Loretto Health and Rehabilitation Center, Syracuse, New York, USA.
J Wound Ostomy Continence Nurs. 2009 Nov-Dec;36(6):616-21. doi: 10.1097/WON.0b013e3181bd813e.
Heel pressure ulcers (PUs) are common in long-term healthcare settings. Early identification of risk and the use of preventive measures are central to reducing the morbidity, mortality, and high medical costs associated with heel PUs. A Quality Improvement Process was initated based on a tailored protocol, in-service education program, and a heel protective device was approved by the US Food and Drug Administration. The Braden Scale was used to evaluate PU risk in 550 patients in a long-term healthcare facility. Patients with a Braden Scale score of 18 or less and with 1 of 7 high-risk comorbidities were considered at high risk for PUs, and this prompted a more aggressive prevention program that included a protocol for reducing the risk of heel ulceration. The number of hospital-acquired heel PUs during the 6-month preintervention period was 39. Following the intervention, there were 2 occurrences, representing a 95% reduction in heel ulcers between the 2 periods. After the cost of 2 heel protectors for 550 at-risk patients was subtracted from the estimated cost of treating the 37 heel ulcers prevented, the estimated cost savings was calculated to be between $12,400 and $1,048,400.
足跟部压疮（PU）在长期医疗护理环境中很常见。早期识别风险并采取预防措施是减少与足跟部 PU 相关的发病率、死亡率和高昂医疗费用的核心。基于定制的方案、在职教育计划和获得美国食品和药物管理局批准的足跟保护装置，启动了一个质量改进流程。Braden 量表用于评估长期医疗护理机构中 550 名患者的 PU 风险。Braden 量表评分为 18 或更低分且有 7 种高风险合并症之一的患者被认为有发生 PU 的高风险，这促使采取更积极的预防计划，包括降低足跟溃疡风险的方案。在干预前 6 个月的医院获得性足跟部 PU 数量为 39 例。干预后，发生了 2 例，表明在这两个时间段之间足跟溃疡减少了 95%。从预计治疗预防的 37 例足跟溃疡的费用中减去为 550 名高危患者提供的 2 个足跟保护器的成本后，估计节省成本在 12400 美元至 1048400 美元之间。
