FOURTEENTH ANNUAL EUROPEAN PRESSURE ULCER ...

Wednesday August 31st
39
14th Annual European Pressure Ulcer Meeting
Oporto, Portugal
ECONOMIC EVALUATION OF PREVENTION OF PRESSURE ULCERS IN INTENSIVE CARE UNITS
Andrade, Melanie 1* , Nogueira, Fernanada 2 , Morais, Ernesto 3
1* CHVNG/E, Portugal, andrade.melanie@gmail.com
2 UTAD,Portugal 3 ESEP, Portugal
Introduction
The prevention of pressure ulcer assumes a fundamental role
in health services economics and management, requiring the
mobilization of material and human resources translated into
significant costs for the institutions involved.
As its aim this study had the determination and comparison
of the costs and direct effects of pressure ulcer prevention
with patients at risk of developing these ulcersm, admitted
to two samples of an intensive care from different hospitals.
Methods
The methodology of this study was an economic evaluation,
cost-effectiveness (CE), from the health institution view
analysis, with patients admitted in intensive care units in
two different hospitals CHVNG and in the HPH, between
May and September 2009. The study population was 132
patients (CHVNG) and 162 (HPH). The sample present
inclusion criteria: patient without UP in admission moment
and at risk of UP developing, with nursing intervention
planed to prevent PU developing. The variables were related
to the socio-biographical characteristics of patients, the costs
of material and human resources recruited from the
prevention PU programs and their direct effects (number of
new cases, incidence and incidence density).
Results
The professional more important in prevention PU plan was
the Nurse. We found that the samples had similar sociobiographical
characteristics. They were hospitalized in ICU
for around 6,7 days (CHVNG) and 5,9 (HPH). Diabetes is
the predominant comorbidity in both samples. The patients’
risk PU development was evaluated by Braden scale
(CHVNG) and Norton scale (HPH). Considering the
different risk PU development degree in each population,
the difference between the averages of the daily frequency
of the interventions for prevent PU development is not
statistically significant. But, considering the two hospitals,
the difference between the averages of daily frequency
interventions was statistically significant - in the HPH,
interventions were more frequently. Patients weren’t
evaluated (using the scales) every days. The time of witch
interventions, in the CHVNG was, for Position (position the
patient, bed linen care) - 15 minutes, and in HPH - 19. For
Monitoring scale was estimated 1,8 min in the CHVNG and
5,87 min in HPH. Application of cream and massage was
similar in both hospitals, 5,5 min in CHVNG and 5,9 in
HPH.
The total cost of PU prevention estimated was €20.915,36 in
CHVNG and €42.100,69 in HPH. The cost of PU prevention
per patient per day of hospitalization in ICU was €30,27 and
€65,12, correspondingly. The human total cost represented
almost 83% of the total cost, material/consumable (gloves,
cream, apron and mask) 16% and material/equipment
(mattress and pillows)