815 / Reduction of pressure ulcers in hospitalised patients

DENMARK
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
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Topic of the reported practice
Quality improvement project
Aim and the benefit of the Patient Safety Practice
 
Reduction of pressure ulcers
Description of the Patient Safety Practice
 
This PSP is part of the The Danish Safer Hospital Programme which is designed to prevent inadvertent errors, injuries and deaths. The aims are to achieve 15 % reduction in mortality and 30 % reduction in harm, by ie. reducing the number of cardiac arrests, eliminating hospital infections, reducing pressure ulcers and preventing medication errors. The results are shared and disseminated to be an inspiration for the country's other hospitals. The programme has five Workstreams, each consisting of a number of bundles or "packages". The five Workstreams are: Critical Care, Perioperative Care, Leadership, and Medicines Management. The contents of the Danish Safer Hospital Programme correspond with recognized and accepted best practices. The project does not intend to teach new clinical knowledge but rather promote agreed upon knowledge in quality improvement. Pressure Ulcer Bundle (PUB) consist of a number of evidence based activities such as; Risk assessment of all patients, Daily review of patients at risk, Nutritional assessment and plan for patients at risk for PU, Maximum mobilization and pressure relief by mattress and other surfaces. Five hospitals participate in The Danish Safer Hospital Programme as exemplar sites (Hillerod Hospital, Hospitalsenheden Horsens, Kolding Sygehus, Nastved Sygehus, Sygehus Thy-Mors). Positive results at the exemplar sites will be spread by an active effort to hospitals in the rest the country. The Danish Safer Hospital Programme introduces a systematic and sequenced approach for health professionals to incorporate measurement and data to track whether safe, quality care is provided. Real time data will be used to identify opportunities for improvement and motivate caregivers to make rapid changes in order to track these improvements. The most recent results are displayed on the webpage (see below) The effects of the PUB were measured as the number of prevented pressure ulcers and the number of saved lives. The effects were at hospital level; 1) a reduction of 9.3% prevented pressure ulcers, and 2) 0.47% prevented deaths. The potential net savings were estimated to be € -38.62 per patient without PU (ref. Mathiesen AS et al. Are labour-intensive efforts to prevent pressure ulcers cost effective? J Med Econ. 2013 Sep 6) Further information is available at: http://www.patientsikkertsygehus.dk/in-english/the-danish-safer-hospital-programme.aspx http://www.patientsikkertsygehus.dk/media/273319/heps%202011%20the%20danish%20safer%20hospital%20programme_2011_03_22_.pdf
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
Unit or ward 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
Quantitative
Enclosure of a reference or attachment in case of published evaluation's results
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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
Not known
Specification of implementation in another health care setting(s)
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Successful implementation's level  of this Patient Safety Practice across settings
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Involved health care staff
 
Nurses
Health care assistants
Therapists
Dieticians/ Nutritionists
Environmental support (Housekeeping)
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
Yes
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
Patient(s)
Relative(s)
Point of time in which service user or their reprasentatives' involvement takes place
During the development of the Patient Safety Practices
During implementation of the Patient Safety Practices
Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
Not known
Short description of the service users' level of involvement
Not known
Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
Not known
List of sources where public information is accessible
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Implementation of the Patient Safety Practice
 
Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice
Yes
Problems encountering in the implememntation course of this Patient Safety Practice like lack of motivation, no management support, etc.
Yes
List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice
Lack of knowledge on implementation strategies
No motivation among staff
Staff or management did not recognise the need for change
List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
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Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice
Not known
Description of used incentives, if any.
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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
Yes
Costs of the Patient Safety Practices
 
Completion of cost calculation related to this Patient Safety Practice
No
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
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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
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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
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Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
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Contact information
 
Name: Jacob Anhoj
Country: DENMARK
Organisation: Danish Society for Patient Safety
E-mail: jacob.anhoej@patientsikkerhed.dk
Phone: There is no specified text here
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