Pressure ulcers, which reduce quality of life of patients, and increase costs and the length of hospital stays, are mostly preventable. Yet they occur in up to 27 per cent of patients in Australian acute-care hospitals.

Commenting on these statistics, Dr Michael Stacey, Associate Professor of Surgery at Fremantle Hospital in Western Australia, says the prevalence of these ulcers could be reduced by institution-wide prevention programs that focus on identifying patients at risk and implementing strategies to reduce that risk.

Major risk factors include immobility, sensory loss, impaired cognitive state and urinary and faecal incontinence. People over 65 are particularly susceptible.

Once a patient's risk has been established, prevention strategies need to be put in place.

"This requires the support of hospital administrations in providing both the necessary trained staff and pressure-reducing or pressure-relieving devices," Dr Stacey said. 

"It is also imperative that staffing levels are adequate to ensure that nurses have sufficient time to provide the 'hands-on' care necessary for these high-risk patients," he said.

In this issue of the Journal, Jolley and colleagues report a randomised controlled trial of the Australian Medical Sheepskin, involving 441 hospital patients at low to moderate risk of developing a pressure ulcer. This showed patients using the Sheepskin developed new pressure ulcers at half the rate of patients who received standard care (no Sheepskin).

While patients using the Sheepskin were less likely to develop a pressure ulcer, Stacey said the answer to preventing pressure ulcers lies not in any one strategy but in an institution-wide prevention program with adequate staffing, devices and staff education. 

The Medical Journal of Australia is a publication of the Australian Medical Association.

CONTACT     Associate Professor Michael STACEY 08 9431 2506 / 0417 933 961

                  Judith TOKLEY, AMA 02 6270 5471 / 0408 824 306