Reducing Pressure Injuries

Pressure injuries – also called bedsores – are common among patients with limited mobility who spend a lot of time sitting or lying down. The injuries most often occur on skin covering the back, shoulder blade and tailbone, and cause great discomfort and pain to patients.

“We see a lot of elderly patients with pressure injuries that could have been prevented with early intervention. By the time they come to us, the condition is often at a late stage, so the treatment applied has to be much more intensive and this causes a lot of discomfort to the patients,” says Ms Png Gek Kheng, Assistant Director of Nursing who started the Pressure Injury Taskforce at Changi General Hospital (CGH) in 2015.

The taskforce consisted of geriatricians, nurses, occupational therapists, dietitians and staff from the Performance Management and Office of Improvement Science. Together, they worked to develop strategies to prevent pressure injuries, manage and treat symptoms and suggest long-term care tips. The strategies were based on the latest guidelines by the National Pressure Ulcer Advisory Panel.

The team also developed a three-tier curriculum, unique to CGH, to train nurses to become Pressure Injury Care champions. To date, 200 nurses have undergone the training.

Nurse Clinician Stacey Chong, Accident & Emergency Department who is part of the team, shared that the Department has seen a growing number of elderly patients over the years.

“There is an increasing need to train nurses in wound care management and look into ways to prevent pressure injuries during patients’ stay in the A&E. Preventing and treating pressure injuries is an inter-departmental effort,” she says.

As a result of the taskforce’s efforts, CGH has seen an increase in the early identification and management of pressure injuries. Between June 2015 to January 2018, the incidence of hospital-acquired pressure injuries fell from 1.40 per 1000 patient days (PDS) to 0.18 per PDS.