Is it possible to monitor Pressure ulcers as a part of adverse event. Reporting – benefits and risks OR Comprehensive and nationwide accepted approach for PU prevention in the Czech Republic

PUs present a major health challenge worldwide: they affect large numbers of people and result in considerable health system expenditure. Hospital-acquired PUs (HAPUs) significantly increase healthcare costs. The increased costs are primarily due to prolonged hospitalization, application of medication (antibiotic treatment, antiseptics, pain killers etc.). According to an international consensus focusing on cost effective wound management [1, p. 2] data collection is often sporadic and, when it is collected, poor or inconsistent methodology can make meta- analysis difficult. Data regarding clinical efficacy and effectiveness may be limited or unavailable. Financial data may be based on measurements that do not provide a true indication of cost. Thus, all of the above reasons are convincing arguments for the reporting of PUs uniformly with appropriate methodological support. Hospital-acquired PU surveillance and prevention can save costs in hospitals and should be considered by nursing executives as a strategy to support qua-lity outcomes [2, p. 239]. Based on reality mentioned above we have tried to analyse data from central system of adverse event reporting (CSAER) where PUs are reported as one of monitored adverse event according the same methodology. Methodological documents for uniform data collection are published on special websites (shnu.uzis.cz) where are guidance for prevention, monitoring and also corrective measures captured. Pilot testing of this system is undergoing under the patronage of the Institute of Health information and Statistics in the Czech Republic and Ministry of Health of the Czech Republic actually. The second source of data which we have used is National Register of hospitalised patients [3, 4]. We have verified that it is possible to collect data about pressure ulcer prevalence through the central system of adverse event reporting (CSAER) [3, 4]. However there is still need to work on local policy, monitoring systems on local level in involved hospitals and individual corporate culture as well as individual responsibility to be able to recognise, report and monitor pressure ulcers. We also would like to highlight that not all pressure ulcers should be treated as adverse events but they are result of the clinical condition of the patient and may be developed despite all the appropriate care given to the patient. There is still need to support risk assessment and realisation accurate and appropriate actions on the national level, to decrease the influence for local policy and uniform clinical practice to achieve higher quality of care.

Literature:
  1. International consensus: Making the case for cost-effective wound management. Wounds International 2013. Available to download from www.woundsinternational.com. (last access to this site: 5.12.2017)
  2. Spetz J, Brown DS, Aydin C, Donaldson N: The value of reducing hospital-acquired pressure ulcer prevalence: an illustrative analysis. Journal of Nursing Administration. 2013;43(4):235–241.
  3. Pokorná, A., Benešová, K., Jarkovský, J., Mužík, J., Beeckman, D. Pressure injuries in inpatient care facilities in the Czech Republic. Journal of Wound, Ostomy and Continence Nursing. 2017;44(4):331-335.
  4. Pokorná, A., Mužík, J. Pressure ulcers monitoring – possibilities and first experiences from the Czech Republic Wund Management Sonderheft 2/2017, pp. 6 – 8.
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