Pressure injuries: not just a nursing problem

24 February 2016

Investing in a national prevention programme could save 30,000 New Zealanders suffering a pressure injury each year, recommends a major report. The KPMG report, The Case for investment in: A quality improvement programme to reduce pressure injuries in New Zealand, was released recently by the Health Quality & Safety Commission, ACC and the Ministry of Health.

It estimates that the annual direct cost of pressure injuries to New Zealand is around $68 million and this balloons to $694 million when the cost of suffering and loss of quality of life are included.

Using prevalence data from several regional studies, indicating 4-8 per cent of patients develop a pressure injury (PI) each year, the report calculates that an estimated 55,000 New Zealanders a year get pressure injuries. More than 3000 of these patients are estimated to receive a severe (grade III or IV) pressure injury costing approximately $123,000 to treat.

The report concludes that investing about $5.7 million a year over ten years in a nationally co-ordinated prevention programme could cut the incidence of PIs by at least 32 per cent and possibly up to 70 per cent with direct savings of up to $46 million a year for the health sector.

Ministry of Health Chief Nurse Dr Jane O’Malley said the ministry supports making prevention of pressure injuries a national priority across sectors including home and community, residential aged care and hospitals.

"Parts of the health sector already have a significant focus on preventing pressure injuries and some good progress has been made," said O'Malley. "However, pressure injuries remain a major cause of preventable harm for people using health care services."  She said the ministry is committed working with the commission, ACC and other health sector partners on national and local quality improvement initiatives.

Not just a nursing problem

The report notes that pressure injuries are predominantly seen as a nursing problem due to nurses being involved in both preventing and treating PIs.

It adds this has had two negative effects as it removes the responsibility of PIs from health management and other health professionals involved and secondly encouraged the prevention of PIs to become the domain of the wound care nurse specialist which also shifts responsibility from the front line of care.

"Until PI prevention and treatment is seen as more than a nursing problem, PI will not attract the high level attention of health care executives, clinical leaders, carers and support agencies."

The report also noted other issues currently effecting PI prevention programmes including inconsistent reporting of PIs as serious adverse events, lack of involvement of families, and under-reporting of PIs to ACC as a treatment-related injury.

It recommends establishing a nationally co-ordinated, multi-agency programme to reduce the incidence of PI with key features including streamlining clinical practice, giving staff the authority to access appropriate equipment, building a leadership culture and improving support systems

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