Pressure ulcer prevalence and prevention of nosocomial development: one hospital's experience.

A 500 bed acute care facility needed to replace their old medical-surgical patient beds and reduce the costly use of specialty beds and overlays. After a review of the literature, the facility focused on the 44-bed AIDS/Oncology unit, first trialing a new therapeutic bed, then replacing all the beds. A prevalence survey was conducted 5 days before the placement of the new beds and monthly thereafter for 6 months. It was hypothesized that (1) incidence of nosocomial pressure ulcers would decrease, (2) use of specialty beds would be reduced, resulting in significant cost savings within a few months, and (3) there would be a learning curve regarding use of the beds and proper "zoning" of patients. From April through November 1995, 256 patients were surveyed. Pre-survey, the average range on the unit for pressure ulcer prevalence was 7.5 to 15% (both nosocomial and admitted). Post-survey, the range was 3 to 16% (admitted ulcers only). Zero nosocomial pressure ulcers developed during the study period. Use of foam overlays and low air loss surfaces decreased, resulting in a savings of 83%. There were no problems with using the beds or zoning patients. These survey results suggest that other institutions could achieve similar clinical and financial outcomes by converting rental dollars to capital assets.