wound care scgh
Post on 12-Apr-2017
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SCGH Wound Care Products and General Advice
Nicole Walsh,Nurse Practitioner Wound
Management
Lola’s story – Traumatic Skin TearPlease tell my story• First documented inspection
of skin- at 36 hrs• Frail / Fragile skin• Pain and suffering
Identification of Risk of Injury
• STAR Staging• NPGL• Gently roll out any clots• Approximate edges• No sutures/staples• No steri stripes• No adherent dressings• No adherent tapes.
• Use soft silicon mesh eg Mepitel,• Apply so onto healthy skin• It is a very tacky dressing non adherent silicon • Moistening your cotton bud
Calcuim Alginate
• Flat sheet of Calcuim Alginate if bleeding continues to assist with Haemostasis
• Goes over top of Mepitel and is removed gently by irrigating with normal saline in 24 hrs.• Mepitel remains in situ
Pressure Injury or Skin Tear Alert Sticker
It has been introduced to:• Alert staff of an identified pressure injury or skin tear • Ensure each injury is appropriately classified and
clearly documented in the notes – to support clinical coders.
• Ensure injuries are accurately coded so that the hospital does not lose funds in relation to the ABM/ABF model.
• Improve reporting of injuries to inform prevention strategies for the future
Mepilex Boarder Flex
• Oval shaped all-in-one foam dressing – easy to use and fits body contours
• Absorbent pad with flex technology – very flexible and conformable
• Less painful for patients at dressing changes – less stress for patients, easier care
• Atraumatic to the wound and surrounding skin at dressing removal3 – undisturbed healing
• Excellent exudate management – reduced risk of leakage and maceration
Mepilex Boarder Heel
All-in-one dressing shaped to fit the heel – easy to use, time-saving dressing changes
• Atraumatic to the wound and to the surrounding skin at removal1 – undisturbed healing
Mepilex Heel
Melgisorb Ag
Silver-containing alginateProvides sustained antimicrobial effect
• Suitable for high exuding wounds• Designed for shallow and deep wounds• Allows removal in one piece
C16 C17
CT Scan
DO23
Emergency Departm
ent G41
G42
G45 GHDU
G51 G53
G54 G61
G62 G63
G64 G66
G71 G72
G74
Gairdner R
ehab Unit
HITH
Intensive Care U
nit PACU
Theatres
0
5
10
15
20
25
30
35
CIM'S Data Recorded Pressure Injuries
Not Present on Admission Present on Admission Unknown if present on admission Total
Pressure Injuries – July to DecemberCIMS
Stage 1 - non-blanchable erythema
Stage 2 - partial thickness skin loss
Stage 3 - full thickness
Suspected deep tissue injury - depth unknown Unknown
Unstageable - depth unknown Total
Jul 6 3 0 0 1 0 10Aug 9 4 1 1 3 0 18Sep 6 9 0 0 1 0 16Oct 7 5 0 0 1 0 13Nov 6 5 0 0 1 1 13Dec 7 4 0 0 0 0 11Total 41 30 1 1 7 1 81
SCGH - Wound Management Product changesProduct Removed Replaced by Company
Calcium Alginate Ribbon
Kaltostat Rope • Calcium Alginate Biatain Alginate
Coloplast
Calcium Alginate with Ag
Silvercel • Calcium Alginate with Ag
Melgasorb Ag
Molnlycke
Post Island Dressing Opsite Cutiplast
• Tegaderm Island• Mepore Island
Tape & Film• Mepilex Island
3MMolnlycke
Absorbent Pads Relevo ( Drymax ) • Zetuvit Plus• Exudry
HartmannSmith & Nephew
Tapes TransporeYuki Ban
• Blenderm• Kind Remove
Silicone Tape
3M
Hydro Capillary AlioneVacutex
Not replaced
Additions New products Additional Information
Company
Soft Silicon Foam Mepilex Heel shaped – non adhesive
Also comes in contoured heel shaped/ adhesive
May be re used if skin intact. Hold insitu with TED stocking/tubular band/non slip sock
Consider for very restless patients
Molnlycke
Hydro Fibres – Ribbon sizes
Aquacel Ribbon Strengthening fibres
Now comes in a 1cm for narrow sinus’s as well as 2cm
Convatec
Skin Barrier Cream Cavilon – more extensive range found on continence contract
Barrier cream, single use sachets, wipes, paddles & spray’s
3M
Product Types of dressings Additional Information Company
Silicon Foam Mepilex range Prophylactic dressing can be lifted for skin inspection and reapplied
Molnlycke
Gels Intrasite ConformibleHydrosorb gel sheet available dressing bank
Smith & Nephew
Hartmann
Antimicrobials • AMD non adherent • AMD Foam
High risk patient onlyCoviden
Antimicrobial •Inadine•Iodosorb ointment•Iodosorb powder
Smith & Nephew
Silver Dressings Atrauman AgAquacel AgMelgasorb AgActicoatMepilex AgBiatain Ag
Ag TulleAg Hydro FibreAg Calcium AlginateAg Flex /ClothAg Silicon FoamAg Foam
HartmansCovidenMolnlyckeSmith & NephewMolnlykeColoplast
SCGH Pressure Injury Prevalence Data
2007 2008 2009 2011 2013 20140
2
4
6
8
10
12
P.I Prevalence Data: May 2007 -2014RPH and SCGH com-parison Grade 2 pressure in-juries and above
5.3% Total No HAPI
11 %
%
2014 State Wide data :
Total No Patients : 2974
Total No HAPI : 5.7%
Excluding Stage 1 : 2.2%
SCGHTotal No Patients :
445Total No HAPI :
5.3%Excluding Stage 1 :
3.4%
Key Information from the 2014 pressure injury prevalence data
• 79.6% of patients on the day had a skin inspection
• Braden scores indicated that 42.9% of patients were identified at risk (either moderate-high risk) of developing a pressure injury. This equates to 202 patients on the day.
• Currently we have 185 air mattresses in the hospital– 115 for high to very high risk patients– 70 for moderate / at risk patients
• 72.1% of patients had a skin assessment documented within 8 hours of admission.
• 12% of the patients with a pressure injury were recorded as device related e.g. IDC, nasal prongs
Key Information from the 2014 pressure injury prevalence data
• 49% of patients assessed with a pressure injury did not have any documentation in the medical or nursing notes identifying a pressure injury
• The patients that were identified as having a pressure injury 56.1% had more than one
• Evidence shows that 50% stage one pressure injuries develop into stage 2 and 3
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