Pressure ulcers are the most expensive chronic wound in the NHS, costing an estimated £3.8 million per day1.
Meanwhile, the number of people living with a pressure ulcer has risen significantly. Studies show that the cost of pressure care amounts to 4% of total NHS expenditure2, and yet with suitable procedures in place, all pressure ulcers are in theory preventable.
It’s crucial as ever to ensure health care professionals learn on pressure care improvement programmes to help reduce pressure damage and improve quality of care1.
Overview of Pressure Care Management and Pressure Ulcers
Pressure ulcers, also known as pressure sores and bed sores, are painful skin and tissue injuries caused by prolonged pressure on the skin. Commonly caused by extended periods in bed, the most often affected areas are the heels, ankles, and hips.
The Royal College of Nursing highlight the importance of pressure care with their recommendation that, “all healthcare professionals should be educated about:
• Pressure ulcer risk assessment and prevention,
• Selection, use, and maintenance of pressure-relieving devices
• Patient education and information-giving
See our helpful pressure care equipment selector tool
The Impact of Pressure Ulcers on the Individual
Anyone who spends extended periods in bed is at risk of developing pressure ulcers, but those at the most risk are individuals with the following:
• Poor Circulation
• Previous Tissue Damage
Pressure ulcers can have severe effects on the individual, and the worst scenarios can lead to disability, amputation, and even a threat to life. The risk of infection is heightened and increases hospital stays. Above all, pressure ulcers can be extremely painful and cause avoidable suffering.
Impact of Pressure Ulcers on the Care Industry
The final implications of pressure ulcers are a significant cause for concern for both the NHS and private care facilities.
The daily cost of pressure care per patient is estimated from £43 to £374 for those in hospital, whether it be for long-term care that is not originally related to pressure care3. When a patient develops a pressure ulcer whilst in hospital, their stay is extended on average by 5-8 days4, taking up beds that would otherwise become free. Meanwhile, a pressure sore worsening from grade 1 to grade 2 increases costs by 300%4.
Did you know?
An extra 5-8 days are added to those who develop a pressure sore in hospital4
In addition to increased cost of care, litigation costs relating to pressure ulcers were at an all-time high of £20m in the year 2017-18, an increase of 43% in just three years5. Whilst cases of nursing homes being liable for pressure ulcer development have led in compensation payouts of up to £11,0006.
As with most health issues, prevention is the most effective cure. In many cases when the necessary guidelines and guidelines are followed for pressure care prevention, almost all pressure ulcers are preventable.
The National Institute for Health and Care Excellence (NICE) recommends that a risk assessment by GP’s could effectively reduce the worsening of existing pressure sores and help to prevent new pressure sores from developing4.
Carer providers need to perform a full risk assessment on every individual who is subject to pressure sore development. Well-known tools such as the Waterlow Score are commonly used in Hospitals, Nursing, and Residential Homes to assess patients’ risk to pressure sore development.
The Waterlow tool simplifies the process and considers multiple factors which includes user skin type, mobility, and nutrition to provide guidance to care providers in determining the user’s level of risk. Once the level of risk is determined, care providers can choose specialist equipment such as mattresses, cushions, and automated turning systems.
How To Improve Pressure Care
As a care provider, it's essential in knowing what is classified as a pressure ulcer. Until recently, there had been no agreed definition of pressure ulcers. Now, a new definition from the NHS is used to educate staff:
“Pressure ulcers (also known as pressure sores or bedsores) are injuries to the skin and underlying tissue, primarily caused by prolonged pressure on the skin7”.
As mentioned previously, once the level of risk has been determined the appropriate pressure care equipment can be selected. Read on to see how products to prevent pressure damage and treat existing pressure sores.
Mattresses | Foam or Pressure Care Technology
High specification pressure care mattresses, such as the Opera Impulse, are designed to automatically redistribute the user’s weight to reduce the pressure levels whilst in bed.
In a recent comparison study between a standard hospital foam mattress and the Opera Impulse Mattress, a reduction in pressure of up to 81% was measured.
The test was performed to assess the level of pressure that an identical user would experience on both mattress types. The results would then be used to identify a user’s risk of developing, or worsening, a pressure ulcer from spending extended periods on a mattress.
The same user was measured laying on both mattresses in the same body position and measurements were simultaneously taken at 1,024 points, recording the pressure between the body and the mattress.
Pressure reductions of 81% were experienced at the head, an average of 56% in the shoulders and an average of 54% in the buttocks.
Pressure Care Mattresses | A cost assessment
Studies have shown that the suitability of pressure care equipment and its effect on the occurrence of pressure sores has been difficult to prove with a degree of accuracy8. However, the mean incidence rate of pressure ulcers forming stands at 4% of hospital inpatients2.
According to a UK study looking at pressure sore costs in the UK, the average cost of treating a pressure ulcer stands at an estimated £208.50 per patient per day, with the average hospital stay being extended by 6.5 days8. This results in a total avg. cost of treating pressure care at £1355.25 per affected patient.
With an incident rate of 4%, we can average this cost between 100 patients to calculate the daily cost for every patient admitted into the hospital. Based on these figures, we can also calculate an average across all hospital inpatients to see how a change in incident rate would affect the total costs of pressure care treatment.
Avg. Daily Cost Analysis
By averaging the pressure care costs across all hospital inpatients, because all inpatients are at risk of being affected by pressure ulcers, allows us to calculate how an improvement in incident rate would affect treatment costs.
At the current 4% incident rate we can see that the daily cost per hospital inpatient is £8.34. Over the course of a year, the cost per occupied bed is £3,044.10.
Improving the incident rate to 1% would reduce the daily cost per hospital inpatient by £6.25 to £2.09. Over the course of a year, the cost per occupied bed would reduce by £2,281.25 to £762.85.
Based on these costs and savings, and assuming pressure care technology would be effective in reducing the incident rate, we can assess the cost effectiveness of investment in pressure care mattress technology.
Cost Analysis of Opera Impulse Hybrid Mattress System – Example Study
The Opera® Impulse Hybrid Mattress offers wound care therapy designed specifically to take care of patients who are at risk of developing pressure ulcers, or already enduring distress and discomfort from pressure ulcers.
The table below shows a scenario of a care facility with 20 beds, currently operating at a 4% incident rate. As part of their programme to improve pressure care, the facility invested in 20 Opera Impulse Hybrid Mattress Systems to replace their existing foam mattresses as an effort to reduce the incident rate.
The statistics below demonstrate a cost analysis of the investment, savings and ROI over three years.
3% Incident Rate – Annual saving per bed of £762.50
2% Incident Rate – Annual saving per bed of £1,522.05
1% Incident Rate – Annual saving per bed of £2,281.25
- At a 3% incident rate the investment is recouped by the end of year 2
- At a 2% or 1% incident rate the investment is recouped by the end of year 1
- At a 2% incident rate there is a saving of over £61,000 after three years
- At a 1% incident rate there is a saving of over £100,000 after three years
Care facilities with pressure care equipment are likely to experience:
- a reduction in healthcare and nursing costs for repositioning residents
- decreased risk of litigation for pressure care issues
- reduced patient durations – not applicable for long term care facilities
The Opera® Impulse Pressure Care Mattresses System
The Opera® Impulse is a dynamic replacement mattress system, combining both high performance static foam, and active alternating air cell technology for exceptional patient comfort and healing. Alternating therapy can be quickly and easily applied by connecting the ultra-quiet pump, whilst still providing a peaceful sleeping environment.
Opera® Impulse Mattress
The Opera® Impulse mattress has a high-performance foam layer which features a zonal area design, which are channels for hose and cell connections to avoid pressure points on the surface to provide effective redistribution of pressure on the sacrum, head, shoulder blades and heel areas and supports patients up to 250kgs.
Opera® Impulse Air Pump
The Opera® Impulse air pump uses auto weigh technology that responds to patient movements on the mattress by automatically adjusting internal mattress pressure. This allows the Impulse power unit to regulate the interface pressure between the patient and the mattress, continuously providing total envelopment.
Call now to speak with a sales advisor to find out more about the Opera range of pressure care mattresses on 0333 222 8584.
1. Pressure ulcers: revised definition and measurement, NHS Improvement, 2018
2. Bennett, G. (2004). The cost of pressure ulcers in the UK. Age and Ageing, 33(3), pp.230-235. Accidentspecialistsolicitors.co.uk. (2019). [online] Available at: https://www.accidentspecialistsolicitors.co.uk/nursing-home-serious-pressure-sore/
3. Dealey, C., Posnett, J. and Walker, A. (2012). The cost of pressure ulcers in the United Kingdom. Journal of Wound Care, 6, pp.230-5, 264, 261-2, 266.
4. Costing statement: Pressure ulcers. (2014). Pressure ulcers: prevention and management. [online] Available at: https://www.nice.org.uk/guidance/cg179/resources/costing-statement-pdf-248688109
5. Stephenson, J. (2019). NHS litigation bill for pressure ulcers soars 53% in three years | Nursing Times. [online] Nursing Times. Available at: https://www.nursingtimes.net/news/technology/nhs-litigation-bill-for-pressure-ulcers-soars-53-in-three-years-08-05-2019/
6. Accidentspecialistsolicitors.co.uk. (2019). [online] Available at: https://www.accidentspecialistsolicitors.co.uk/nursing-home-serious-pressure-sore/
7. Improvement.nhs.uk. (2019). Pressure ulcers: revised definition and measurement. [online] Available at: https://improvement.nhs.uk/documents/2932/NSTPP_summary__recommendations_2.pdf
8. Gray, D., Cooper, P. and Stringfellowe, S. (2013). Evaluating pressure - reducing foam mattresses and electric bed frames. British Journal of Nursing, 10(5).