A. Bugalska-Żak B. Bladowska B. Wieczorek-Wójcik M. Dykas The Nursing Team for the Prevention and Treatment of Pressure Sores and Stomy Care

1. "PRESSURE SORES IN NON-HOSPITAL
SETTINGS - PRESENTATION
OF A COOPERATION MODEL BETWEEN
HOSPITAL AND EXTERNAL INSTITUTIONS"
A. Bugalska-Żak
B. Bladowska
B. Wieczorek-Wójcik
M. Dykas
Ceynowa Hospital in Wejherowo, Poland
The Nursing Team for the Prevention and Treatment of Pressure Sores and Stomy Care

2. Introduction:
Patients with pressure sores arising in non-hospital settings are a significant group of hospitalised
patients, especially in the departments of internal medicine and medical treatment wards.
This can be attibuted to inefficiencies of PATIENT’S CARERS, and also deficiencies in the primary
care and non-regulated system of private nursing homes.
The Hospital – Public sector General Practitioner
- Non Public SECTOR
Nursing Homes
-Non Public SECTOR
LACK OF CO-OPERATION….

3. Aim:
To present data detailing 3 years of collaboration between Ceynowa Hospital and primary care
centres/nursing homes in the Wejherowo district regarding pressure sores prevention and care
after hospital discharge.
Poland

4. Method:
The introduction of organisational changes to improve the quality of nursing care, the
presentation of modified tasks of the Team for Prevention and Treatment of Pressure Sores and
Stomy Care, and a demonstration of the Co-ordinator’s role in the context of incidence and
morbidity of pressure sores in six key hospital departments:
• Department of General Surgery - 60 Beds
• Department of Neurology - 36 Beds
• Department of Cardiology -37 Beds
• Department of ICU -10 Beds
• Department of Orthopaedics – 37 Beds
• Department Pulmonary Diseases – 50 Beds

5. TO PROVIDE:
 A constant records of patients admitted to hospital;
 Continous monitoring of the pressure sore treatment and supervision of care;
 Development of the standards/procedures of prevention and treatment of pressure
sores;
 Documentation control;
 Opinions and guidance on the management of patients discharged from the hospital;
 Co-operation with GP, Nursing homes and the patient’s families and carers;
 An ONLINE record of bedsores in „Decubitus Project”
GOALS FOR THE NURSING TEAM FOR THE
PREVENTION AND TREATMENT
OF PRESSURE SORES AND STOMY CARE:

6. Chart of solving a problem…
Ceynowa Hospital
Team
CO-ORDINATOR
General Practictioner
&
District Nurse
Hospital Units Nursing Homes
Consultant District Nurse
of Wound Treatment
(Nursing and Midwives District Chamber in Gdańsk)
regular training
„ Wound Care”

7. Results:
35 571 patients were admitted to hospital departments between November 2009 and
November 2012, 13 691 of which were considered to be at high and very high of pressure sore.
1151 patients had pressure sores arising outside hospital. During hospitalisation, pressure sores
occurred in 504 of patients.
PROFILE OF PATIENTS WITH BEDSORES…
• Age ~ 73 years old
• Waterlow scale ~ 28 points
• Hospital pressure sores Iº-IIº(Torence scale)
• Non hospital pressue sores IIIº-Vº (Torence scale)

8. 30%
70%
Pressure sores in Ceynowa Hospital
2009-2012
hospital pressure sore
non-hospital pressure sore 96,4%
3,6%
patients with the risk of pressore sores
hospital pressure sores

9. PATIENT ADMISSION
PATIENTS WITH PRESSURE SORES
IN CEYNOWA HOSPITAL SINCE 2009
•Keepinig wound documents
•Report bedsores (in each Unit where
patient is treating)
•Take a bedsore tissue to Department of
Microbiology ( the surgeon)
•According to the standard and
procedures of patient care
•Consultation
•Assessment by the Torence scale
•Surgical treatment of pressure sores
•Recommendation of care and treatment
•Registration to electronic records
•Changing dressing
•Photo of bedsores
•Contact with the Co-ordinator of the
Nursing Team for the Prevention and
Treatment of Pressure Sores and Stomy
Care
•Establishment of patient discharge card
of bedsores
•Print Photos of bedsores and attach to
the patient documentation (addmition
and discharge ones)
•Recommendations for families / carers
•Contact with GP/District Nurse/
Nursing Home
Patients
discharge
Emergency
Unit
WARD
Team
Co-ordinator

10. Conclusions:
Pressure sores remain a big problem that require innovative solutions.
The knowledge about pressure sore prevention should be shared with the
medical personnel looking after patients in hospitals and primary care
centres, as well as the patients’ families and carers.
Only such cooperation between primary and secondary care personnel will
prevent unnecessary long-term hospitalisation.
CONTACT: abugalska@wp.pl
Ceynowa Hospital in Wejherowo, Poland