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  1. Shannon, Ronald J. MPH
  2. Coombs, Martha MSN, RN, CNS, CWOCN
  3. Chakravarthy, Debashish PhD, FAPWCA


OBJECTIVE: To determine the effect of a silicone-based dermal nourishing emollient (SBDNE) regimen on the reduction of pressure ulcers (PrUs) and costs in a hospital medical unit.


RATIONALE: PrUs represent a serious problem for patients within the acute care setting and are a significant care management challenge for clinicians. Effective October 1, 2008, the Centers for Medicare and Medicaid Services will no longer reimburse hospitals at the higher diagnosis-related group rate for Stages III and IV PrUs that are not documented on admission. In addition, formation of PrUs in the hospital also puts the institution at financial risk of lawsuits.


RESEARCH DESIGN AND METHODS: The wound healing center at Porter Adventist Hospital, Denver, Colorado, documented the hospital-acquired incidence rate of PrU patients in the hospital from May 2006 to December 2007. A retrospective, quasi-experimental design was used to examine the changes in PrU incidence rates and the economic effect of introducing a SBDNE regimen into an existing PrU prevention protocol.


RESULTS: The replacement of a mixture of ad hoc skin care products, none of which contained silicone-based emollients, with an SBDNE skin care regimen into an existing prevention program significantly reduced the proportion of hospital-acquired PrUs to 0% after 8 months. Estimated cost savings per patient admitted to the medical unit attributed to SBDNE averaged $6677.11 per patient.


MAIN CONCLUSIONS: The use of an SBDNE skin care regimen was important in bringing about a significant reduction in the number of patients with PrUs and respective treatment costs in a medical unit experiencing high incidence rates of PrUs.