Findings from a new survey of healthcare executives and clinical and administrative decision-makers reveal strong awareness of the severity of the impact of hospital-acquired pressure injuries (HAPIs), but healthcare organizations still struggle to adhere to the current standard of care, which calls for repositioning patients at risk of developing pressure injuries every two hours. The survey, which was conducted by Healthcare Dive in conjunction with Smith+Nephew, also shows that stakeholders firmly believe that significant care quality improvements would be realized if patients could be turned consistently and frequently enough to prevent pressure injuries from occurring.
Hospital-acquired pressure injuries impact millions of patients around the world with more than 2.5 million pressure injuries in the United States each year, according to the Agency for Healthcare Research and Quality. The total financial burden of caring for these patients, who tend to have longer hospital stays and are more likely to be readmitted to the hospital for additional treatment after their initial discharge, is estimated to be between $11 billion and $26.8 billion per year.
Most of the participants in the survey work in healthcare facilities that retain metrics on HAPI incidence. 79.3% of respondents reported that more than six HAPIs occur every month within their healthcare organization, while nearly one quarter (24.2%) report that more than ten HAPIs are incurred on a monthly basis in the facility where they’re employed.
The survey showed that stakeholders are aware of the severity of the problem, as well as the extent of its damaging consequences. Nonetheless, 84.8% of survey participants said that their clinical care teams were repositioning patients less frequently than best practice guidelines call for. Broadly speaking, these findings agree with other recent studies, which report that the national average standard of care adherence rate falls between 30 and 66%.
Additional key findings from the survey include the following:
- The financial impact of HAPIs is severe, causing healthcare organizations to incur regulatory fines and penalties, legal costs, and reputational damage. 96% of survey participants reported that their organization was incurring more than $100,000 in HAPI-related expenses on an annual basis, while 80.4% said their organization was spending more than $250,000 on HAPI-related expenses each year. 58.6% of respondents indicated that their facility had had its CMS Quality Measures reduced due to HAPIs’ occurrence, while 36.4% had been found negligent in a HAPI-related lawsuit.
- Healthcare executives agree that HAPI prevention is important – both to them individually and to their organizations. As many as 96% of respondents said that it was at least somewhat important to them to work in a hospital environment where few HAPIs were incurred. 74.8% stated that that they felt it was tremendously important to work in such a facility.
- Staffing shortages and a need to focus on urgent priorities limit caregivers’ ability to turn patients on schedule. Staffing shortages are a chronic issue in healthcare. 48% of respondents said that not having enough staff to turn patients who need two nurses to lift them interfered with their care team’s ability to turn patients as often as needed. 37.9% said that they simply didn’t have enough staff to turn all patients, while 40.9% said that the need to focus on critical care and emergent issues limited their ability to adhere to the standard of care.
- Healthcare organizations tend to rely on a varied assortment of tools and systems to help caregivers remember when to turn patients and document when patients are turned. Nearly half of survey participants (46.5%) stated that their organization relies on a general-purpose timer (such as a kitchen timer) to help nurses and caregivers remember to turn patients on time. 17.2% are still dependent upon paper turn clocks. 53% of respondents said that their hospital relies on whiteboards or paper charts to document when at-risk patients are turned.
In the past, the ineffectiveness of the legacy systems used to alert caregivers when it’s time to turn a patient presented a significant barrier to improvement. Paper turn clocks are cumbersome, error-prone, and hard to manage centrally. Timers set to ring at a standard interval don’t allow care teams to optimize turn frequency for each individual patient. With these manual systems, it’s a perennial challenge to maintain accurate documentation, but without such documentation, it’s impossible to identify trends or understand how to make improvements.
Today, there’s a better solution. The LEAF♢ Patient Monitoring System uses a small, single use sensor that adheres to the patient’s skin to monitor patient movement, allowing patients to be repositioned according to individualized turn protocols and providing staff with visual reminders. This system also gives access to robust data that users can leverage to address patient needs, manage treatment or identify trends across the entire facility. This provides a foundation for making evidence-based improvements. Please see the LEAF Instructions for Use for indications and safety information.
More detailed findings are available in the survey report, entitled “Preventing Hospital-Acquired Pressure Injuries (HAPIs): How Stakeholders Perceive Their Prevalence and Impact.”
Survey Methodology
The survey, fielded online, polled 198 healthcare executives – 51 serving as executives, managers or directors in administrative departments, 22 serving as executives or directors in clinical departments and 26 with other clinical roles. One participant reported a job title of ‘other.’ Conducted in Q2 of 2022, the survey used an assortment of multiple-choice, Likert-scale and matrix questions to understand participants’ attitudes about the prevalence and impact of HAPIs, as well as their incidence within their organizations and steps taken to reduce this incidence. All respondents worked for hospitals with more than 500 employees, and most (56%) worked for hospitals with more than 1,000 employees. All survey participants were required to have at least six years of experience in their current position or closely related ones. Most (56%) had ten years’ experience or more.
Smith+Nephew is a portfolio medical technology business focused on the repair, regeneration and replacement of soft and hard tissue. The company exists to restore people’s bodies and their self-belief by using technology to take the limits off living. Smith+Nephew calls this purpose Life Unlimited. It has locations in over 100 countries around the world.
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