This document evaluates pressure ulceration in St. Mary's Hospital over a four year period. It finds that 51.4% of pressure ulcers were acquired in the hospital, compared to 48.5% present on admission. Ulcers acquired in the hospital tended to be lower severity and affect non-traditional sites like the feet and heels. The total person time spent with pressure ulcers and associated costs decreased from 2014-2016, suggesting staff education on prevention was effective. Ongoing education is still needed for all staff and carers to address ulcers on admission and prevent ulcers acquired in the hospital.

1. Pressure Ulceration in St. Mary’s
Hospital: A Four Year Health Service
Evaluation
M Barry CNSp Tissue Viability, St. Marys Hospital
C Murphy School of Nursing and Human Sciences, DCU

2. Introduction
• Pressure ulcers cause great pain and suffering

3. Introduction
• Major financial burden for healthcare
providers

4. Introduction
• €48/day for a stage1 pressure ulcer to
€418/day for a stage 4 pressure ulcer
(Dealey et al 2012)

5. Aims
1. Examine differences in the site and severity
of pressure ulceration in persons admitted to
St. Mary’s compared to pressure ulceration
acquired as an inpatient over a four year
period
2. Describe trends in total person time exposed
to pressure ulceration

6. Methods
• Incidence, prevalence and healing data
collected

7. Overview of pressure ulcer data
2013 2014 2015 2016 Total
N N N N
Patient with PU on admission 15 17 10 9 51 (48.5%)
Patient with PU acquired in St. Marys 16 11 13 14 54 (51.4%)
Total number of new patients 31 28 23 23 105
Multiple PU
Single PU 24 21 21 18 84 (80%)
Two PU 6 3 2 3 14 (13%)
Three PU 1 4 0 2 7 (7%)
Total number of new PUs 39 39 25 30 133

8. Figure 1: Differences in pressure ulceration site in persons
resident in St. Mary’s compared to those with pressure
ulceration on admission

9. Figure 2: Differences in severity of pressure ulceration in persons
resident in St. Mary’s compared to those with pressure
ulceration present on admission
0
10
20
30
40
50
60
70
Grade 2 Grade 3 Grade 4
Acquired in St Marys Present on admission
%
Pressure ulcer grade

10. Table 1: Total person time spent with a pressure ulcer in St.
Mary’s from 2014-2016 and estimated associated costs

11. Discussion
• Inpatients had lower severity of Pressure
Ulcers
• Shift from traditional sites compared to
ulceration present on admission.
• A decrease in the number of days exposed to
PU over the period suggesting an associated
reduction in health care costs

12. Discussion
• On-going staff education
• Heighten awareness of vulnerability of foot
and heel
• Multi-disciplinary involvement
• Off Loading devices
• Carer/patient/resident education

13. Conclusion
• The need for on-going education for all staff and
evaluation of practice is essential to ensure there is
continued awareness of the importance of pressure
ulcer prevention.
• The increasing prevalence of pressure ulceration at
“non-traditional” sites in residents has implications
for education and equipment provision at the facility
whilst the prevalence of pressure ulceration at
“traditional” sites found on admission could be
incorporated into a wider educational programme for
community based carers.

14. Thankyou