Pressure ulcers, decubitus ulcers, or bedsores are injuries to the skin and underlying tissue that can develop over hours or even days. These ulcers occur when bony areas of the body have prolonged contact with an external surface, such as a bed, causing pressure and decreased blood flow to the area, leading to necrosis of the skin. Even though pressure ulcers are adverse events that are considered avoidable or preventable, they continue to be a problem.
Pressure ulcers/injuries are staged according to the level of injury to the patient's skin and HAPI (hospital-acquired pressure injury), with stage 3 or greater being considered never events. These "never events" cause patients pain, infection, and increase the mortality risk for the patient. Reimbursement rates for facilities are significantly reduced for patients that acquire pressure ulcers and in the case of "never events", the hospital does not get reimbursed for the costs required to manage it.
Every year 2.5 million patients suffer from hospital-acquired pressure ulcers (HAPU), and 60,000 patients die from complications of these events. The US spends 26 billion dollars a year on treatment costs for pressure ulcers. Pressure ulcers cost as much as $70,000 per incidence to treat and increase the length of stay on an average of 4.31 days. In 2007 the Centers for Medicare and Medicaid Services (CMS) estimated that each pressure ulcer stage 3 and above added $43,000 in costs to a hospital stay.
Prevention and identification of pressure ulcers in a healthcare facility are very resource-intensive and require the collaboration of the multidisciplinary care team. Comprehensive education and tools exist to help clinicians identify, prevent, and treat pressure ulcers, and many hospitals have dedicated staff to evaluate patient's skin on a regular basis as a part of implementing the best practices to prevent pressure ulcers.
ViSi mobile is a wearable monitor that can help reduce the prevalence of pressure ulcers by providing clinicians a valuable tool that not only displays the patient's current position but also has an alert that will display if the patient has not been turned in a defined amount of time intended to augment manual clinical practice. The ViSi mobile monitor is a body-worn wireless vital sign monitor that utilizes a three-axis accelerometer mounted to the patient's torso. The accelerometer measurements are processed with an algorithm that provides real-time information on the orientation and duration of the patient's position. This provides the clinician with real-time data and notifications to reposition the patient without having to have separate tools to monitor the patient's vital signs.
Reference Articles
https://www.centerfortransforminghealthcare.org/improvement-topics/hospital-acquired-pressure-ulcers-prevention/
https://www.healthcarefinancenews.com/news/pressure-ulcers-cost-health-system-268-billion-year
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2957315/
https://www.ahrq.gov/patient-safety/settings/hospital/resource/pressureulcer/tool/intro.html