TACKLING PRESSURE ULCERS: CAN WE DO BETTER?

FOLLOWING the summer and well deserved vacations do we leave work
with a feeling that we are in control of pressure ulcer prevention and
management? Or do we remain uncertain that our efforts have helped
reduce the burden imposed on our health care system by pressure ulcers?
Recently in the United Kingdom a Member of Parliament posed questions
related to pressure ulcers to the UK government. The government’s response
(which can be read in full on the UK Tissue Viability Society web-site
www.tvs.org.uk) makes rather depressing reading for in 2001–02 there were
15,292 hospital patients reported to have pressure ulcers with this number
rising in subsequent years to 17,178 and in 2003–4 to 18,087. If these figures
appear low to you then you should consider that these were the cases where
pressure ulcers were entered as a specific diagnostic code during the in-patient
episode. On many occasions pressure ulcers were likely not to have
been reported in this way. Regardless of whether the actual total number of
patients with pressure ulcers is a multiple of 2, 4 or 10 times the reported
number, the number of people with a diagnosis of pressure damage increased
each year. Does this mean we in the UK are getting better at reporting pressure
ulcers using diagnosis codes? Or are we more aware of pressure ulcers
generally? Or could our efforts in pressure ulcer prevention be failing? How
do we untangle the correct interpretation of these data? Obviously appropriate,
consistent and accurate data collection reporting all patients with
pressure ulcers would be the ideal and it is time for us in Europe and beyond
to look at the practical issues related to such a strategy. How expensive would
this recording be, who would do this and how would the data be reported
are clear and pressing issues. Perhaps one intermediate solution is to implement
the EPUAP prevalence and incidence monitoring position statement
reported in the previous issue of the EPUAP Review within a random sample
of health care providers in each country? The final question to leave you
with is one of responsibility – if we want accurate comparable data upon the
occurrence of pressure ulcers who should pay the bill – government, industry,
health care systems or the funding bodies who support clinical research?
What do you think the answer is? Send us an e-mail or visit us on-line at
www.epuap.org and let us know.

Michael Clark
Editor