Reducing avoidable pressure ulcers: an online clinical ordering system

Abstract

Healthcare practitioners face diverse challenges presented by an ageing population, reducing funds, public demand for better health care, and a zero tolerance to avoidable healthcare-acquired injuries, such as pressure ulcers. To support the reduction in avoidable pressure ulcers European Pressure Ulcer Advisory Panel and National Institute for Health and Clinical Excellence guidelines recommend patient repositioning, the provision of either an active or reactive pressure-redistributing support surface and, for some, complete and permanent off-loading of the tissue. Guys and St Thomas's NHS Foundation Trust recognised that an evidence-based prevention strategy was required to reduce the incidence of pressure ulcers in line with the Harm Free Care initiative. As part of the prevention strategy, eTRACE was implemented, an online clinical ordering system that uses the patients' clinical risk assessment in conjunction with the Trust's clinical protocols to recommend appropriate equipment selection. Additionally the system supports the organisational and national reporting/management requirements. This article will review the clinical and economic evidence to support the introduction of eTRACE and how this system has contributed to the Trust's agenda in reducing avoidable pressure ulcers.