Using the Braden Scale and NICE Pressure Ulcer Guidelines to Reduce the Burden and Costs of Pressure Ulcers

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Background: Home Health Care services (HHC), provided by the Family and Community Medicine Department at Prince Sultan Military Medical City (PSMMC) is one of the largest home health care organizations in Saudi Arabia.Pressure ulcers were selected in 2017 as one of the top priority areas for quality improvement in relation to its cost and reoccurrence among the patients and health care services.Aim: The goal of this quality improvement project is to evaluate the effectiveness of risk assessment and preventive management plan for pressure ulcers prevention among patients admitted to HHC, PSMMC. Methods:We used the Braden Scale to assess patient risk for possible development of pressure ulcers, and from this a preventive action plan was adopted from Nice Guideline 2018 according to the patient level of risk.Results: Over the 6-month duration of the study in which we used the Braden Scale, we saw a six percent decrease in the incidence of pressure ulcers.As for the duration of care, this study saw a reduction from 4 months of care per ulcer to only 1.67 months of care per ulcer.We estimate PSMMC would save more than $22 million annually using these measures. Conclusion:The incidence rate of pressure ulcer development improved compared to patients without implementation of the program.Overall burdens, including time and financial costs, are reduced.Recommendations: This quality improvement program emphasizes proactive risk assessment, management plan, staff development, and patient care education to help in the active prevention of pressure ulcers.Further assessment of the outcomes of this program is advised in relation to cost benefit outcome of these care programs on a longer timeline.

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