Successful heel pressure ulcer prevention program in a long-term care setting

J Wound Ostomy Continence Nurs. 2009 Nov-Dec;36(6):616-21. doi: 10.1097/WON.0b013e3181bd813e.


Heel pressure ulcers (PUs) are common in long-term healthcare settings. Early identification of risk and the use of preventive measures are central to reducing the morbidity, mortality, and high medical costs associated with heel PUs. A Quality Improvement Process was initated based on a tailored protocol, in-service education program, and a heel protective device was approved by the US Food and Drug Administration. The Braden Scale was used to evaluate PU risk in 550 patients in a long-term healthcare facility. Patients with a Braden Scale score of 18 or less and with 1 of 7 high-risk comorbidities were considered at high risk for PUs, and this prompted a more aggressive prevention program that included a protocol for reducing the risk of heel ulceration. The number of hospital-acquired heel PUs during the 6-month preintervention period was 39. Following the intervention, there were 2 occurrences, representing a 95% reduction in heel ulcers between the 2 periods. After the cost of 2 heel protectors for 550 at-risk patients was subtracted from the estimated cost of treating the 37 heel ulcers prevented, the estimated cost savings was calculated to be between $12,400 and $1,048,400.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Cost of Illness
  • Cost-Benefit Analysis
  • Female
  • Follow-Up Studies
  • Homes for the Aged / organization & administration
  • Humans
  • Long-Term Care / organization & administration
  • Male
  • Nursing Homes / organization & administration
  • Pressure Ulcer / economics*
  • Pressure Ulcer / nursing
  • Pressure Ulcer / prevention & control*
  • Prevalence
  • Primary Prevention / organization & administration*
  • Program Evaluation
  • Protective Devices / economics
  • Protective Devices / statistics & numerical data*
  • Risk Assessment
  • Severity of Illness Index
  • Skin Care / methods
  • Treatment Outcome
  • United States
  • Wound Healing / physiology