five aspects: dressing change frequency, any contamination by effluent, wound condition, wound size and peri-wound skin condition. These assessments were done at 3-days, 1-week, 2-weeks, 3-weeks and 4-weeks intervals, or until wounds healed, patients discharged or patients passed away after the bordered foams were applied.
Result & Outcome :
We have recruited 23 patients in this project, among these patients, 80% of the wound had reduction in size, 85.4% of the wounds showed improvement in wound condition, the peri-wound skin of all wounds has improved or remained the same. 77.1% of the applied bordered foam could be kept intact and not contaminated by effluent until next dressing change.
In conclusion the bordered foam was effective to promote wound healing even for stage 3 and deep pressure injuries. Some wounds have even showed obvious improvement in 3 days. Moreover, it could usually prevent the dressing material from contamination by effluent, which could hardly be achieved by using other dressing material.
