Preventing pressure ulcers already in the ED – or even before the patient arrives

For high-risk patients, 30 minutes on a hospital gurney is sufficient to cause a pressure ulcer. This is why the emergency department in Huddinge focuses on identifying these patients as soon as they arrive. Preventive measures are immediately implemented and continued throughout the patient’s hospital stay.

30 minutes is enough for high-risk patients to develop a pressure ulcer

Pressure ulcers are a major health care issue worldwide. They cause enormous suffering for the patient, prolong hospitalization and increase mortality.

Video: New process for efficient prevention

World leading in early initiation of pressure ulcer prevention – starting even before the patient arrives at the hospital.

Difficult to identify the signs in time

– Moreover, pressure ulcers can develop very quickly and the signs may be difficult to discover in time. This is why preventive measures are so important, says Jenny Delin, assistant university nurse.

She headed up the Karolinska innovation project to prevent pressure ulcers as early as possible within the hospital chain of care. High-risk patients are identified as soon as they arrive at the Emergency Department and can be placed directly on a pressure relief mattress, which they retain throughout their hospital stay. The process is now implemented at the hospital.

Follow-up in the medical records system

– At the same time an entry is made in the patient's medical records. The entry then follows the patient from the ED to the ward to alert hospital personnel to be extra careful to avoid pressure ulcers later in the chain of care, says Jenny Delin.

Emergency Department – a strategic choice

An estimated one fifth of patients at the Huddinge Emergency Department require preventive measures, according to an initial preliminary study. The clinic is growing and is on the way to becoming the largest in Europe.

Great need throughout Sweden

According to the Swedish Association of Local Authorities and Regions (SALAR), a national survey in 2017 showed that pressure ulcers affect about 13% of patients in Swedish hospitals. Despite various initiatives at the national, regional and local levels, this percentage has essentially remained unchanged since 2015. The problem has not decreased. Consequently, there is a great need for innovative new solutions to address the problem.

13 percent of patients in Swedish hospitals are affected

PEP Prevention Emergency Project – preventive measures for pressure ulcers

PEP was a patient care innovation project, which has developed a new process to effectively prevent pressure ulcers among patients in the risk zone. When initiatives are already implemented in the emergency room the entire hospital is affected since patients are often admitted from there to the various hospital wards. This also applies to other care services, such as assisted living facilities. The process is now implemented atthe hospital.

The emergency department at Karolinska University Hospital, Huddinge, run the project in collaboration with Mölnlycke. The process involves most services at the hospital, as well as five ambulance companies.

Project manager: Jenny Delin.
Coordinator at the Center for Innovation: Nina Lahti.